Objective To investigate the clinical value of hemoglobin and its association with hepatocyte steatosis in chronic hepatitis B (CHB) patients.Methods A retrospective analysis was performed for the clinical and pathological data of 1580 CHB patients who were hospitalized in The First People's Hospital of Shunde from January 2006 to December 2014 and underwent liver biopsy, among whom 216 (13.67%) had hepatocyte steatosis (hepatocyte steatosis group) and 1364 had no hepatocyte steatosis (non-hepatocyte steatosis group) .The patients were divided into groups 1, 2, and 3 according to hemoglobin level, and the clinical and pathological features were analyzed and compared between the three groups.The t-test was used for comparison of continuous data between group;a one-way analysis of variance was used for comparision between multiple groups.The Mann-Whitney U test was used for ranked data between groups.The Kruskal-wallis H test was used for ranked data between multiple groups;the chi-square test was used for comparison of categorical data between groups.Spearman correlation analysis was also performed to determine the correlation between two variables.Univariate logistic regression analysis and multivariate stepwise regression analysis were used to identify the influencing factors for hepatocyte steatosis.Results Body mass index (BMI) , systolic pressure, diastolic pressure, uric acid, total cholesterol, low-density lipoprotein, and HBV DNA load increased with the increase in hemoglobin level (F=12.718, 3.024, 4.026, 4.624, 38.276, 28.108, 7.358, all P<0.05) .The incidence rates of hepatocyte steatosis in groups 1, 2, and 3 were 7.59%, 11.76%, and 21.67%, respectively (χ2=44.23, P<0.05) .Hemoglobin was positively correlated with hepatic steatosis (rs=0.211, P<0.001) .The multivariate logistic regression analysis showed that hemoglobin (odds ratio [OR]=1.066, P<0.05) , BMI (OR=1.576, P<0.05) , age (OR=1.041, P<0.05) , sex (OR=0.261, P<0.05) , aspartate aminotransferase (OR=0.987, P<0.05) , triglyceride (OR=1.690, P<0.05) , and uric acid (OR=1.006, P<0.05) were independent influencing factors for hepatocyte steatosis in CHB patients.The area under the receiver operating characteristic curve was 0.852 (95% confidence interval [CI]:0.811-0.893, P<0.01) for BMI, 0.701 (95% CI:0.662-0.740, P<0.01) for low-density lipoprotein, 0.694 (95% CI:0.653-0.734, P<0.01) for triglyceride, 0.689 (95% CI:0.650-0.728, P<0.01) for total cholesterol, 0.675 (95% CI:0.637-0.714, P<0.01) for hemoglobin, 0.654 (95% CI:0.617-0.691, P<0.01) for age, 0.619 (95%CI:0.575-0.662, P<0.01) for uric acid, and 0.612 (95% CI:0.569-0.655, P<0.01) for blood glucose.Conclusion CHB patients with a high hemoglobin level tend to develop hepatocyte steatosis, and hemoglobin may be an independent influencing factor for hepatocyte steatosis in CHB patients.A high hemoglobin level has a certain value in predicting hepatocyte steatosis and awaits further research.
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