Abstract: Objective To explore the relationship between high blood hemoglobin levels and the risk of non-alcoholic fatty liver disease (NAFLD). Methods 6540 NAFLD-free participants at physical examination in Baoshan Steel were recruited and their data including blood glucose, blood lipids and hemoglobin in 1995 to 1996 were collected. We explored the baseline blood hemoglobin level longitudinal associations with NAFLD risk throughout 6 years. Results During follow-up, 2 (11.7%) cases of NAFLD developed among 106 patients with anemia, 645(11.0%) NAFLD in 5884 participants with normal hemoglobin, and 116 (21.1%) NAFLD in 550 patients with high blood hemoglobin; Cox univariate analysis showed that hemoglobin level was related to the risk of NAFLD (high hemoglobin group vs. anemia group, HR=11.18, 95% CI: 2.76-45.23, P=0.001; normal hemoglobin vs. anemia group, HR=5.81, 95% CI: 1.45-23.28, P=0.013); Cox multivariate analysis showed that male (HR=1.465,95% CI:1.114-1.928,P=0.006), BMI (HR=1.298,95% CI:1.259-1.320,P<0.001), hypertriglyceridemia (HR=1.781, 95% CI: 1.533-2.068, P<0.001) and hemoglobin (HR=1.008, 95% CI: 1.002-1.015, P=0.014) were the independent risk factors for occurrence of NAFLD.Conclusion High blood hemoglobin levels is correlated with NAFLD risk. The potential value of early screening blood hemoglobin and intervention for NAFLD deserve further study.

Key words: Nonalcoholic fatty liver disease, Hemoglobin, Anemia, Risk factors