Kim Kunhee, Lee Yaeji, Lee Jae Seung, Kim Mi Na, Kim Beom Kyung, Kim Seung Up, Park Jun Yong, Kim Do Young, Ahn Sang Hoon, Jung Inkyung, Lee Hye Won
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
J Gastroenterol Hepatol. 2024 Dec;39(12):2845-2852. doi: 10.1111/jgh.16755. Epub 2024 Sep 29.
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing worldwide, coinciding with aging population. However, limited studies have evaluated its incidence and progression to advanced fibrosis in the elderly population. Therefore, our study aimed to investigate the incidence of MASLD and advanced fibrosis in this age group.
We included 878 686 individuals aged ≥60 years from the Korea National Health Insurance Service-Senior cohort. After excluding participants with preexisting MASLD, 329 388 individuals were finally analyzed. Participants were categorized into four groups based on the presence of overweight/obesity and additional risk factors (aRF) included in the cardiometabolic diagnostic criteria of MASLD.
The overall incidence of MASLD was 1.94 per 100 person-years, and the incidence of advanced fibrosis in MASLD patients was 1.78 per 100 person-years. MASLD development was significantly higher in overweight/obese patients (2.65 per 100 person-years) compared to lean patients (1.09 per 100 person-years), and this trend persisted after stratification by the presence of aRF. Similarly, the incidence of advanced fibrosis among MASLD patients was higher in overweight/obese individuals (2.06 per 100 person-years) compared to lean counterparts (0.87 per 100 person-years), irrespective of aRF.
The lower incidence of MASLD in the elderly population compared to the general population underscores the importance of identifying age-specific risk factors. Overweight/obesity emerged as a robust predictor of MASLD development and advanced fibrosis. Additionally, the presence of additional cardiometabolic risk factors further increased the risk of incident MASLD and advanced fibrosis among the elderly.
代谢功能障碍相关脂肪性肝病（MASLD）在全球范围内的患病率呈上升趋势，这与人口老龄化相吻合。然而，针对老年人群中MASLD的发病率及其进展至晚期纤维化的研究有限。因此，我们的研究旨在调查该年龄组中MASLD和晚期纤维化的发病率。
我们纳入了韩国国民健康保险服务-老年队列中878686名年龄≥60岁的个体。在排除已患有MASLD的参与者后，最终对329388名个体进行了分析。根据超重/肥胖的存在情况以及MASLD心脏代谢诊断标准中包含的其他风险因素（aRF），将参与者分为四组。
MASLD的总体发病率为每100人年1.94例，MASLD患者中晚期纤维化的发病率为每100人年1.78例。超重/肥胖患者中MASLD的发病率（每100人年2.65例）显著高于体重正常患者（每100人年1.09例），并且在按aRF的存在情况进行分层后，这一趋势仍然存在。同样，无论aRF如何，超重/肥胖的MASLD患者中晚期纤维化的发病率（每100人年2.06例）高于体重正常的患者（每100人年0.87例）。
与一般人群相比，老年人群中MASLD的发病率较低，这凸显了识别特定年龄风险因素的重要性。超重/肥胖是MASLD发生和晚期纤维化的有力预测因素。此外，其他心脏代谢风险因素的存在进一步增加了老年人发生MASLD和晚期纤维化的风险。
