Background
Methods
Definition of liver disease and comorbidities
Follow-up mortality data
Statistical analysis
Results
Baseline characteristics
Aged 60–74 (n = 2095) | Aged 75 and over (n = 1176) | All (n = 3271) | |||
---|---|---|---|---|---|
N. of NAFLD | 973 | 461 | 1434 | ||
% of NAFLD (95% CI) | 40.3% (37.2 to 43.5%) | 39.2% (34.4 to 44.0%) | 40.0% (37.5 to 42.4%) | ||
NAFLD | No NAFLD | NAFLD | No NAFLD | ||
Age, mean (SE) | 67.15 (0.12)† | 67.33 (0.17) | 80.59 (0.23)* | 81.22 (0.18) | 71.16 (0.18) |
Male, % | 52.33 (1.74)*† | 39.23 (1.39) | 43.78 (2.06)* | 30.82 (1.40) | 42.06 (0.63) |
Race, % | |||||
non-Hispanic white | 81.29 (2.17)† | 82.82 (1.27) | 89.52 (2.16) | 88.80 (1.18) | 84.16 (1.38) |
non-Hispanic black | 7.00 (0.66)*† | 9.89 (0.89) | 4.56 (0.87)* | 8.35 (0.86) | 8.20 (0.67) |
Mexican American | 4.35 (0.45)*† | 1.26 (0.12) | 1.89 (0.36)* | 0.78 (0.14) | 2.14 (0.18) |
Other race | 7.35 (1.94) | 6.03 (0.98) | 4.02 (1.90) | 2.06 (0.53) | 5.50 (1.12) |
Current Smoker, % | 14.85 (1.80)*† | 19.94 (0.95) | 7.24 (1.07) | 8.23 (0.96) | 15.02 (0.70) |
Waist circumference (cm), mean (SE) | 106.86 (0.30)*† | 91.22 (0.34) | 101.22 (0.55)* | 90.65 (0.32) | 96.75 (0.25) |
BMI, mean (SE) | 30.57 (0.19)*† | 25.34 (0.12) | 28.25 (0.22)* | 24.67 (0.11) | 27.06 (0.11) |
BMI (kg/m2) > 30, % | 46.24 (1.78)*† | 13.24 (0.75) | 31.77 (2.52)* | 10.00 (0.86) | 24.26 (0.82) |
Diabetes, % | 33.22 (2.18)* | 4.06 (0.58) | 32.85 (1.77)* | 6.06 (0.76) | 16.03 (0.73) |
Hyperlipidemia, % | 88.12 (1.19)* | 81.38 (1.24) | 86.07 (1.20)* | 79.15 (1.51) | 83.46 (0.70) |
Hypertension, % | 63.32 (1.63)*† | 47.53 (1.41) | 72.56 (2.02) | 71.31 (1.64) | 59.00 (0.86) |
Metabolic Syndrome, % | 44.42 (2.26)* | 8.26 (0.62) | 40.75 (2.21)* | 9.30 (1.04) | 22.49 (0.79) |
History of cancer, % | 17.42 (1.39)† | 18.50 (1.52) | 27.28 (1.87) | 27.11 (1.38) | 20.66 (0.99) |
History of CVD, % | 20.63 (1.28)*† | 12.75 (1.14) | 31.21 (2.35)* | 19.86 (1.54) | 18.32 (0.84) |
Baseline characteristics according to NAFLD status, stratified by age group
Aged 60–74 (n = 2095) | Aged 75 and over (n = 1176) | All (n = 3271) | |||
---|---|---|---|---|---|
NAFLD | No NAFLD | NAFLD | No NAFLD | ||
AST (IU/L), mean (SE) | 21.75 (0.27)* | 19.98 (0.17) | 21.28 (0.47) | 20.51 (0.17) | 20.73 (0.13) |
ALT (IU/L), mean (SE) | 17.83 (0.39)*† | 12.43 (0.25) | 14.26 (0.61)* | 10.68 (0.20) | 13.89 (0.29) |
Albumin (g/dL), mean (SE) | 4.04 (0.02) | 4.02 (0.02) | 3.99 (0.01) | 3.98 (0.01) | 4.02 (0.01) |
Platelet (1000 cell/uL), mean (SE) | 259.01 (3.75) | 261.57 (2.90) | 252.90 (2.84) | 247.93 (3.39) | 257.51 (2.23) |
ASCVD, mean (SE) | 20.80 (0.32)*† | 14.42 (0.26) | 44.39 (0.63)* | 40.95 (0.66) | 24.21 (0.42) |
eGFR, mean (SE) | 76.20 (0.38)*† | 78.40 (0.48) | 61.34 (0.96)* | 65.79 (0.70) | 73.67 (0.33) |
HOMA, mean (SE) | 7.36 (0.36)* | 1.79 (0.03) | 7.24 (0.57)* | 1.80 (0.02) | 4.01 (0.14) |
NFS, mean (SE) | −0.64 (0.06)*† | −1.06 (0.05) | 0.07 (0.06) | −0.05 (0.05) | −0.64 (0.04) |
NFS, % | |||||
> 0.676 | 13.92 (1.08)*† | 6.13 (0.80) | 31.54 (2.05)* | 23.49 (1.21) | 14.20 (0.84) |
0.676 - -1.455 | 60.65 (1.86) | 59.50 (1.29) | 60.27 (2.14)* | 65.78 (1.73) | 61.00 (0.88) |
< −1.455 | 25.43 (2.07)*† | 34.38 (1.47) | 8.19 (1.11) | 10.74 (1.20) | 24.80 (1.01) |
APRI, mean (SE) | 0.28 (0.01)* | 0.25 (0.00) | 0.28 (0.01) | 0.27 (0.00) | 0.27 (0.00) |
APRI (> 0.7) % | 2.05 (0.36)* | 0.56 (0.15) | 1.77 (0.76) | 1.08 (0.25) | 1.22 (0.14) |
Long-term outcomes of NAFLD in the elderly subjects
Mortality outcome by age group | No. of subjects | No. of deaths | Cumulative mortality (%) | 5-year Mortality aHR (95% CI) | 10-year Mortality aHR (95% CI) | Cumulative mortality aHR (95% CI) |
---|---|---|---|---|---|---|
All-cause | ||||||
Aged 60–74 | ||||||
No NAFLD | 1122 | 643 | 54.02 | Reference | Reference | Reference |
NAFLD | 973 | 625 | 66.23* | 1.60 (1.24–1.96)† | 1.22 (1.01–1.49)† | 1.23 (1.07–1.42)† |
Aged 75 + | 1112 | |||||
No NAFLD | 715 | 675 | 92.21 | Reference | Reference | Reference |
NAFLD | 461 | 437 | 94.20 | 1.11 (0.88–1.40) | 1.17 (0.99–1.36) | 1.12 (0.97–1.29) |
Cardiovascular disease | ||||||
Aged 60–74 | ||||||
No NAFLD | 917 | 201 | 15.71 | Reference | Reference | Reference |
NAFLD | 772 | 188 | 20.46* | 2.12 (1.20–3.75)† | 1.06 (0.73–1.52) | 1.20 (0.95–1.52) |
Aged 75 + | ||||||
No NAFLD | 707 | 260 | 34.96 | Reference | Reference | Reference |
NAFLD | 458 | 175 | 36.36 | 1.05 (0.76–1.44) | 1.13 (0.89–1.42) | 1.07 (0.90–1.26) |
All-cause Mortality | CVD Mortality | |||
---|---|---|---|---|
Risk Factors | Aged 60–74 | Aged 75 and over | Aged 60–74 | Aged 75 and over |
NAFLD | 1.23 (1.07–1.42)† | 1.12 (0.97–1.29) | 1.20 (0.95–1.52) | 1.07 (0.90–1.26) |
Male | 1.41 (1.20–1.65)† | 1.55 (1.30–1.84)† | 1.50 (1.20–1.87)† | 1.51 (1.21–1.87)† |
Smoker | 2.01 (1.70–2.38)† | 1.27 (0.91–1.77) | 2.09 (1.61–2.71)† | 1.11 (0.66–1.87) |
Hypertension | 1.45 (1.27–1.67)† | 1.23 (1.01–1.51)† | 1.60 (1.26–2.03)† | 1.24 (0.97–1.60) |
Hyperlipidemia | 0.96 (0.81–1.13) | 1.01 (0.81–1.25) | 1.35 (1.01–1.81)† | 1.21 (0.88–1.66) |
Advanced fibrosis | 1.53 (1.21–1.93)† | 1.43 (1.25–1.63)† | 1.27 (0.88–1.82) | 1.37 (1.15–1.64)† |
History of CVD | 2.00 (1.74–2.31)† | 1.17 (0.94–1.46) | 3.59 (2.86–4.49)† | 1.59 (1.32–1.91)† |
History of cancer | 1.49 (1.24–1.78)† | 1.15 (0.99–1.33) | 1.44 (1.08–1.94)† | 1.06 (0.90–1.25) |