Analysis of influencing factors and causes of death in elderly residents with non-alcoholic fatty liver disease
10.3760/cma.j.issn.1007-3418.2019.03.007
- VernacularTitle:老年居民非酒精性脂肪性肝病的影响因素和死因分析
- Author:
Jingyuan XU
1
;
Yong SHAO
;
Xiaolan LU
;
Jiang DENG
;
Xiaoling LI
;
Haitao SHI
Author Information
1. 西安交通大学第二附属医院消化科 710004
- Keywords:
Fatty liver,non-alchoholic;
Elderly residents;
Causes of death;
Metabolic syndrome;
Risk factors
- From:
Chinese Journal of Hepatology
2019;27(3):204-209
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand and analyze the incidence rate,risk factors,independent risk factors and the causes of death in elderly population with non-alcoholic fatty liver disease (NAFLD).Furthermore,analyze the relationship between metabolic syndrome (MS) and mortality rate in patients with NAFLD to provide evidence for the prevention and control of NAFLD in the elderly population.Methods A total of 7 619 elderly people aged over 60 years,and local household registered in Kunshan city,Jiangsu province in 2016 were included as subjects to analyze the incidence rate,influencing factors and causes of death in patients with NAFLD and the relationship between MS and mortality rate in patients with NAFLD.According to different data,using Kruskal-Wallis H test,analysis of variance,t-test,chi-square test or logistic regression analysis were performed.Results The prevalence of NAFLD was14.10％ (1 074/7 619) among the elderly over 60 years in Kunshan city,Jiangsu province in 2016,and the female prevalence rate was significantly higher than that of males (P ＜ 0.05).When the body mass index (BMI) was ＜ 32 (kg/m2),the prevalence of NAFLD increased with the increase of BMI index.When BMI was 18.5-23.9 kg/rn2,24-27.9 kg/m2 and ＞ 32 kg/m2,the prevalence of NAFLD was significantly higher in females than males (P ＜ 0.05).There was no significant difference in prevalence between males and females with BMI ＜18.5 kg/m2 and 28～31.9 kg/m2 (P＞ 0.05).BMI gradually decreased (P ＜ 0.05) with the increase of age,and the incidence of NAFLD showed a downward trend (P ＜ 0.05).An independent risk factors for NAFLD (P ＜ 0.01) were gender (OR =0.616),age (OR =0.970),waist circumference (OR =1.065),triglycerides (OR =1.162),BMI (OR =1.238),and diastolic blood pressure (OR =1.012).The probability of NAFLD combined with three and four kinds of MS was significantly higher than control group (P ＜ 0.05).Subjects' mortality rate during the follow-up period was 1.94％,2.23％ in the NAFLD group,and 1.89％ in the control group.Average life expectancy was 75.58 years in NAFLD group and 78.68years in the control group.All deaths in NAFLD groups were associated with MS,and 70.83％ combined with three or more MS.The primary canse of death in NAFLD group was tumors (37.5％),followed by cardiovascular disease (16.67％) and three cases died directly from MS.Conclusion The prevalence of NAFLD in the elderly population in Kunshan city,Jiangsu province is relatively low,which may be associated with local diet and highintensity workouts.MS disorders represented by obesity and diabetes mellitus are closely associated to the onset of NAFLD.Obesity is the most important risk factor for the incidence of NAFLD in the local elderly population over 60 years old.However,the risk of NAFLD should not be neglected in people with normal BMI,especially in aged women,and the weight control should be the most important means to prevent and control NAFLD.NAFLD may increase mortality rate and reduce life expectancy in the elderly population.The main reason to cause death in the elderly with NAFLD is cardiovascular disease and malignant tumors.Simultaneously,multiple MS development may increase the death rate in elderly with NAFLD.
