Abstract: Objective To investigate the association between glycosylated haemoglobin (HbA1c) and nonalcoholic fatty liver disease (NAFLD) in adults. Methods A total of 11 943 subjects were selected from the health examination adults in Tianjin First Central Hospital from January to December 2017. Data included physical examination and blood biochemical index detection. The differences of NAFLD prevalence between age and gender were calculated using the age composition of the national population in 2010 as the standard population. One-way ANOVA was applied to the comparison of multiple groups, and the comparison of the rate was carried out by chi-square test. Logistic regression model was used to assess the relationship between HbA1c and NAFLD. Results A total of 5 651 (49.44%) subjects fulfilled the diagnostic criteria of NAFLD, and the standardized prevalence of NAFLD was 40.46%. The prevalence of NAFLD was significantly higher in subjects with serum HbA1c level (HbA1c≥6.5%) than those with serum HbA1c level (6.0%≤HbA1c＜6.5%) and serum HbA1c level (HbA1c＜6.0%) (75.60% vs. 69.35% vs. 44.60%, P ＜0.05). The prevalence of NAFLD increased with the progressively higher serum HbA1c levels in subjects under 70 years old (P＜0.05). Stepwise logistic regression analysis showed that the risk factors for NAFLD were increased in the subjects of Quartile 3 (5.5%≤HbA1c＜5.8%) (odds ratio 1.41,95% confidence interval 1.220-1.631) and Quartile 4 (HbA1c≥5.8%) (odds ratio 2.003, 95% confidence interval 1.714-2.342) as compared with the subjects of Quartile1(HbA1c＜5.2%) after adjusting for the related factors including age, gender and body mass index. Among the population with HbA1c＜6.0%, the risk factors for NAFLD were increased in the subjects of Q3 (5.4%≤HbA1c＜5.6%) (odds ratio 1.267,95% confidence interval 1.087,1.477) and Q4 (5.6%≤HbA1c＜6.0%) (odds ratio 1.557, 95% confidence interval 1.339-1.811) as compared with the subjects of Q1(HbA1c＜5.2%). Conclusion The elevated levels of HbA1c in adults are independent risk factors of NAFLD.

Key words: Nonalcoholic fatty liver disease, Glycosylated hemoglobin, Physical examination