title: Prevalence and associated metabolic factors of fatty liver disease in the elderly.
abstract: OBJECTIVE
  The aim of this study was to investigate the metabolic risk factors for fatty liver disease in the elderly, and determine the prevalence of fatty liver disease in the elderly in Wuhan, central China.
  
  
  METHODS
  The study was a case-control study based on all 4226 adults above 60 years of age from a cohort investigated in 2010-11 at the medical examination center of Zhongnan hospital, using 3145 randomly selected adults under 60 years of age from the same cohort as controls. Fatty liver disease (FLD) was identified with ultrasound imaging. The risk factors measured were body mass index (BMI), and plasma concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low density lipoprotein (LDL) and serum uric acid (SUA). The probability of steatohepatitis with advanced fibrosis was predicted using a score based on BMI, age, ALT, and TG (BAAT),and using AST/ALT ratio (AAR).
  
  
  RESULTS
  FLD was higher in the elderly (26.7%) than in the non-elderly (22.8%) and similar in the elderly between men and women (26.6% vs 27.0%, p>0.05). BMI, TC, TG, LDL, SUA, AST and ALT were all significantly higher in FLD, whereas the level of HDL was markedly lower. Multiple regression analyses showed that obesity, high TC, TG, SUA, low HDL, and elevated ALT, AAR<1 were closely related to the elderly FLD, while male sex, obesity, high TC, TG, low HDL, elevated ALT, AST and AAR<1 were closely related to the non-elderly FLD. The prevalence of steatohepatitis with advanced fibrosis estimated as BAAT index≥3 was 2.4% in all subjects, and was higher in the elderly FLD patients than in the non-elderly FLD patients.
  
  
  CONCLUSIONS
  The prevalence of FLD is higher in the elderly, and is broadly related to the same metabolic risk factors as in the non-elderly. However, female-sex is no longer protective with increasing age, and the prevalence of steatohepatitis with advanced fibrosis is estimated to be considerably higher in the elderly FLD patients than in the non-elderly FLD controls.
authors.affiliation: Department of Internal Medicine & Geriatrics, Zhongnan Hospital, Wuhan University School of Medicine, Wuhan, China. wzl200411@yahoo.com.cn
authors.forename: Zhongli
authors.initials: Z
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Xu
authors.forename: Jianhong
authors.initials: J
authors.lastname: Peng
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.forename: Zhengguo
authors.initials: Z
authors.lastname: Hu
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.forename: Shiqing
authors.initials: S
authors.lastname: Zhou
authors.forename: Rui
authors.initials: R
authors.lastname: Zhou
authors.forename: Michael
authors.initials: M
authors.lastname: Hultström
authors.forename: En Yin
authors.initials: EY
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism*; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005234:Fatty Liver / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D014280:Triglycerides / Q000378:metabolism
chemical_list: D014280:Triglycerides; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: AAR; ALT; AST; Advanced fibrosis; BAAT; Elderly; FLD; Fatty liver; HDL; LDL; MS; NAFLD; NASH; Prevalence; Risk factors; SUA; TC; TG; alanine aminotransferase; aspartate aminotransferase; aspartate aminotransferase/alanine aminotransferase ratio; body mass index, age, ALT, and triglyceride score; fatty liver disease; high-density lipoprotein; low-density lipoprotein; metabolic syndrome; non-alcoholic fatty liver disease; non-alcoholic steatohepatitis; serum uric acid; total cholesterol; triglyceride