Metabolic-associated fatty liver disease and older age

Abstract

With the growing obesity epidemic around the world, metabolic associated fatty liver disease (MAFLD), formerly called non-alcoholic fatty liver disease (NAFLD), has become a common cause of liver disease, including in older age groups, the incidence of which is increasing significantly due to significant social change economic development and improvements in health care over recent years. While NAFLD primarily focuses on the accumulation of fat in the liver, MAFLD considers both the presence of fatty tissue in the liver and associated metabolic risk factors such as diabetes mellitus, dyslipidemia or obesity, providing a more detailed approach to diagnosis and treatment of steatotic liver disease. Thus, the introduction of the term MAFLD reflects a more comprehensive approach to encompass the diverse spectrum of patients affected by this disease and recognizes the complex relationship between metabolic disorders and liver health. Age-associated structural changes can significantly affect the morphology, physiology and oxidative capacity of the liver. With age, the weight of the liver decreases, the functionality of liver cells decreases, leading to a decrease in the rate of protein synthesis, its participation in fat, carbohydrate, pigment, water-electrolyte metabolism decreases, detoxification function and vitamin synthesis are inhibited. That is, the involutive effect on the structure and functional activity of the liver during the aging process, the presence of comorbidity and features of structural and functional changes in MAFLD in elderly people require a special approach in choosing tactics for managing this group of patients. The review article examines data from scientific studies on the prevalence and diagnosis of MAFLD, taking into account involutive changes in the liver in elderly people.