Reduced Quality of Life in Patients with Non-Alcoholic Fatty Liver Disease May Be Associated with Depression and Fatigue

Abstract

Non-alcoholic fatty liver disease (NAFLD) is often thought of as clinically asymptomatic. However, many NAFLD patients complain of fatigue and low mood, which may affect their quality of life (QoL). This may create a barrier to weight loss and hinder the achievement of NAFLD therapy goals. Our study aimed to evaluate the QoL in NAFLD patients vs. healthy volunteers, and to analyze likely influencing factors. From March 2021 through December 2021, we enrolled 140 consecutive adult subjects (100 NAFLD patients and 40 controls). Overall, 95 patients with NAFLD and 37 controls were included in the final analysis. Fatty liver was diagnosed based on ultrasonographic findings. We employed 36-Item Short Form Health Survey (SF-36) to evaluate QoL, Hospital Anxiety and Depression Scale (HADS) to identify anxiety and/or depression, and Fatigue Assessment Scale (FAS) to measure fatigue. NAFLD patients had significantly lower physical component summary scores, as well as significantly higher HADS-D scores, compared with the control group (Mann-Whitney U criterion = 1140.0, p = 0.001 and U = 1294.5, p = 0.022, respectively). Likewise, fatigue was more common in NAFLD patients (χ2 = 4.008, p = 0.045). Impaired QoL was significantly associated with fatigue (FAS score ≥ 22, p < 0.001) and depression (HADS-D ≥ 8, p < 0.001). In conclusion, NAFLD patients had significantly poorer QoL vs. controls, in particular with respect to the physical component of health. Impaired QoL may be associated with fatigue and depression, and together they may interfere with increased physical activity and lifestyle modifications in patients with NAFLD.

Clinically Meaningful Fatigue and Depression Are Associated with Sarcopenia in Patients with Non-Alcoholic Fatty Liver Disease

“…Finally, according to the results of our study, the subgroup of NAFLD patients with sarcopenia reported substantially poorer QoL compared to the subgroup of NAFLD patients without sarcopenia, specifically, regarding the physical component of health, which complies with previously published data [ 39 ]. However, as far as we know the association of sarcopenia with reduced QoL among patients with NAFLD has not been previously reported.…”

Mobile App–Based Lifestyle Coaching Intervention for Patients With Nonalcoholic Fatty Liver Disease: Randomized Controlled Trial

“…Even though NAFLD is an asymptomatic disease, the SMART-Liver program was also effective in managing NAFLD's nonspecific symptoms, such as fatigue. Recently, Golubeva et al [44] reported that fatigue was almost twice more common in patients with NAFLD than in those without it. However, chronic liver disease fatigue management remains a challenge because the pathophysiology of fatigue is complex.…”

Fatigue, depression, and sleep disorders are more prevalent in patients with metabolic-associated fatty liver diseases

“…', 'had problems concentrating?'. A Likert scale response format was used for all items ranging from (1) meaning most impairment to (7) representing least impairment. Each domain was represented separately in the CLDQ-NAFLD score [19].…”

“…Fatigue is associated with sleep deprivation, depression, and cardiovascular disease. Julia et al found that fatigue was nearly twice as common in patients with MAFLD [2,[5][6][7][8] . .…”