Relationship between obesity, metabolic syndrome, and nonalcoholic fatty liver disease in the elderly agricultural and fishing population of Taiwan
Hsi-Che Shen,1–3 Zi-Hao Zhao,4 Yi-Chun Hu,2,5,6 Yu-Fen Chen,7–9 Tao-Hsin Tung4,10,11
1Department of Surgery, New Taipei City Hospital, 2School of Health Care Administration, Taipei Medical University, Taipei, 3Department of Healthcare Management, Yuanpei University, Hsinchu, 4Faculty of Public Health, School of Medicine, Fu-Jen Catholic University, New Taipei City, 5Oriental Institute of Technology, 6Department of Nursing, New Taipei City Hospital, 7Business Place Hygiene Management, Department of Health, Taipei City Government, 8Institute of Health and Welfare Policy, National Yang-Ming University, 9Department of Nursing, Kang-Ning Junior College of Medical Care and Management, 10Department of Medical Research and Education, Cheng-Hsin General Hospital, Taipei, 11Department of Crime Prevention and Correction, Central Police University, Taoyuan, Taiwan
Background: The purpose of this study was to explore the relationship between obesity, the metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) in the elderly agricultural and fishing population of Taipei, Taiwan.
Methods: The study participants comprised 6,511 (3,971 male and 2,540 female) healthy elderly subjects voluntarily attending a teaching hospital for a physical check-up in 2010. Blood samples and real-time ultrasound-proven fatty liver sonography results were collected.
Results: The prevalence of NAFLD in this elderly population was 27.2%, including mild NAFLD (16.0%), moderate NAFLD (10.3%), and severe NAFLD (0.9%). The prevalence of moderate or severe NAFLD for metabolic syndrome proved to be substantially greater (P<0.0001, Χ2 test) for one or two metabolic factors. Using multinomial logistic regression analysis, age, sex, metabolic syndrome, and higher body mass index had a statistically significant association with mild NAFLD. Age, sex, metabolic syndrome, higher body mass index, and higher alanine aminotransferase were significantly related to moderate NAFLD. In addition, higher body mass index, higher uric acid, and higher alanine aminotransferase levels were significantly related to severe NAFLD. The sensitivity and specificity of body mass index and waist circumference as markers of NAFLD were estimated to be 81% and 84%, respectively, and 77% and 69%, respectively.
Conclusion: The prevalence of mild or moderate NAFLD was related to obesity and metabolic syndrome. Higher body mass index was also related to severe NAFLD but not to metabolic syndrome. Targeting this population for control of obesity and improved metabolic function is important.
Keywords: agriculture, fishing, elderly, metabolic syndrome, nonalcoholic fatty liver disease
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