Objective To investigate the correlation between serum sex hormone-binding globulin(SHBG)level and metabolically associated fatty liver disease(MAFLD)in the elderly.Methods A total of 852 patients aged≥60 years who were admitted to the Geriatric Department of Nanjing Drum Tower Hospital were enrolled in this study from June 2015 to October 2023 and divided into MAFLD group(n=426)and non-MAFLD group(n=426).General data,metabolic indexes and serum SHBG were compared between the two groups.The correlation between serum SHBG and various metabolic indexes,the mediating effects of serum SHBG and MAFLD risk,BMI,T2DM and metabolic dysfunction in the association between serum SHBG and elderly MAFLD were analyzed.Results Body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(γ-GT),serum uric acid(SUA),triglycerides(TG),fasting plasma glucose(FPG),fasting insulin(FIns),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR),prevalence of T2DM were higher,while high density lipoprotein cholesterol(HDL-C),testosterone(TT)and SHBG were lower in MAFLD group than in non-MAFLD group(P<0.05).Partial correlation analysis showed that SHBG was negatively correlated with BMI,γ-GT,SUA,TG,FIns,HbA1c and HOMA-IR(P<0.05),and positively correlated with LDL-C and HDL-C(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,a stepwise increase in the OR for MAFLD risk in patients across SHBG 38.00～51.25 nmol/L,27.90～37.90 nmol/L and 6.19～27.85 nmol/L compared with 51.30～147.00 nmol/L.The analysis of mediating effect showed that BMI mediated the effect of SHBG on MAFLD(effect value=-0.0015,P<0.05),and the mediating effect accounted for 25.22%.Conclusions SHBG level is significantly associated with MAFLD in the elderly,and the reduction of SHBG level increases MAFLD risk.

Objective:To explore the relationship between serum ferritin(SF), triglyceride-glucose(TyG) index, and metabolic dysfunction-associated fatty liver disease(MAFLD), and to assess their interaction on MAFLD risk in the health checkup population.Methods:A cross-sectional analysis was conducted with 1 439 participants from the Health Management Centre of Nanjing Drum Tower Hospital in 2022. Data were collected through physical examination, laboratory tests, and abdominal imaging. Differences in metabolic indicators, SF, and TyG index were compared between MAFLD and non-MAFLD groups. Logistic regression analysis was used to assess the associations of SF and TyG index with MAFLD, and their on MAFLD interaction was evaluated. Results:Both SF and TyG index were significantly higher in the MAFLD group between than those in the non-MAFLD group( P<0.05). After adjusting for sex, age, history of hypertension, history of diabetes, body mass index, waist circumference, haemoglobin, alanine aminotransferase, aspartate aminotransferase, and uric acid, the SF and TyG index were positively associated with the risk of MAFLD[ OR(95% CI), SF: 1.00(1.00-1.00); TyG index: 2.98(2.19-4.06). The additive interaction analysis showed that the risk of MAFLD was significantly higher in the G4 group(SF≥135.4 ng/mL, TyG index≥8.52) compared to the G1 group(SF<135.4 ng/mL, TyG index<8.52) [ OR 4.43(95% CI 2.70-7.25)]. Conclusions:Elevated SF and TyG index were independently associated with increased risk of MAFLD, with a significant synergistic interaction between the two.

Objective To investigate the correlation between serum sex hormone-binding globulin(SHBG)level and metabolically associated fatty liver disease(MAFLD)in the elderly.Methods A total of 852 patients aged≥60 years who were admitted to the Geriatric Department of Nanjing Drum Tower Hospital were enrolled in this study from June 2015 to October 2023 and divided into MAFLD group(n=426)and non-MAFLD group(n=426).General data,metabolic indexes and serum SHBG were compared between the two groups.The correlation between serum SHBG and various metabolic indexes,the mediating effects of serum SHBG and MAFLD risk,BMI,T2DM and metabolic dysfunction in the association between serum SHBG and elderly MAFLD were analyzed.Results Body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(γ-GT),serum uric acid(SUA),triglycerides(TG),fasting plasma glucose(FPG),fasting insulin(FIns),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR),prevalence of T2DM were higher,while high density lipoprotein cholesterol(HDL-C),testosterone(TT)and SHBG were lower in MAFLD group than in non-MAFLD group(P<0.05).Partial correlation analysis showed that SHBG was negatively correlated with BMI,γ-GT,SUA,TG,FIns,HbA1c and HOMA-IR(P<0.05),and positively correlated with LDL-C and HDL-C(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,a stepwise increase in the OR for MAFLD risk in patients across SHBG 38.00～51.25 nmol/L,27.90～37.90 nmol/L and 6.19～27.85 nmol/L compared with 51.30～147.00 nmol/L.The analysis of mediating effect showed that BMI mediated the effect of SHBG on MAFLD(effect value=-0.0015,P<0.05),and the mediating effect accounted for 25.22%.Conclusions SHBG level is significantly associated with MAFLD in the elderly,and the reduction of SHBG level increases MAFLD risk.

Objective:To explore the relationship between serum ferritin(SF), triglyceride-glucose(TyG) index, and metabolic dysfunction-associated fatty liver disease(MAFLD), and to assess their interaction on MAFLD risk in the health checkup population.Methods:A cross-sectional analysis was conducted with 1 439 participants from the Health Management Centre of Nanjing Drum Tower Hospital in 2022. Data were collected through physical examination, laboratory tests, and abdominal imaging. Differences in metabolic indicators, SF, and TyG index were compared between MAFLD and non-MAFLD groups. Logistic regression analysis was used to assess the associations of SF and TyG index with MAFLD, and their on MAFLD interaction was evaluated. Results:Both SF and TyG index were significantly higher in the MAFLD group between than those in the non-MAFLD group( P<0.05). After adjusting for sex, age, history of hypertension, history of diabetes, body mass index, waist circumference, haemoglobin, alanine aminotransferase, aspartate aminotransferase, and uric acid, the SF and TyG index were positively associated with the risk of MAFLD[ OR(95% CI), SF: 1.00(1.00-1.00); TyG index: 2.98(2.19-4.06). The additive interaction analysis showed that the risk of MAFLD was significantly higher in the G4 group(SF≥135.4 ng/mL, TyG index≥8.52) compared to the G1 group(SF<135.4 ng/mL, TyG index<8.52) [ OR 4.43(95% CI 2.70-7.25)]. Conclusions:Elevated SF and TyG index were independently associated with increased risk of MAFLD, with a significant synergistic interaction between the two.