Non-alcoholic Fatty Liver Disease (NAFLD) is associated with impairment of Health Related Quality of Life (HRQOL)

Abstract

BackgroundNAFLD impacts patient reported outcomes (PROs). Our aim was to assess the impact of NAFLD on patients’ HRQOL.MethodsNational Health and Nutrition Examination Survey (NHANES) 2001–2011 data were used to identify adult patients with NAFLD [Fatty Liver Index (FLI) > 60 in absence of other liver disease and excessive alcohol >20 g/day for men, >10 g/day for women]. Patients with other chronic diseases (ex. HIV, cancer, end-stage kidney disease) were excluded. Subjects without any of these conditions were healthy controls. HCV RNA (+) patients were HCV-controls. All patients completed NHANES HRQOL-4 questionnaire. Linear regression determined the association between NAFLD and HRQOL components adjusting for age, gender, race, and BMI.ResultsParticipants with complete data were included (n = 9661); 3333 NAFLD (age 51 years and BMI 34 kg/m2); 346 HCV+ (age 49 years; BMI 27 kg/m2) and 5982 healthy controls (age 48 years and BMI 26 kg/m2). The proportion of subjects rating their health as “fair” or “poor” in descending order were HCV controls (30 %) NAFLD (20 %) and healthy controls (10 %) (p < 0.001). HRQOL-4 components scores 2–4 were lowest for HCV, followed by NAFLD and then healthy controls (p-values p = 0.011 to < .0001). After adjustment for age, gender, race, and BMI, NAFLD patients were 18–20 % more likely to report days when their physical health wasn’t good or were unable to perform daily activities as a result (p < .0001).ConclusionsNAFLD causes impairment of HRQOL. As NAFLD is becoming the most important cause of CLD, its clinical and PRO impact must be assessed.

Metabolic Syndrome Is Associated with Health-Related Quality of Life in Suspected Patients with Nonalcoholic Steatohepatitis

“…Our study indicates impairment of HRQOL among patients with suspected NASH that is comparable with previous reports [21,22]. In their studies, Golabi et al [23] and Sarrafzadegan et al [24] illustrated a noticeable QOL impairment in NAFLD [23,24].…”

Neglected features of lifestyle: Their relevance in non-alcoholic fatty liver disease

“…The important most recent reviews appropriately address benefits of healthy diet and exercise on NAFLD[27] both in adults[28] and in children[29], even if other factors, genetic[30], behavioural and environmental should not be neglected[31,32]. The opportunity for the medicine are relevant since articulated clinical intervention, which, according to our results, are justified, can be pursued with a focus on nutritional profile, physical exercise mainly open-air for enhancing sun exposure and improving sleep duration and rhythm[33], cultural and traditional medicine issues and, comprehensively, the quality of life[34-39]. The pre-requisite is that both medical doctor and patient should not be mucking around in search of the magic bullet, and instead try to take seriously and with a strategy the road of lasting lifestyle change.…”

Patient‐Reported Outcomes and the Economic Effects of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis: The Value Proposition

“…One study reported that 67% of overweight and 94% of obese individuals have NAFLD . Although NAFLD is highly prevalent in the general population, its progressive subtype of nonalcoholic steatohepatitis (NASH) is more clinically relevant . In the United States, an estimated 1.5%‐6.45% of the general population has NASH .…”

“…Outcomes frequently measured in studies of patients with chronic diseases such as nonalcoholic fatty liver disease (NAFLD) include morbidity and mortality . Since these outcomes are difficult to measure in clinical trials, investigators rely on histologic, radiologic or other biomakers as surrogates of clinical outcomes . However, assessments of the burden of NAFLD that are limited only to these clinical outcomes do not fully capture the impact of this disease on patients and society .…”

“…Since these outcomes are difficult to measure in clinical trials, investigators rely on histologic, radiologic or other biomakers as surrogates of clinical outcomes . However, assessments of the burden of NAFLD that are limited only to these clinical outcomes do not fully capture the impact of this disease on patients and society . A comprehensive understanding of the burden of NAFLD requires information not only on clinical outcomes but also on patient‐reported outcomes (PROs) and economic outcomes .…”