[Liver function and distribution of liver fibrosis in older adults aged 65 years and above in 18 longevity areas in China].

Nearly half of older adults aged 65 and above in Chinese longevity areas were at high risk for progressive liver fibrosis.

• The study included 5,403 participants with an average age of (85.2±11.6) years, of whom 2,365 (43.8%) were men.
• Older adults at high risk for progressive liver fibrosis accounted for 49.7% of the total sample.
• The proportions at high risk were 50.0% in men and 49.4% in women.
• Data were drawn from cross-sectional data of the 2021 China Healthy Ageing and Biomarkers Cohort Study across 18 longevity areas.
• The Fibrosis-4 (FIB-4) index was used to assess liver fibrosis risk.

The risk for advanced liver fibrosis increased with age and was consistently higher in men than in women across age groups.

• Men aged 65–79 years had a higher high-risk rate compared with women in the same age group (42.0% vs. 36.9%).
• Men aged 80–89 years had a higher high-risk rate compared with women in the same age group (50.0% vs. 45.2%).
• Men aged ≥100 years had a higher high-risk rate compared with women in the same age group (69.1% vs. 60.9%).
• The high-risk proportion showed an upward trend with increasing age in both sexes.

AST, ALT, ALB, TP, and A/G levels showed downward trends with age, while AST/ALT and GLOB levels increased with age.

• The skewness-median-coefficient of variation method was used to describe the distribution of liver function indicators.
• AST, ALT, albumin (ALB), total protein (TP), and A/G all declined as age increased.
• AST/ALT ratio and globulin (GLOB) levels increased as age increased.
• These trends were observed across the full age range of participants (≥65 years).

Men showed more abnormal liver damage indicators compared with women, while women showed more abnormal liver synthesis indicators compared with men.

• Men had higher rates of low AST (9.9% vs. 4.3%) and low ALT (55.7% vs. 51.2%) compared with women.
• Women had higher rates of low ALB (29.2% vs. 25.2%) and low A/G (11.1% vs. 9.2%) compared with men.
• Liver function abnormalities in older adults were characterized by levels lower than the reference range rather than elevated levels.
• Low AST and low ALT were classified as liver damage indicators, while low ALB and low A/G were classified as liver synthesis indicators.

The study used face-to-face interviews and fasting blood samples to assess liver function and fibrosis in older adults across 18 longevity areas in China.

• Information on demographic characteristics, lifestyles, cognitive function, and disease history was collected through face-to-face interviews.
• Fasting blood samples were taken for routine blood tests and liver function tests including AST, ALT, AST/ALT, TP, ALB, GLOB, and A/G.
• The FIB-4 index for liver fibrosis was calculated from the blood test results.
• The study was based on cross-sectional data from the 2021 China Healthy Ageing and Biomarkers Cohort Study.
• A total of 5,403 participants from 18 longevity areas were included.