| Background and Purpose of the studyToday’s high-calorie diet and sedentary lifestyle with less exercise have led to an increase in obesity and a gradual increase in the incidence of non-alcoholic fatty liver disease(NAFLD).The pathogenesis of this disease is complicated.The incidence of non-alcoholic fatty liver disease varies greatly.Relatively few studies have examined the incidence of nonalcoholic fatty liver disease and its influencing factors in the elderly.The purpose of this study was to investigated association between baseline levels and longitudinal changes in the total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL_C),high density lipoprotein cholesterol(HDL_C)levels and LDL_C/HDL_C with the incidence of NAFLD by analyzing the health examination data of the elderly in a community of Baiyun District,Guangzhou for three consecutive years.The purpose of this study was to understand the relationship between blood lipids and NAFLD in the elderly,and provide scientific basis for the effective development of prevention and treatment strategies and intervention measures for NAFLD of the elderly in communities.MethodsHealth examination reports of elderly residents in a community in Guangzhou from 2016 to 2018 were collected and analyzed.The collected information includes basic population information,physical examination status(including biochemical indicators such as TC,TG,LDL_C,and HDL_C)and chronic medical history.Relevant physical examination data were input into EXCEL firstly.Then all data were processed by SPSS 25.0 and R.4.2.1 software.Count data were expressed as percentage and compared by χ2 test.Quantitative data with normal distribution were presented in the form of x±s and compared by t-test or analysis of variance.The median and interquartile range[M(P25,P75)]were used to represent quantitative data that did not follow normal distribution,and the rank-sum test was used to compare the differences between the two groups.The general Cox model and Joint model were established to analyze the relationship between the baseline levels and dynamic changes of TC,TG,LDL_C,HDL_C,LDL_C/HDL_C and the occurrence of NAFLD according to the results of the model.ResultsA total of 3196 subjects were collected at the beginning of this study,and 2445 subjects were included according to the inclusion and exclusion criteria.There were 817 males(33.41%)and 1628 females(66.58%),with a baseline age range of 60 to 93 years.During the follow-up period,the number of NAFLD cases was 1244(incidence rate was 50.88%,incidence density was 37.74/100 person-years).Among them,346 were males(42.35%,incidence density 28.95/100 person-years)and 898 were females(55.16%,incidence density 42.74/100 person-years).The incidence of NAFLD in females was higher than that in males(P<0.05).The baseline TC and TG levels in NAFLD group were higher than those in non-NAFLD group(P<0.05).In the general Cox model,each unit increase in baseline TC,the risk of NAFLD was 1.0589(HR=1.0589,95%CI:1.0067,1.1138),and each unit increase in baseline TG,the risk of NAFLD was 1.0143(HR=1.0 1 43,95%CI:1.0001,1.0288).The Joint model showed that the risk of NAFLD increased 1.2658 times(HR=2.2658,95%CI:1.7826,2.8799)for each longitudinal unit increase in LNTG.Conclusions1.The incidence of NAFLD in this study population is higher in women than that in men.It is suggested that the implementation of NAFLD control strategies should pay more attention on the elderly female population.2.The increase of TG in the longitudinal level will lead to the increase of the risk of NAFLD.3.Elderly people need to take regular physical examination,and they should control lipid levels in the dynamic(especially TG levels),what is helpful to prevent and control the occurrence and progression of NAFLD in the elderly. |
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