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PLoS One. 2017 Feb 10;12(2):e0172027. doi: 10.1371/journal.pone.0172027. eCollection 2017.

Red blood cell count has an independent contribution to the prediction of ultrasonography-diagnosed fatty liver disease.

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Faculty of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, The People's Republic of China.
Health Examination Centre, Shenzhen Luohu People's Hospital, Shenzhen, Guangdong Province, The People's Republic of China.
Health Examination Centre, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, The People's Republic of China.



Red blood cell (RBC) indices have been demonstrated to be associated with fatty liver disease (FLD) and metabolic syndrome. However, controversy exists regarding the relationship of RBC indices with FLD to date and few has focused on RBC count. This study aimed to explore the association between RBC count and risk of FLD in Southern Chinese adults.


A hospital-based cross-sectional study was performed in two hospital health examination centers, including information on ultrasonography-diagnosed FLD, anthropometric indices and biochemical measurements. Covariance analysis was used to evaluate group differences. After quintile classification of RBC counts, logistic regression analysis was conducted to evaluate the odds ratios (ORs) of FLD.


This study consisted of 8618 subjects (4137 men and 4481 women) aged between 20 and 89 years. FLD cases had higher RBC counts than non-FLD cases in both genders (P<0.001). The prevalence rates of FLD increased with the RBC quintiles in both genders (all P trend<0.001), and were higher in men than women. Binary logistic regression analysis showed positive association between RBC count and FLD, and the OR (95% confidence interval (CI)) were 2.56 (2.06-3.18) in men and 3.69 (2.74-4.98) in women, respectively, when comparing Q5 with Q1. Stratified analyses showed similar trends among subjects with and without FLD risk factors. Gender independent results were similar to gender dependent results.


Elevated RBC count is independently associated with high risk of FLD, suggesting that the RBC count may be a potential risk predictor for FLD.

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