Correlation Analysis Of Nonalcoholic Simple Fatty Liver, Cystatin C And Lipoprotein(a) In The Northeast Elderly

Nonalcoholic simple fatty liver disease (NAFLD) is a kind of metabolicstress-induced liver damage which is related closely to insulin resistance and geneticsusceptibility, and its pathological changes is similar to alcoholic liver disease. Thesepatients have no histories of heavy drinking. Its development process is nonalcoholicsimple fatty liver (NAFL) to nonalcoholic steato hepatitis(NASH) to liver cirrhosisand hepatocellular carcinoma (HCC).Now it has become a common diseasethreatening human health currently, and prevalence rates are more and more higher inour country. For instance,it is around15%in Shanghai,Guangzhou and Hongkong andother developed areas.Specially, nonalcoholic simple fatty liver (NAFL)is liverbenign lesions with the excessive accumulation of fat but little or noinflammation.Due to aging, metabolism,obesity and other factors, Elderly has becomea high risk group of NAFL. Now there have been a large amount of researchesanalyzing the correlation of nonalcoholic simple fatty liver,theblood lipid (includingtriglyceride, total cholesterol, low density lipoprotein cholesterol, high densitylipoprotein cholesterol) and the level of apolipoprotein（a）.Domestic and foreignscholars prevalently suggested that hypertriglyceridemia, rather thanhighcholesterol,is a risk factor for the fatty liver. Lipoprotein(a) induces fatty liver.Onthe contrary, fatty liver promote increased expression of lipoprotein（a）.Furthermore,cystatin C has a close relation to adipose tissue, which induces fat related diseases.Asa part of asmetabolic syndrome group, nonalcoholic simple fatty liver coordinatedwith cystatin C and lipoprotein （a）in the occurrence and development of promotedatherosclerosis. These eventually cause cardiovascular and cerebrovascular diseaseswith a series of pathological progresses. But recently there is no research about thecorrelation of nonalcoholic simple fatty liver and serum cystatin C and lipoprotein（a） in elderly patients in the whole world. Therefore, we chose the elderly in Northeast to do the research, and aim to strengthen the diagnosis and treatment ofnonalcoholic simple fatty liver disease in elderly patients, and provide certaintheoretical basis for the clinical management.[Objective]Observing and analyzing the different levels of cystatin C andlipoprotein (a) in elderly with or without nonalcoholic simple fatty liver, and thedifferent prevalence of comorbidities. Meanwhile, we analyzed the affection ofhypertension or diabetes mellitus on the level of serum cystatin C and lipoprotein (a).[Methods]Prospective analysis on the272cases of elderly patients, whose theaverage age was84.34±3.40(age75~94years old), treated in geriatrics departmentof geriatrics in China-Japan union hospital of Jilin University between September1,2012and December2014. According to with or without nonalcoholic simple fattyliver, these patients were divided into2groups, respectively the fatty liver group(n=102, age84.60±3.32years old) and the control group (n=170, age84.18±3.45years old).There is no significant difference between two groups of patients in gender,age, culture degree and other aspects (P>0.05), which means they have comparability.We compared the differences of TG，CHOL，HDL-C，LDL-C， Cys C, Apo-A1,Apo-B, Lp （a）,UA,GLUserum level and non-HDL-C, CHOL/HDL-C,TG/HDL-C,BMI respectively. Comparing the prevalence of hypertension、diabetes mellitus、 hyperlipidaemia and AS in fatty liver group and the controlgroup. Furthermore, we compared TG，CHOL，HDL-C，LDL-C， Cys C, Apo-A1,Apo-B, Lp（a）,serum level and UA, non-HDL-C, CHOL/HDL-C,TG/HDL-C, BMIin fatty liver combined with diabetes mellitus or hypertension.[Result]: TG, Cys C,UA, non-HDL-C,TG/HDL-C, BMI,GLU are higher in thefatty liver group compared to the control group, but Lp（a） is lower than the controlgroup, which are significant difference (P <0.05). The prevalence rate ofhypertension、 diabetic mellitus and hyperlipidemia in fatty liver groupis higher thanthe control group, and there is statistical difference (P <0.05). The fatty liver groupsare divided into diabetic group and control group according to diabetes mellitus, CysC and ApoA1and BMI in diabetic group are higher than the control group, and thereis statistical difference (P <0.05). The fatty liver groups are divided into hypertension group and control group, TG and Cys C in hypertension group are higher than thecontrol group, and there is statistical difference (P <0.05).[Conclusion]: There is no difference of gender in nonalcoholic simple fattyliver of elderly. Nonalcoholic simple fatty liver patients have the higher levels ofserum TG and Cys C and UA and non-HDL-C and TG/HDL-C and BMI,anddecreased Lp（a）. The level of serum Cys C elevated with nonalcoholic simple fattyliver complicated with diabetes mellitus, while the level of serum TG and Cys Cup-regulated in nonalcoholic simple fatty liver with hypertension group. Elderlypatients with nonalcoholic simple fatty liver have a higher prevalence rate in diabetes,hypertension and hyperlipidemia. In summary, including the changing of Cys C，Lp(a)，TG, UA, non-HDL-C, TG/HDL-C, all have significant closed correlations withnonalcoholic simple fatty liver in elderly.