The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China.
Department of Pathophysiology, School of Basic Medical Sciences Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China.
Front Public Health. 2024 Feb 8;12:1330221. doi: 10.3389/fpubh.2024.1330221. eCollection 2024.
Although previous studies found that frailty is prevalent in NAFLD patients with advanced liver fibrosis and cirrhosis, studies examining the relationship are spare.
Our study aspires to investigate the potential correlation between the Frailty Index (FI) and hepatic fibrosis among middle-aged and older adults with NAFLD.
Data from the 2017-2020.03 National Health and Nutrition Examination Survey (NHANES) were utilized for this study, with a final of 2,383 participants aged 50 years and older included. The quantification of frailty was executed employing a 49-item frailty index. The recognition of hepatic steatosis and fibrosis was accomplished through the utilization of the controlling attenuation parameter (CAP) and transient elastography (TE). The relationship between the FI and hepatic fibrosis were investigated employing univariable and multivariable-adjusted logistic regression analyses. A subgroup analysis was conducted, dividing the subjects based on gender, Body Mass Index (BMI), and the presence of hyperlipidemia.
The findings demonstrated a positive correlation between the FI and significant hepatic fibrosis in NAFLD, even after using multivariate logistic regression models adjusting for potential confounding factors (OR = 1.022, 95% CI, 1.004-1.041) and in tertiles (Q3vs Q1: OR = 2.004, 95% CI, 1.162-3.455). In the subgroup analysis, the correlation was more statistically significant in male (OR = 1.046, 95% CI, 1.022-1.071), under/normal weight (OR = 1.077, 95% CI, 1.009-1.150), overweight (OR = 1.040, 95% CI, 1.010-1.071), and subjects without hyperlipidemia (OR = 1.054, 95% CI, 1.012-1.097). The area under the Receiver Operating Characteristic (ROC) curve for the FI in assessing the existence of substantial fibrosis in NAFLD was 0.612 (95% CI, 0.596-0.628).
This study demonstrated a positive correlation between significant hepatic fibrosis and frailty, particularly among males aged 50 years and older, who were non-obese and did not have hyperlipidemia with NAFLD. Additional studies are required to further validate these findings.
尽管先前的研究发现，肝纤维化和肝硬化的非酒精性脂肪性肝病（NAFLD）患者中普遍存在衰弱，但研究这种相关性的研究却很少。
本研究旨在探讨衰弱指数（FI）与中老年非酒精性脂肪性肝病（NAFLD）患者肝纤维化之间的潜在相关性。
本研究使用了 2017-2020.03 年全国健康与营养调查（NHANES）的数据，共纳入了 2383 名年龄在 50 岁及以上的参与者。使用 49 项衰弱指数来评估衰弱程度。通过控制衰减参数（CAP）和瞬态弹性成像（TE）来识别肝脂肪变性和纤维化。采用单变量和多变量调整的逻辑回归分析来研究 FI 与肝纤维化之间的关系。还进行了亚组分析，根据性别、体重指数（BMI）和高脂血症的存在对受试者进行分组。
研究结果表明，即使在使用多变量逻辑回归模型调整潜在混杂因素后（OR=1.022，95%CI，1.004-1.041），FI 与 NAFLD 中的显著肝纤维化之间仍存在正相关关系，并且在三分位（Q3 与 Q1：OR=2.004，95%CI，1.162-3.455）中也是如此。在亚组分析中，在男性（OR=1.046，95%CI，1.022-1.071）、低体重/正常体重（OR=1.077，95%CI，1.009-1.150）、超重（OR=1.040，95%CI，1.010-1.071）和无高脂血症的受试者（OR=1.054，95%CI，1.012-1.097）中，相关性更具有统计学意义。FI 评估 NAFLD 中显著纤维化的受试者工作特征（ROC）曲线下面积为 0.612（95%CI，0.596-0.628）。
本研究表明，显著的肝纤维化与衰弱之间存在正相关，特别是在年龄 50 岁及以上、非肥胖且无高脂血症的男性非酒精性脂肪性肝病患者中。需要进一步的研究来进一步验证这些发现。
