Prevalence and risk factors of non-alcoholic fatty liver disease in the elderly: Results from the Rotterdam study

• Published in: Journal of hepatology Vol. 57; no. 6; pp. 1305 - 1311
• Main Authors: Koehler, Edith M, Schouten, Jeoffrey N.L, Hansen, Bettina E, van Rooij, Frank J.A, Hofman, Albert, Stricker, Bruno H, Janssen, Harry L.A
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01.12.2012; Elsevier
• Subjects: Aged; Aged, 80 and over; Alanine Transaminase - blood; Biological and medical sciences; Elderly; Epidemiology; Exercise; Fatty Liver - epidemiology; Fatty Liver - etiology; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Logistic Models; Male; Medical sciences; Metabolic diseases; Metabolic syndrome; Miscellaneous; Non-alcoholic Fatty Liver Disease; Other diseases. Semiology; Other metabolic disorders; Physical activity; Prevalence; Risk Factors; Smoking; Smoking - adverse effects; Tobacco, tobacco smoking; Toxicology; NAFLD; gamma glutamyltransferase; FLI; non-alcoholic fatty liver disease; Physical activity; MET-h/wk; ALP; alanine aminotransferase; Homeostasis Model Assessment of Insulin Resistance; ALT; Metabolic syndrome; Epidemiology; BP; HDL-C; high-density lipoprotein cholesterol; alkaline phosphatase; BMI; blood pressure; AST; body mass index; fatty liver index; aspartate aminotransferase; HOMA-IR; GGT; metabolic task hours per week; Elderly; Smoking; Non-alcoholic fatty liver disease; Endocrinopathy; Human; Prevalence; Tobacco smoking; Metabolic diseases; Cardiovascular disease; Hepatic disease; Non alcoholic steatohepatitis; Risk factor; Gastroenterology; Digestive diseases
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2012.07.028

Background & Aims The prevalence of non-alcoholic fatty liver disease (NAFLD) appears to increase with age. However, limited data are available concerning the prevalence of NAFLD in the elderly. Our aim was to determine the prevalence and risk factors of NAFLD in an elderly population. Methods This study was based on participants in the population-based Rotterdam Study. Each participant was interviewed and had a clinical examination at the research center, including a fasting blood collection, liver ultrasonography, and anthropometric assessment. Ordinal and logistic regression analysis was used to assess associations between covariables and (severity of) NAFLD. Results Data from 2811 participants (mean age 76.4 ± 6.0 years) were analyzed. The prevalence of NAFLD was 35.1%. The prevalence of NAFLD decreased with advancing age ( p <0.001). In logistic regression analysis, age (OR 0.97; 95% CI 0.95–0.99; p <0.001), total physical activity level (OR 0.98, 95% CI 0.96–0.99; p = 0.005), pack years of smoking (OR 1.01, 95% CI 1.00–1.01; p = 0.02), waist circumference >88 cm for women and >102 cm for men (OR 4.89; CI 4.00–5.96; p <0.001), fasting glucose ⩾100 mg/dl or drug treatment for elevated blood glucose (OR 2.11, 95% CI 1.72–2.59; p <0.001), blood pressure ⩾130/85 mmHg or drug treatment for elevated blood pressure (OR 1.80, 95% CI 1.08–3.01; p = 0.03), and triglycerides ⩾150 mg/dl or treatment with serum lipid reducing agents (OR 1.56, 95% CI 1.28–1.91; p <0.001) were associated with NAFLD. Conclusions NAFLD is common in the elderly, although the prevalence decreases with advancing age. Further studies are warranted exploring potential factors contributing to this apparent positive selection effect in the elderly.