Age-stratified Analysis of Associations Between Participant’s Characteristics and NAFLD
Abstract Background: Nonalcoholic fatty liver disease (NAFLD) is highly prevalent and a leading cause of liver transplantation. In clinical settings, diagnosis is often inferred based on patient attributes and generalized algorithms that haven’t been tailored to patients’ age. This study aims to understand age-dependent associations between NAFLD and patient characteristics. Methods: Subjects were identified from the National Health and Nutrition Examination Survey (NHANES) 2007-2016. NAFLD status was established through the U.S. Fatty Liver Index in the absence of excessive alcohol consumption and viral etiology. Descriptive patient attributes' distributions are reported relying on the mean and standard deviation for continuous variables and proportions for categorical variables. Prevalence estimates and prevalence ratios for NAFLD are provided in the following age stratifications: 18 and younger, 19-49, 50-64, 65-74, and 75+. Results: A total of 4,560 NHANES participants from 2007-2016 were included, with a mean age of 42.9. Prevalence ratios of NAFLD in the context of clinical/demographic characteristics varied between age groups. The NAFLD prevalence ratio for Mexican Americans compared to Non-Hispanic White was 3.44 in respondents 18 years old or younger (95%CI: 2.48-4.77) and 1.60 in respondents 75 or older (95%CI: 1.30-1.97). The magnitude of the association between albumin and NAFLD was negative. It ranged from a prevalence ratio of 0.32 (0.20 – 0.51) for respondents under 19 years of age to 1.15 (0.86-1.53) over the age of 74. Conclusion: The significant differences between participant characteristics and NAFLD within different age groups suggest that age plays an essential role in the magnitude of the association between risk factors and NAFLD. This study highlights that the accuracy of a NAFLD diagnosis in the absence of imaging and histological conformation may depend on the patients' age. Additional work should evaluate the need for diagnostic and management guidelines formally tailored to patients’ age.