Age patterns of nonalcoholic fatty liver disease incidence: heterogeneous associations with metabolic changes

Abstract

Background As the nonalcoholic fatty liver disease (NAFLD) epidemic matures, understanding how metabolic changes in NAFLD development vary over the age distribution is important to guide precise prevention. We aimed to clarify metabolic trends in age-specific NAFLD incidence. Methods We conducted a 4-year longitudinal retrospective cohort study enrolling 10,240 consecutive healthy individuals who received annual physical examination during 2012–2019. Baseline and dynamic changes in metabolism and hepatic steatosis determined with ultrasound were collected and analyzed stratified by age into the following groups: 20–34, 35–49, 50–64, and over 65 years. Results Overall, 1701 incident NAFLD participants (16.6%) were identified. Adjusted Cox regression analysis showed that the baseline and increased body mass index were the main risk factors for NAFLD in people ≤ 65 years old. Baseline high-density lipoprotein (HR = 0.56; 95% CI 0.39–0.78) was a protective factor for newly onset NAFLD in the 50-to-64-year-old group, while baseline SBP (HR = 1.03; 95% CI 1.01–1.05), baseline uric acid (HR = 1.04; 95% CI 1.01–1.07), triglyceride increase (HR = 4.76; 95% CI 3.69–6.14), fasting blood glucose increase (HR = 1.32; 95% CI 1.06–1.65) were independently associated with incident NAFLD in over-65-year-old group. Conclusions NAFLD incidence attributable to potentially metabolic risk factors varied substantially across age groups in a cohort of Chinese people. The adoption of age targeted metabolic prevention strategies might reduce the burden of NAFLD.

New-Onset Age of Nonalcoholic Fatty Liver Disease and Cancer Risk

“…In Chinese populations, the highest incidence of NAFLD was in individuals aged younger than 50 years. 24 Hence, this finding may hold importance in raising awareness and altering perceptions among the Chinese population regarding early and new-onset NAFLD. Similar to our findings, another study 25 found that with an increase in the age of new-onset NAFLD, the risk of diabetes decreased, with the relative risk decreasing from 3.992 at age 30 years to 1.908 at age 60 years.…”

“…On further exploration, we found that risk factors, incidence, and characteristics of patients with NAFLD differed by age group. In Chinese populations, the highest incidence of NAFLD was in individuals aged younger than 50 years . Hence, this finding may hold importance in raising awareness and altering perceptions among the Chinese population regarding early and new-onset NAFLD.…”

The Effect of Measurement Depth and Technical Considerations in Performing Liver Attenuation Imaging

“…A low inverse correlation between the age and liver MRI-PDFF was observed (Pearson correlation r = −0.18, p = 0.08), which is consistent with a previously reported inverse correlation between the age and patients with NAFLD in the general population. 25 Thus, an age matched study in populations with and without NAFLD is warranted. Lastly, the ultrasound scanner hardware and software used in the study were designed by a single ultrasound vendor.…”

Weigh change across adulthood is related to the presence of NAFLD: results from NHANES III

“…In this study, there are statistically significant differences in ages between weight change pattern subgroups. Previous studies indicated that the prevalence and incidence of NAFLD increased with age in a stepwise manner [34,35]. It can be explained that with age increasing, subcutaneous adipose tissue dysfunction would be induced via the accumulation of senescent adipocytes, impaired preadipocyte development, and reduced mitochondrial activity which leads to the incidence of NAFLD [36][37][38].…”