The Association Between Aspirin Use And Nonalcoholic Fatty Liver Disease In The Elderly

Backgrounds and AimsWith the development of economy and improvement of living conditions,non-alcoholic fatty liver disease(NAFLD)has become one of the main chronic liver diseases in china.Epidemiological surveys show that the prevalence of NAFLD increased from 15%to more than 31%over 10 years,accompanied by an increase in the prevalence of liver cirrhosis and HCC,especially in elderly patients.In recent years,more and more studies have shown that the recruitment and activation of platelets in the liver play an important role in the occurrence and progression of NAFLD.A prospective cohort study based on NAFLD confirmed by adult liver biopsy supports this point of view.By analyzing the correlation between the use of aspirin and the severity of pathological manifestations in this cohort,it was found that regular aspirin consumption was associated with a lower degree of fibrosis.In mammalian studies,the intervention of aspirin and clopidogrel on NASH mice induced by a choline-deficient high-fat diet significantly improved their liver pathology and significantly reduced the incidence of liver cancer caused by NASH.It is suggested that antiplatelet therapy may block the progress of NAFLD.This study aims to explore the relationship between aspirin consumption and the risk of NAFLD and advanced liver fibrosis among the elderly.Methods1.Analyze the association between regular aspirin use and NAFLD in the elderly.NAFLD patients admitted to the Department of Geriatrics at Peking University People’s Hospital were the study group including 208 cases,and non-NAFLD patients hospitalized at the same time as the control group including 379 cases in all.Demographic data,comorbidities,medications,and biochemical indicators of the two groups of people,and collect the years of taking aspirin were collected.We first perform a single factor analysis based on the above data.Statistically different indicators were selected as independent variables.A Logistic regression analysis model was constructed to explore the correlation between regular use of aspirin andNAFLD in the elderly.Subsequent group analysis to explore the correlation between the two in different subgroups were made.2.Explore the correlation between the length of aspirin use and the risk of advanced liver fibrosis in the elderly with NAFLD.208 NAFLD patients in the aforementioned samples were selected as the research objects,general data and clinical data were collected.Based on the years of aspirin use,the objects was divided into four groups.The non-invasive serological score NFS was used to assess the level of liver fibrosis of NAFLD,and the highcut-off value was used as the standard for advanced fibrosis.We first evaluate the clinical characteristics between advanced fibrosis group and the other group,following which we construct a regression equation.After correcting for other potential influencing factors,and analyze the correlation between the duration of aspirin administration and NAFLD advanced fibrosis.Results1.After adjusting for confounding factors including age,gender,comorbidities,medications,biochemical and metabolic indicators that may affect it,we found that compared with those who did not take aspirin,regular use of aspirin was independently associated with a lower risk of NAFLD(OR=0.599,95%CI 0.366～0.981,P<0.05).Subgroup analysis showed that the non-obese group(BMI≤23kg/m2)(OR=0.183,95%CI 0.034～0.976,P<0.05)and the elderly group under 85(OR=0.553,95%CI 0.317～0.965,P<0.05)were negatively correlated with NAFLD taking aspirin,with significant statistical differences.2.Among elderly NAFLD patients,80 cases were divided into the advanced fibrosis group and 108 cases in the non-advanced fibrosis group.The age of the advanced fibrosis group was significantly higher than that of the control group(78.80±8.25 years vs 71.85±8.26 years,P<0.001)with statistical difference;The BMI of the fibrosis group was higher(26.91±3.2 1kg/m2),which was significantly higher(25.93±3.07 kg/m2)than the control group.Divide aspirin into 4 groups according to the years of taking,which is not use,0-1 years,1-5 years,and more than 5 years.After adjusting for age,gender,comorbid diseases,medication history and other biochemical indicators,It shows that the correlation between aspirin consumption and NAFLD was not statistically different(OR=1.597,95%CI 0.970～2.631,P=0.066).Conclusion:Regular use of aspirin is independently associated with a lower risk of NAFLD,especially in the elderly under the age of 85 and the lean NAFLD population.In addition,in elderly patients with NAFLD,aspirin consumption is not significantly associated with the risk of advanced fibrosis.