Risk factors of non-alcoholic fatty liver disease among elderly people in the community / 中华全科医师杂志

ABSTRACT

Objective:To analyze the risk factors of non-alcoholic fatty liver disease (NAFLD) among elderly residents in the community.Methods:A total of 1 894 patients aged 60-75 years with NAFLD visiting general practice clinic from March 2016 to March 2018 were enrolled in the study; 1 894 age and sex-matched subjects without NAFLD served as the control group. The data of gender, age, smoking status,body mass index (BMI), waist circumference, blood pressure, blood biochemistry,past medical history and other clinical and laboratory testing were collected in the two groups. Multivariate logistic regression analysis was performed to explore the related risk factors of NAFLD.Results:The BMI [(27±3) kg/m 2vs.(24±3) kg/m 2, t=-26.139], waist circumference [(89±8) cm vs.(82±8) cm, t=-24.398], heart rate [(75±11) bpm vs. (74±11) bpm, t=-2.370], and diastolic blood pressure [(87±10) mmHg vs. (85±10) mmHg(1 mmHg=0.133 kPa), t=7.898] in the NAFLD group were significantly higher than those in the control group(all P<0.05). The levels of fasting blood glucose (FBG) [(5.9±2.0)mmol/L vs. (5.3±1.5) mmol/L, t=10.438], glycated hemoglobin (HbA1c) [(6.2±1.2)% vs. (5.9±0.9)%, t=11.654], alanine aminotransferase (ALT)[(24±16) mmol/L vs. (18±15) mmol/L, t=11.915], aspartate aminotransferase (AST) [(23±11) mmol/L vs.(22±13) mmol/L, t=4.300], blood uric acid (UA) [(342±84) mmol/L vs. (307±80) mmol/L, t=13.189], total cholesterol (TC) [(5.3±1.1) mmol/L vs. (5.1±1.0) mmol/L, t=6.073], triglycerides (TG)[1.71(1.29,2.35) mmol/L vs. 1.17 (0.91,1.57) mmol/L, Z=37.261], and low-density lipoprotein cholesterol (LDL-C)[(3.4±0.9) mmol/L vs. (3.2±0.9) mmol/L, t=6.984] in NAFLD group were significantly higher than those in the control group (all P<0.01); and the levels of blood creatinine (Cr) [(70±17) mmol/L vs. (71±18) mmol/L, t=-2.712] and high-density lipoprotein cholesterol (HDL-C) [(1.3±0.3) mmol/L vs. (1.5±0.4) mmol/L, t==-16.726] in NAFLD group were significantly lower than those in the control group (all P<0.01). The proportion of people with hypertension [53.8% (1 019/1 894) vs. 43.4% (822/1 894)], type 2 diabetes [16.7%(317/1 894) vs. 11.3%(214/1 894)], metabolic syndrome [48.3% (915/1 894) vs. 18.0% (341/1 894)] in NAFLD group was significantly higher than that in the control group (χ 2=41.013, 23.237, 392.446, P<0.01). Logistic regression analyses revealed 13 independent risk factors of NAFLD, including 60-75 years-old female ( OR=2.348, 95 %CI: 1.917-2.876, P<0.01), high BMI ( OR=1.143, 95 %CI: 1.099-1.189, P<0.01), elevated TG ( OR=1.894, 95 %CI: 1.716-2.090, P<0.01), LDL-C ( OR=3.066, 95 %CI: 2.359-3.983, P<0.01) and HbA1c ( OR=1.276, 95 %CI: 1.175-1.386, P<0.01). Conclusion:The factors associated with NAFLD are complicated; and corresponding measures targeting the risk factors should be taken to reduce the occurrence and development of NAFLD among elderly people in the community.