BackgroundThe progression of hepatic fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) constitutes a major concern in public health as it is associated with many liver-related complications and mortalities such as cirrhosis, varices, or the development of liver cancer. The purpose of this study was to identify predictive factors that deteriorated the degree of hepatic fibrosis, using the FIB-4 score, in elderly NAFLD patients.MethodsWe collected data from a health examination database. Background information, including demographic characteristics, biochemical blood tests, blood pressures, body mass index (BMI), and abdominal sonography, was collected. We compared the FIB-4 scores from patientsâ first and last visits at their health check-up, and multiple logistic regression models with 95% confidence intervals (CI) were used for adjusting covariates to test the risk factors for deterioration of the FIB-4 scores.Results:A total of 742 patients with NAFLD were included in this study, and 534 (72%) were female. The average age and BMI were 71.8 ± 5.6 years and 26.1 ± 3.0 kg/m2, respectively. We divided the population based on mild, moderate, and severe hepatic fibrosis groups according to their FIB-4 scores. Patients with severe FIB-4 scores had a baseline total cholesterol and low-density lipoprotein (LDL) lower than the mild and moderate group (p<0.05), and fasting glucose was higher in the mild versus moderate group (p<0.05). After adjusting for covariates, dyslipidemia, including higher serum levels of LDL (odds ratio [OR]:1.02, CI: 1.00-1.03) and log-triglyceride (OR: 1.68, CI: 1.15-2.45), lower levels of log-high-density lipoprotein (OR:1.68, CI: 1.16-2.42), and longer follow-up years (OR:1.17, CI: 1.08-1.27) were factors that deteriorated the FIB-4 scores.ConclusionsOur study concluded that FIB-4 scores increased over time, and dyslipidemia was a major deteriorating factor for hepatic fibrosis. Therefore, elderly patients with NAFLD should be regularly followed-up and assessed for dyslipidemia to prevent further deterioration of hepatic fibrosis.