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Abstract Details
Metabolic dysfunction-associated steatotic liver disease in older adults is associated with frailty and social disadvantage
1Department of Gastroenterology, Alfred Health, Melbourne, Australia.
2Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia.
3Department of Gastroenterology, Eastern Health, Melbourne, Australia.
4Department of Gastroenterology, Northern Health, Melbourne, Australia.
5School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
6School of Health and Biomedical Science, RMIT University, Melbourne, Australia.
7Department of Medicine, Eastern Clinical School, Monash University, Melbourne, Australia.
8Department of Pathology, Alfred Health, Melbourne, Australia.
Abstract
Background & aims: The burden of metabolic dysfunction-associated steatotic liver disease (MASLD) is growing rapidly, as is the number of older adults globally. However, relatively few studies have been performed evaluating the prevalence and risk factors for MASLD in older adults. As such, we aimed to identify the prevalence of MASLD in older adults, as well as sociodemographic, clinical, functional and biochemical associations.
Methods: The study population included older adults without a history of cardiovascular disease, dementia or independence-limiting functional impairment who had participated in the ASPirin in Reducing Events in the Elderly (ASPREE) randomised trial. MASLD was defined using the Fatty Liver Index (FLI). Associations were identified using Poisson regression with robust variance for FLI ≥ 60 vs FLI < 30.
Results: 9097 Australian participants aged ≥70 years had complete biochemical and anthropometric data to identify MASLD. The study population had a mean age of 75.1 ± 4.3 years and was 45.0% male. Almost one-third (33.0%) had prevalent MASLD, and the prevalence decreased with increasing age (adjusted RR [aRR] 0.96, 95% CI: 0.96-0.97). MASLD was also negatively associated with social advantage (aRR 0.94, 95% CI: 0.90-0.99) and exercise tolerance and was positively associated with diabetes mellitus (aRR: 1.22, 95% CI: 1.16-1.29), hypertension (aRR: 1.31, 95% CI: 1.22-1.41), male sex (aRR: 1.66, 95% CI: 1.57-1.74), pre-frailty (aRR: 1.99, 95% CI: 1.82-2.12) and frailty (aRR: 2.36, 95% CI: 2.16-2.56). MASLD and nonalcoholic fatty liver disease (NAFLD) results were 100% concordant.
Conclusion: This study in a large cohort of relatively healthy community-dwelling older adults shows that MASLD is common, decreases with age and is associated with poorer metabolic health, social disadvantage and frailty.
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