Retrospective analysis of clinical characteristics of patients with metabolic-associated fatty liver disease at high and low altitude areas

Abstract

Objective: To explore differences in clinical characteristics and hemoglobin levels between different age groups in patients with metabolic-associated fatty liver disease (MAFLD) at high and low altitude areas, so as to provide a basis for further research on the effect of chronic hypoxia on MAFLD. Methods: Liver function indexes, non-invasive fibrosis indexes, metabolic indexes, and routine blood test of 1 458 (Xining area of Qinghai province) and 1 633 cases (Huzhou area, Zhejiang province) with MAFLD who underwent physical examination were retrospectively analyzed. The total population of the two places were compared and analyzed with the hemoglobin reference limit of 180 g/L. The population of Xining was divided into high and low hemoglobin groups for comparative analysis. The population of the two places was divided into five groups according to age stratification (≤30 years old, 31-40 years old, 41-50 years old, 51-60 years old, ≥61 years old). After multivariate adjustment, the characteristics of high and low hemoglobin groups and MAFLD were compared between the two groups. Statistical analysis was performed with t-test or χ2 test. Results: The detected indexes values observed were higher in Xining than Huzhou area population [fibrosis indexes (FIB4, 1.08±0.02 vs. 1.19±0.02), erythrocyte (5.14±0.13 vs. 5.30±0.13), hemoglobin (156.82±0.37 vs. 164.19± 0.39), alanine aminotransferase (ALT, 33.70±0.66 vs. 43.68±0.70), aspartate aminotransferase (AST, 24.34±0.28 vs. 29.23±0.30), γ-glutamyltransferase (42.40±1.02 vs. 51.82±1.53), alkaline phosphatase (77.92±0.56 vs. 84.63±0.85), triglyceride (TG, 2.07±0.04 vs. 2.74±0.05), uric acid (UA, 383.42±2.15 vs. 406.44±2.36)]. The detected indexes values observed were higher in Huzhou than Xining area population [platelet count (220.54±1.32 vs. 181.62±1.40), total cholesterol (TC, 5.10±0.02 vs. 5.04±0.03), fasting blood glucose (FBG, 5.67±0.04 vs. 5.29±0.04)]. The differences were statistically significant (P<0.01). Xining population UA and body mass index were increased in high hemoglobin group than low hemoglobin group, and the other parameters difference were not statistically significant. After the population in Xining was grouped by age, high and low FIB4, ALT, and AST and UA levels were detected in the age group of 31-40 and 51-60 years old, >61 years old, 31-40 years old, and the difference between hemoglobin groups were statistically significant (P<0.01). Conclusion: Patients with MAFLD are more likely to develop fibrosis, liver function impairment, metabolic disorders and so on under high-altitude hypoxic environment. Additionally, there is certain correlation with disease severity and age changes, suggesting that chronic hypoxia can accelerate MAFLD progression.