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TOPLINE:

The prevalence of steatotic liver disease (SLD) was 33.3% in older adults, whereas fibrosis was less prevalent. Low physical activity, multimorbidity, and other factors were strongly associated with SLD.

METHODOLOGY:

• Researchers conducted a nested study involving 1021 older adults (mean age, 72.5 years; 75.9% men) within a prospectively recruited cohort to examine the prevalence of SLD and its associations with various factors in this population.
• They used transient elastography incorporating the controlled attenuation parameter (CAP) to assess liver fibrosis and steatosis, with SLD defined as CAP ≥ 275 dB/m.
• Participants underwent at least 10 liver stiffness measurements. Significant fibrosis was defined by a liver stiffness measurement ≥ 7.9 kPa.
• Cardiometabolic risk factors, physical activity levels, motor function, a multimorbidity score incorporating nine chronic conditions, and other factors were evaluated.

TAKEAWAY:

• Among 983 participants with valid CAP results, the prevalence of SLD was 33.3%; among those with SLD, 95.4% had at least one cardiometabolic risk factor.
• Factors associated with increased odds of SLD included low physical activity (adjusted odds ratio [aOR], 1.6), overweight/obesity (aOR, 3.91), low high-density lipoprotein (HDL) cholesterol (aOR, 3.23), diabetes (aOR, 1.84), and multimorbidity (aOR, 1.31; P < .05 for all).
• Applying a higher CAP threshold for SLD (≥ 290 dB/m) resulted in minor changes to the findings, except for a significant association with frailty (aOR, 4.63; P = .034).
• Significant fibrosis was observed in only 23 participants (2.4%), with low HDL cholesterol, diabetes, and increased multimorbidity associated with an increased likelihood of significant fibrosis (P < .05 for all).

IN PRACTICE:

"These data reaffirm that SLD in older adults is associated with cardiometabolic risk factors, but the prevalence of advanced liver disease is relatively low," the authors wrote.

"These data suggest that conventional advice for SLD in younger adults, in terms of cardiovascular exercise, may need to be modified for older adults with different levels of physical performance," they added.

SOURCE:

This study was led by O. Oduwole, Institute for Liver and Digestive Health, University College London, London, England, and was published online on May 5, 2025, in npj Gut and Liver.

LIMITATIONS:

The study population predominantly consisted of male and Caucasian participants, limiting the generalizability of the findings to broader populations. Clinical characteristics may have varied over time, as they were measured approximately 4 years before transient elastography. The observed associations may have been subject to residual confounding.

DISCLOSURES:

The study was funded by the National Institute for Health and Care Research under its Research for Patient Benefit Programme. One author was supported by Cancer Research UK. Another author disclosed holding shares in Hepyx Limited and Yaqrit Limited, both of which are involved in liver disease therapeutics, and reported holding a patent.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.