Analysis of the Prevalence and Influencing Factors of Non-alcoholic Fatty Liver Disease in Different Gender Groups

Abstract

Background Fatty liver disease is a common frequently-occurring disease in daily life, and the number of non-alcoholic fatty liver disease (NAFLD) patients has been gradually increasing in recent years with an important impact on people's health. The differences in lifestyle and basal metabolism in different gender groups may lead to differences in the prevalence of NAFLD. However, few studies have been conducted to investigate the prevalence of NAFLD in different gender populations. Objective To explore the prevalence and influencing factors of NAFLD in different gender groups, so as to provide reference for the prevention and treatment of NAFLD. Methods A total of 29 271 subjects received physical examination in the Physical Examination Center of Jinshan Hospital of Fudan University were selected in the retrospective case-control study from August 2020 to August 2021. General data, physical examination data, laboratory indexes, combination of underlying diseases, and imaging findings of the subjects were collected. The included subjects were divided into the NAFLD group and control group according to the diagnostic criteria of NAFLD, and the prevalence and characteristics of NAFLD in different gender groups were analyzed. Multivariate Logistic regression analysis was used to explore the influencing factors of NAFLD by gender; the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of related indicators for NAFLD in different gender groups, and the area under the ROC curve (AUC), sensitivity and specificity were calculated. Results There were 10 524 cases of NAFLD among 29 271 subjects with an overall prevalence of 35.95%, including 7 854 NAFLD patients in the 18 322 male subjects with a prevalence of 42.87%, 2 670 NAFLD patients in the 10 949 male subjects with a prevalence of 24.39%. There was a statistically significant difference in the prevalence of NAFLD among subjects with different genders (χ2=1 016.505, P<0.001). Multivariate Logistic regression analysis showed that waist circumference, BMI, age, alanine aminotransferase, uric acid, total cholesterol, triglyceride, fasting blood glucose and electrocardiogram results were the influencing factors of NAFLD in the subjects by gender (P<0.05). Waist circumference, BMI, and the combination of waist circumference and BMI had a high predictive value for NAFLD in different gender populations. The sensitivity and specificity of waist circumference in predicting NAFLD risk in male subjects were 0.778 and 0.613, respectively, with the optimal cut-off value of 85.5 cm, the sensitivity and specificity of BMI in predicting the NAFLD risk in male subjects were 0.720 and 0.711, with the optimal cut-off value of 24.6 kg/m2, the sensitivity and specificity of the combination of waist circumference and BMI were 0.744 and 0.692, with the AUC of 0.789, the optimal cutoff value is 0.394. The sensitivity and specificity of waist circumference in predicting the risk of NAFLD in female subjects were 0.815 and 0.754, respectively, with the optimal cut-off value of 78.5 cm, the sensitivity and specificity of BMI in predicting the risk of NAFLD in female subjects were 0.797 and 0.759, respectively, with the optimal cut-off value of 23.6 kg/m2, the sensitivity and specificity of the combination of waist circumference and BMI were 0.853 and 0.734, with the AUC of 0.872, the optimal cutoff value is 0.202. Conclusion The influencing factors of NAFLD in male and female are slightly different. Age, alanine transaminase, uric acid, triacylglycerol, total cholesterol, fasting blood glucose, electrocardiogram results, waist circumference and BMI were all influencing factors of NAFLD in different gender groups. Waist circumference, BMI and waist circumference combined with BMI have a high predictive value for NAFLD risk in both males and females, which can be applied to the screening of NAFLD in physical examination.

Keywords

• nonalcoholic fatty liver disease|prevalence|sex factors|root cause analysis|physical examination