Extrahepatic manifestations and healthcare expenditures of non-alcoholic fatty liver disease in the Medicare population

Sayıner, Mehmet; Arshad, Tamoore; Golabi, Pegah; Paik, James; Farhat, Freba; Younossi, Zobair M.

doi:10.1007/s12072-020-10038-w

Cited by 34 publications

(26 citation statements)

References 34 publications

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“…After initial screening, a full-text review was done for 50 articles, and finally, 10 articles involving 2,041,752 NAFLD patients were included in the analysis ( Figure 1 ). Of the included studies, one is a prospective study ( 35 ), while the remainder are retrospective studies ( 17 , 21 , 22 , 36 – 41 ). Depression was identified through clinician-rated scales [National Institute of Mental Health Diagnostic Interview Schedule (DIS), Version III ( 36 ); DSM-IV-TR ( 35 ) and International Classification of Disease, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) ( 41 , 42 )], self-rated scales [HADS ( 21 ), CES-D ( 38 ), Beck Depression Inventory scale ( 22 )], and self-reported physician diagnosis ( 17 , 37 , 40 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the included studies, one is a prospective study ( 35 ), while the remainder are retrospective studies ( 17 , 21 , 22 , 36 – 41 ). Depression was identified through clinician-rated scales [National Institute of Mental Health Diagnostic Interview Schedule (DIS), Version III ( 36 ); DSM-IV-TR ( 35 ) and International Classification of Disease, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) ( 41 , 42 )], self-rated scales [HADS ( 21 ), CES-D ( 38 ), Beck Depression Inventory scale ( 22 )], and self-reported physician diagnosis ( 17 , 37 , 40 ). NAFLD was diagnosed through liver biopsy in four studies ( 17 , 21 , 35 , 40 ) and imaging techniques in four studies ( 17 , 22 , 38 , 40 ) and identified through ICD-9 and ICD-10 codes in two studies ( 41 , 42 ).…”

Section: Resultsmentioning

confidence: 99%

“…To account for differences in the diagnosis of depression as a potential source for heterogeneity, estimates were stratified by diagnostic criteria of depression. Prevalence of depression in NAFLD patients in four studies where depression was identified through clinician-rated scales was 20.26% (CI: 9.38–38.42%) ( 35 , 36 , 41 , 42 ), which was lower than self-reported diagnosis used in three studies where prevalence was 32.43% (CI: 27.03–38.33%) ( 17 , 37 , 40 ) and higher than self-rated depression reported in three studies where prevalence was 8.19% (CI: 4.66–14.01%) ( 21 , 22 , 38 ).…”

Section: Resultsmentioning

confidence: 99%

“…Sayiner et al analyzed depression as an independent predictor of overall 1-year mortality in NAFLD patients in both inpatient and outpatient settings. The odds for overall 1-year mortality of NAFLD patients with depression was statistically significant in both inpatient (OR: 1.07, CI: 1.05–1.09) and outpatient settings (OR: 1.21, CI: 1.18–1.25) ( 41 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the included studies, one is a prospective study (35), while the remainder are retrospective studies (17,21,22,(36)(37)(38)(39)(40)(41) (17,37,40). NAFLD was diagnosed through liver biopsy in four studies (17,21,35,40) and imaging techniques in four studies (17,22,38,40) and identified through ICD-9 and ICD-10 codes in two studies (41,42). NASH was diagnosed through liver biopsy in one study (36) and identified through selfreported physician diagnosis in another study (37).…”

Section: Summary Of Included Articlesmentioning

confidence: 99%

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Is Fatty Liver Associated With Depression? A Meta-Analysis and Systematic Review on the Prevalence, Risk Factors, and Outcomes of Depression and Non-alcoholic Fatty Liver Disease

Xiao

Lim

et al. 2021

Front. Med.

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Background and Aims: Both non-alcoholic fatty liver disease (NAFLD) and depression have a high global prevalence which is projected to increase further. While studies exploring the association have been done, there are conflicting data. This study aims to assess the prevalence and association between depression and NAFLD.Methods: Medline and Embase were searched from inception to March 3, 2020. Meta-analysis of proportions using the generalized linear mix model was conducted to analyze the pooled prevalence of depression in NAFLD patients. Risk factors for depression in NAFLD patients were evaluated in conventional pairwise meta-analysis.Results: Ten studies involving 2,041,752 NAFLD patients were included. Pooled prevalence of depression was 18.21% (CI: 11.12–28.38%) in patients with NAFLD and 40.68% (CI: 25.11–58.37%) in patients with non-alcoholic steatohepatitis (NASH). NAFLD resulted in significantly higher risk of development of depression (OR: 1.29, CI: 1.02–1.64, p = 0.03). NASH patients had a significantly higher risk of depression compared with NAFLD patients (RR: 2.83, CI: 2.41–3.32, p < 0.001). Diabetes, body mass index (BMI), female sex, smoking, and history of pulmonary disease were significant risk factors for depression in NAFLD patients.Conclusion: This study demonstrated a high prevalence of depression in NAFLD patients and a significant association between both conditions. Furthermore, patients with NASH had a significantly higher risk of depression compared with those with NAFLD. Diabetes, BMI, history of lung disease or smoking, and female gender were significant risk factors. Further studies investigating the pathophysiological mechanism underlying depression and NAFLD are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Summary Of Included Articlesmentioning

confidence: 99%

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Is Fatty Liver Associated With Depression? A Meta-Analysis and Systematic Review on the Prevalence, Risk Factors, and Outcomes of Depression and Non-alcoholic Fatty Liver Disease

Xiao

Lim

et al. 2021

Front. Med.

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Extracellular Vesicles and Fatty Liver

Lu,

Song,

Gao

2023

Advances in Experimental Medicine and Biology

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Anxiety and depression in metabolic-associated steatotic liver disease: relation with socio-demographic features and liver disease severity

Brodosi,

Stecchi,

Musio

et al. 2024

Acta Diabetol

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Purpose We aimed to evaluate the prevalence of anxiety and depression traits in Italian patients with metabolic dysfunction-associated steatotic liver disease (MASLD), and the possible relation with the severity of liver disease. Methods Demographic, anthropometric, clinical and laboratory parameters were collected in patients referred to a metabolic unit for a comprehensive evaluation of possible liver disease. Hepatic steatosis and fibrosis were evaluated by surrogate biomarkers. Imaging (controlled attenuation parameter-CAP and vibration-controlled transient elastography-VCTE). Beck depression inventory (BDI) and state-trait anxiety inventory-Y (STAI-Y) were used to define depressive/anxiety states; calorie intake and lifestyle were self-assessed by questionnaires. Results The whole sample comprised 286 patients (61.9% females; mean age 52.0 years; BMI, 34.6 kg/m2); 223 fulfilled MASLD criteria. BDI and trait anxiety scores were lower in the MASLD cohort, and the prevalence of both moderate/severe depression and severe trait anxiety was reduced compared with non-MASLD cases, despite VCTE-diagnosed fibrosis F3–F4 present in over 15% of cases. However, after correction for demographic and anthropometric confounders, MASLD was not associated with a lower risk of moderate/severe depression or severe anxiety trait (odds ratio, 0.34; 95% confidence interval, 0.12–1.01 and 0.79, 0.27–2.34). Additional adjustment for the severity of fibrosis did not change the results. No differences in state anxiety were observed. Conclusion The risk of anxiety and depression in MASLD is not different from that generated by diabetes and obesity per se. MASLD patients do not perceive liver disease as a specific source of psychological distress, possibly as a consequence of the unawareness of progressive liver disease.

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Extrahepatic manifestations and healthcare expenditures of non-alcoholic fatty liver disease in the Medicare population

Cited by 34 publications

References 34 publications

Is Fatty Liver Associated With Depression? A Meta-Analysis and Systematic Review on the Prevalence, Risk Factors, and Outcomes of Depression and Non-alcoholic Fatty Liver Disease

Is Fatty Liver Associated With Depression? A Meta-Analysis and Systematic Review on the Prevalence, Risk Factors, and Outcomes of Depression and Non-alcoholic Fatty Liver Disease

Extracellular Vesicles and Fatty Liver

Anxiety and depression in metabolic-associated steatotic liver disease: relation with socio-demographic features and liver disease severity

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