Analysis of risk factors and clinical features in elderly patients with nonalcoholic fatty liver disease combined with mild cognitive impairment / 中国综合临床

ABSTRACT

Objective To investigate the risk factors for NAFLD patients with mild cognitive impairment ( MCI) in elderly through comparing the clinical features among elderly NAFLD patients with MCI. Methods A total of one hundred and sixteen elderly patients with NAFLD were enrolled in this study and were divided into MCI group (37 cases) and non-MCI group (79 cases). The clinical data including medical history of myocardial infarction,diabetes mellitus,hypertension,medications,blood pressure,BMI,liver function, kidney parameters,glucose metabolism, serum lipid profile, vitamin D, NAFLD fibrosis score, HOMA-IR and carotid plaques were analyzed and compared. Results Compared with non-MCI group,the age,AST/ALT ratio, serum creatinine,NAFLD fibrosis score,serum uric acid of MCI group were significantly higher ((80. 5±7. 4) years vs.(72.5±8.0)years,t＝5.87,P＜0.001; (1.33±0.51) vs. (1.09±0.30),t＝2.599, P＝0.012;(100.86±78.02) μmol/L vs. (78.12±22.12) μmol/L,t＝2.402, P＝0.018; (0.73±1.01) vs. (0.03 ±1. 17),t＝3. 132,P＝0. 002; (382. 95±79. 61) μmol/L vs (349. 99±79. 18) μmol/L,t＝2. 086,P＝0. 039), while serum γ-glutamyl transpeptidase (γ-GT),diastolic blood pressure (DBP),estimated glomerular filtration rate (eGFR) of MCI group were significantly lower than those in the non-MCI group (22. 00(17. 00,26. 00) U/L vs. 28. 00(19. 00,39. 50) U/L,Z＝－3. 038,P＝0. 002;(69. 30±6. 78) mmHg vs. (74. 30±9. 45)mmHg,t＝－3.252, P＝0.002; (62.60±17.78)(ml/min×1.73 m2) vs. (79.41±16.95)(ml/min×1.73 m2),t＝－4. 900,P＜0. 001). Detection rates of carotid unstable plaques and high BMI in MCI group were higher than those in the non-MCI group (83. 78%(31/37) vs. 64. 56%(51/79),χ2＝4. 496, P＝0. 034)(83. 78%(31/37) vs. 60. 76%(48/79),χ2＝6. 149, P＝0. 013) . There were no significantly differences between the two groups in history of myocardial infarction,diabetes mellitus,hypertension,usage rates of antiplatelet drugs and statins. Logistic regression showed that age (regression coefficient＝0. 166,OR＝1. 181,95%CI 1. 078－1. 293,P＜0. 001), high BMI (regression coefficient＝1. 942,OR＝6. 974,95%CI 1. 466－33. 176,P＝0. 015),diastolic blood pressure ( regression coefficient＝ －0. 099, OR＝ 0. 905, 95%CI 0. 828－0. 990, P＝ 0. 029 ), γ-GT (regression coefficient＝－0. 094,OR＝0. 910,95%CI 0. 852－0. 972,P＝0. 005), serum uric acid (regression coefficient＝－0. 009,OR＝1. 009,95%CI 1. 000－1. 017,P＝0. 039) and low density lipoprotein cholesterol ( LDL-C) (regression coefficient＝0. 898,OR＝2. 454,95%CI 1. 029－5. 854,P＝0. 043) were related to elderly NAFLD patients with MCI. Conclusion The high BMI,diastolic blood pressure,serum uric acid,low density lipoprotein are related to MCI in elderly patients with NAFLD. For elderly patients with NAFLD,these indicators may be used to assess the risk of MCI and to locate high-risk groups at an early stage.