Background Metabolic associated fatty liver disease (MAFLD), previously known as non-alcoholic fatty liver disease (NAFLD), is one of the most prevalent chronic liver diseases worldwide. The prevalence rate and risk factors of MAFLD among middle-aged and elderly patients are unclear.
Objective To analyze the prevalence and risk factors of MAFLD in middle-aged and elderly patients in Beijing.
Methods A cross sectional study was designed to collect the physical examination results of middle-aged and elderly patients from January to December in 2021 in the Second Medical Center of Chinese PLA General Hospital. Prevalence of MAFLD in middle-aged and elderly patients was investigated. Univariate and multivariate logistic regression were used to analyze the risk factors of MAFLD.
Results Totally 2 825 middle-aged and elderly patients were included with an average age of (71.62 ± 11.29) years, and male patients accounted for 95.8% (2 705 cases). The prevalence of MAFLD was 55.5%, with higher incidence in male than in female (56.0% vs 45.5%, P=0.031). The prevalence rates of patients aged 45-59, 60-69, 70-79 and ≥80 years old were 45.1%, 58.9%, 59.9%, 53.0% (P<0.05). The prevalence of MAFLD in smokers was significantly higher than that of non-smokers (59.5% vs 54.7%, P=0.047). The prevalence of MAFLD in drinkers was also significantly higher than that of non-drinkers (59.3% vs 52.3%, P<0.05). Multivariate logistic regression analysis showed that the risk of MAFLD in patients aged 60-69, 70-79 and ≥80 years old was 1.953 (95% CI: 1.490-2.559), 2.029 (95% CI: 1.522-2.707) and 1.722 (95% CI: 1.279-2.317) times higher than that of 45-59 years old, respectively. The risk of obese, overweight patients was 23.131 (95% CI: 14.451-37.025), 6.232 (95% CI: 5.170-7.512) times higher than that of normal weight cases. In addition, patients with hypertension (OR=1.279, 95% CI: 1.055-1.551), diabetes (OR=3.053, 95% CI: 2.245-4.153), higher ALT level (OR=1.016, 95% CI: 1.007-1.026), hyperuricemia (OR=1.535, 95% CI: 1.211-1.947), hypertriglyceridemia (OR=2.927, 95% CI: 2.334-3.670) or thyroid nodules (OR=1.344, 95% CI: 1.077-1.677) had a higher risk of MAFLD. ROC curve showed that combined application of facotrs including age, BMI, hypertension, diabetes, ALT, hyperuricemia, hypertriglyceridemia and thyroid nodules would be helpful in the diagnosis of MAFLD, with an area under the ROC curve of 0.812 (95% CI: 0.797-0.828), a sensitivity of 0.743, a specificity of 0.748, and an accuracy of 0.745.
Conclusion The prevalence of MAFLD among middle-aged and elderly patients in our study is 55.5%. Age over 60 years, overweight/obesity, hypertension, diabetes, higher ALT level, hyperuricemia, hypertriglyceridemia and thyroid nodules are potential risk factors for MAFLD among middle-aged and elderly patients.
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