Cognitive function observation and clinical features of 100 cases of elderly patients with non-alcoholic fatty liver disease

Abstract

Objective To observe the changes of cognitive function, clinical characteristics and hippocampal structure in elderly patients with non-alcoholic fatty liver disease (NAFLD). Methods From December 2014 to June 2016, at Department of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 169 elderly hospitalized patients who underwent health checkups were enrolled and divided into NAFLD group and non-NAFLD group. The clinical data of two groups were collected, and the Montreal cognitive assessment scale (MoCA) was used for cognitive function assessment. The serum level of soluble transferrin receptor (sTfR) was detected, the liver-spleen ratio was measured and hippocampal proton magnetic resonance spectroscopy (1H-MRS) was performed. T test and linear regression analysis were used for statistical analysis. Results Among the 169 elderly patients, 100 were NAFLD and 69 were non-NAFLD. The body mass index(BMI) and waist-to-hip ratio(WHR)of patients in NAFLD group were (25.9±3.4) kg/m2 and 1.03±0.13, respectively, which were higher than those in non-NAFLD group ((24.2±3.7) kg/m2 and 0.95±0.06), and the differences were statistically significant (t=-2.714 and -3.605, both P<0.01). MoCA score of the patients in NAFLD group was 20.1±5.8, which was lower than that in non-NAFLD group (22.1±4.4), and the difference was statistically significant(t=2.154, P=0.033). The serum sTfR level and liver-spleen computed tomography(CT) ratio of NAFLD group were (8.78±4.31) mg/L and 0.97±0.12, respectively, which were lower than those of non-NAFLD group ((12.66±3.93) mg/L and 1.19±0.15), and the differences were statistically significant(t=3.765 and 6.142, both P<0.01). The CT ratio of liver to spleen (β=7.597, 95% confidence interval(CI): 2.938 to 12.935) and sTfR (β= 0.552, 95%CI: 0.304 to 0.787) were positively correlated with cognitive function in elderly patients (both P<0.01). The height of right hippocampus of NAFLD group was (0.410±0.074) mm, which was lower than that of non-NAFLD group ((0.453±0.086) mm), and the difference was statistically significant (t=2.078, P=0.042). Conclusion Cognitive impairment in elderly NAFLD patients is closely related to iron load and liver fat. Key words: Cognition; Non-alcoholic fatty liver disease; Soluble transferrin receptor; Proton magnetic resonance spectroscopy