Abstract
BackgroundThe Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region. We aimed to 1) compare the characteristics of elderly (i.e. age ≥ 60) vs. non-elderly patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD); 2) identify predictors of advanced fibrosis in elderly patients with NAFLD; and 3) assess the performance of non-invasive fibrosis scores in the prediction of advance fibrosis in the elderly population.MethodsWe abstracted the data of 1008 patients with NAFLD from nine centers across eight countries. Characteristics of elderly and non-elderly patients with NAFLD were compared using 1:3 sex-matched analysis.ResultsOf the 1008 patients, 175 were elderly [age 64 (62–67) years], who were matched with 525 non-elderly patients [46 (36–54) years]. Elderly patients were more likely to have advanced fibrosis (35.4% vs. 13.3%; p < 0.001). By multivariable analysis, factors associated with advanced fibrosis in elderly patients included female sex [odds ratio (OR) 3.21; 95% confidence interval (CI) 1.37–7.54] and hypertension (OR 3.68; 95%CI 1.11–12.23). The area under receiver-operating characteristics curve (95% CI) of aspartate aminotransferase-to-platelet ratio index, NAFLD fibrosis score and Fibrosis-4 index for predicting advanced fibrosis in elderly patients were 0.62 (0.52–0.72), 0.65 (0.55–0.75) and 0.64 (0.54–0.74) respectively.ConclusionsElderly patients with NAFLD had a higher prevalence of advanced fibrosis than non-elderly patients. Female and hypertension were predicting factors for advanced fibrosis in the elderly. Non-invasive fibrosis scores had a lower specificity in elderly.
Highlights
The Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region
We aimed to investigate factors associated with liver fibrosis in elderly vs. non-elderly patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD), and to identify predictors of advanced fibrosis in elderly patients
Characteristics of elderly and non-elderly NAFLD patients Of 1008 patients with biopsy-proven NAFLD, 175 patients were elderly, who were matched with 525 nonelderly patients
Summary
The Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region. NAFLD broadly encompasses two conditions with different prognosis: nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). The prevalence of NASH has consistently been reported to increase with age besides being associated with obesity, diabetes mellitus and the metabolic syndrome [1,2,3]. Ballestri and colleagues conducted a comprehensive review of NAFLD studies and found age, sex and the metabolic syndrome to be major factors influencing NAFLD onset and progression. The prevalence of NAFLD increases during young adulthood to middle age and decline after the age of 50– 60 years [6, 7]. The incidence of NAFLD is low but increases rapidly after menopause [9, 10]. The striking gender difference has long been reported in NAFLD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
