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Metabolic profiles and fibrosis of non-alcoholic fatty liver disease in the elderly: A community-based study.

Published on Apr 24, 2020in Journal of Gastroenterology and Hepatology3.632
· DOI :10.1111/JGH.15073
Tsung‐Po Chen (PRC: China Medical University (PRC)), Michelle Lai20
Estimated H-index: 20
(BIDMC: Beth Israel Deaconess Medical Center)
+ 2 AuthorsKuen-Cheh Yang9
Estimated H-index: 9
(NTU: National Taiwan University)
Abstract
BACKGROUND&AIMS: There are sparse data on the epidemiology of fatty liver in the elderly Asian population. We evaluated for predictors of fatty liver and high risk of advanced fibrosis in a community-based elderly population. METHODS: A total of 1091 participants (mean age was 74.6+/-6.3 years) were enrolled from 2017 to 2018. Subjects with age younger than 65 years, alcoholism, history of hepatitis B and hepatitis C were excluded. Fatty liver was diagnosed with abdominal ultrasound by using ultrasonographic fatty liver indicator (US-FLI), a semi-quantitative measurement grading the severity (normal, mild, moderate-to-severe). Fibrosis-4(FIB-4) score was used for the prediction of the high risk of advanced fibrosis. Using a multivariable logistic regression model, we identified predictors of fatty liver and high risk of advanced fibrosis. RESULTS: In this ambulatory elderly Asian population, the prevalence of fatty liver is 41.9% and of high risk of advanced fibrosis is 12.3%. The prevalence of fatty liver decreases (44.5% to 31.8%), and the high risk of advanced fibrosis increases (3.9% to 27.0%) with aging significantly (both p<0.05). Metabolic syndrome is a risk factor for fatty liver (odds ratio (OR), 3.19, 95% CI, 2.41-4.22), but not for high risk of advanced fibrosis (OR:0.67, 95% CI, 0.41-1.08). Hypertriglyceridemia decreases the risk for high risk of advanced fibrosis (OR, 0.53, 95% CI, 0.33-0.87). CONCLUSION: Fatty liver is prevalent in the ambulatory elderly Asian population, affecting over 40% of this population. Age is a risk factor for high risk of advanced fibrosis, with the disease likely progressing from a steatotic to a fibrotic picture with age.
  • References (37)
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References37
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#1Guang-Qin XiaoH-Index: 7
#2Sixian ZhuH-Index: 1
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Many noninvasive methods for diagnosing liver fibrosis (LF) have been proposed. To determine the best method for diagnosing LF in nonalcoholic fatty liver disease (NAFLD), we conducted a systemic review and meta-analysis to compare the performance of aspartate aminotransferase to platelets ratio index (APRI), fibrosis-4 index (FIB-4), BARD score, NAFLD fibrosis score (NFS), FibroScan, shear wave elastography (SWE), and magnetic resonance elastography (MRE) for diagnosing LF in NAFLD. We compared...
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#1Marek Hartleb (Medical University of Silesia)H-Index: 16
#2Kamil Barański (Medical University of Silesia)H-Index: 4
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Introduction & Aim Development of non-alcoholic fatty liver (NAFL) is dependent on metabolic factors occurring at an increased frequency with advancing age. Until now, few studies have explored the prevalence of NAFL in aged populations. Our study aimed to determine the prevalence of NAFL and advanced fibrosis in the elderly population participating in a national survey of a community-based elderly cohort. Methods A total of 3003 participants (mean age 79.6 years, 46.8% male) were enrolled in th...
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#1Salvatore Petta (University of Palermo)H-Index: 41
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Background & Aims Metabolic syndrome (MS) and its individual components are associated with the severity and progression of nonalcoholic fatty liver disease (NAFLD). We sought to evaluate the relationship between MS components and the risk of severe hepatic fibrosis in NAFLD patients discriminated by age. Methods We considered 863 consecutive patients with biopsy-proven NAFLD, who had been fully evaluated for components of MS. Results Multivariate logistic regression analysis showed that F3-F4 w...
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Abstract Background and aims Fatty liver is a common feature of different types of liver diseases. The sensitivity and specificity of ultrasonography for diagnosing fatty liver are variable. A semi-quantitative ultrasound score, i.e., the ultrasonographic fatty liver indicator (US-FLI), is closely associated with metabolic/histological variables in patients with nonalcoholic fatty liver disease (NAFLD). The main aims of this study were to assess the diagnostic performance of US-FLI in detecting ...
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Liver fibrosis is the most important predictor of mortality in nonalcoholic fatty liver disease (NAFLD). Quantitative risk of mortality by fibrosis stage has not been systematically evaluated. We aimed to quantify the fibrosis stage–specific risk of all-cause and liver-related mortality in NAFLD. Through a systematic review and meta-analysis, we identified five adult NAFLD cohort studies reporting fibrosis stage–specific mortality (0-4). Using fibrosis stage 0 as a reference population, fibrosis...
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Nonalcoholic fatty liver disease (NAFLD) is a spectrum of liver pathologies characterized by hepatic steatosis with a history of little to no alcohol consumption or secondary causes of hepatic steatosis. The prevalence of NAFLD is 20–25 % of the general population in the Western countries and is associated with metabolic risk factors such as obesity, diabetes mellitus, and dyslipidemia. The spectrum of disease ranges from simple steatosis to nonalcoholic steatohepatitis, fibrosis, and cirrhosis....
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textabstractGiven that little is known about the prevalence of, and factors associated with, liver fibrosis in the general population, we aimed to investigate this in a large, well-characterized cohort by means of transient elastography (TE). This study was part of the Rotterdam Study, a population-based study among individuals ≥45 years. All participants underwent abdominal ultrasound and TE. Liver stiffness measurement (LSM) ≥8.0 kilopascals (kPa) was used as a cutoff suggesting clinically rel...
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#2Dante Romagnoli (University of Modena and Reggio Emilia)H-Index: 16
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We review the role of liver ultrasonography (US) and related techniques as non-invasive tools in predicting metabolic derangements, liver histology, portal hypertension and cardiovascular risk as well as allowing early diagnosis and management of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease. In this setting, US detects fatty changes as low as ≥20% and hepatic steatosis identified ultrasonographically, in its turn, closely mirrors coronary and carotid atherosclerosis...
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