Department of Gastroenterology, Alfred Health, Melbourne, Australia.
Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia.
Liver Int. 2024 Jan;44(1):39-51. doi: 10.1111/liv.15725. Epub 2023 Sep 12.
BACKGROUND & AIMS: The burden of metabolic dysfunction-associated steatotic liver disease (MASLD) is growing rapidly, as is the number of older adults globally. However, relatively few studies have been performed evaluating the prevalence and risk factors for MASLD in older adults. As such, we aimed to identify the prevalence of MASLD in older adults, as well as sociodemographic, clinical, functional and biochemical associations.
The study population included older adults without a history of cardiovascular disease, dementia or independence-limiting functional impairment who had participated in the ASPirin in Reducing Events in the Elderly (ASPREE) randomised trial. MASLD was defined using the Fatty Liver Index (FLI). Associations were identified using Poisson regression with robust variance for FLI ≥ 60 vs FLI < 30.
9097 Australian participants aged ≥70 years had complete biochemical and anthropometric data to identify MASLD. The study population had a mean age of 75.1 ± 4.3 years and was 45.0% male. Almost one-third (33.0%) had prevalent MASLD, and the prevalence decreased with increasing age (adjusted RR [aRR] 0.96, 95% CI: 0.96-0.97). MASLD was also negatively associated with social advantage (aRR 0.94, 95% CI: 0.90-0.99) and exercise tolerance and was positively associated with diabetes mellitus (aRR: 1.22, 95% CI: 1.16-1.29), hypertension (aRR: 1.31, 95% CI: 1.22-1.41), male sex (aRR: 1.66, 95% CI: 1.57-1.74), pre-frailty (aRR: 1.99, 95% CI: 1.82-2.12) and frailty (aRR: 2.36, 95% CI: 2.16-2.56). MASLD and nonalcoholic fatty liver disease (NAFLD) results were 100% concordant.
This study in a large cohort of relatively healthy community-dwelling older adults shows that MASLD is common, decreases with age and is associated with poorer metabolic health, social disadvantage and frailty.
代谢功能障碍相关脂肪性肝病（MASLD）的负担正在迅速增加，全球老年人的数量也在增加。然而，评估老年人 MASLD 的患病率和危险因素的研究相对较少。因此，我们旨在确定老年人 MASLD 的患病率，以及社会人口统计学、临床、功能和生化相关性。
研究人群包括无心血管疾病、痴呆或限制独立功能病史的老年人，他们参加了 ASPirin in Reducing Events in the Elderly（ASPREE）随机试验。使用脂肪肝指数（FLI）定义 MASLD。使用具有稳健方差的泊松回归识别 FLI≥60 与 FLI<30 的关联。
9097 名澳大利亚≥70 岁的参与者具有完整的生化和人体测量数据来识别 MASLD。研究人群的平均年龄为 75.1±4.3 岁，45.0%为男性。近三分之一（33.0%）患有 MASLD，患病率随年龄增长而降低（调整后的 RR[aRR]0.96，95%CI：0.96-0.97）。MASLD 也与社会优势呈负相关（aRR0.94，95%CI：0.90-0.99）和运动耐量呈正相关，与糖尿病（aRR：1.22，95%CI：1.16-1.29）、高血压（aRR：1.31，95%CI：1.22-1.41）、男性（aRR：1.66，95%CI：1.57-1.74）、虚弱前期（aRR：1.99，95%CI：1.82-2.12）和虚弱（aRR：2.36，95%CI：2.16-2.56）呈正相关。MASLD 和非酒精性脂肪性肝病（NAFLD）的结果完全一致。
这项在大型相对健康的社区居住老年人队列中的研究表明，MASLD 很常见，随年龄增长而减少，与代谢健康状况较差、社会劣势和虚弱有关。
