Patients With Nonalcoholic Steatohepatitis Experience Severe Impairment of Health-Related Quality of Life.


Journal Article

INTRODUCTION: Although there is substantial evidence suggesting poor health-related quality of life (HRQL) in patients with chronic hepatitis C (CHC), similar data in nonalcoholic steatohepatitis (NASH) have not been fully assessed. The aim is to compare HRQL scores in patients with CHC to those with NASH. METHODS: Matched patients with advanced fibrosis (bridging fibrosis and compensated cirrhosis) due to CHC and NASH completed Short Form-36 (SF-36) questionnaire, Chronic Liver Disease Questionnaire (CLDQ), and Work Productivity and Activity Instrument questionnaire. RESULTS: We included 1,338 patients with NASH with advanced fibrosis (mean age 57.2 years, 47% men, 55% cirrhosis) and 1,338 matched patients with CHC. Patients with CHC and NASH had similar rates of employment and psychiatric disorders (P > 0.05). As expected, patients with NASH had higher body mass index (mean 33.7 vs 27.6) and more type 2 diabetes (74% vs 16%) (all P < 0.01). Patients with NASH had significantly lower HRQL scores related to physical health: Physical Functioning, Bodily Pain, General Health, Vitality, Physical Summary of SF-36, and Fatigue of CLDQ (P < 0.02). By contrast, patients with CHC had a lower Mental Health score of SF-36 and Emotional score of CLDQ and reported greater impairment in daily activities as measured by the Work Productivity and Activity Instrument questionnaire (P < 0.002). In multivariate analysis, after adjustment for demographic parameters, cirrhosis, and history of psychiatric disorders, having NASH was associated with lower physical HRQL scores and higher mental health-related scores (P < 0.05). DISCUSSION: Patients with NASH and advanced fibrosis have more impairment of their physical health-related scores than patients with CHC with advanced fibrosis. These data should dispel the misconception that NASH is an asymptomatic disease with little negative impact on patients' well-being.

Full Text

Duke Authors

Cited Authors

  • Younossi, ZM; Stepanova, M; Lawitz, EJ; Reddy, KR; Wai-Sun Wong, V; Mangia, A; Muir, AJ; Jacobson, I; Djedjos, CS; Gaggar, A; Myers, RP; Younossi, I; Nader, F; Racila, A

Published Date

  • October 2019

Published In

Volume / Issue

  • 114 / 10

Start / End Page

  • 1636 - 1641

PubMed ID

  • 31464743

Pubmed Central ID

  • 31464743

Electronic International Standard Serial Number (EISSN)

  • 1572-0241

Digital Object Identifier (DOI)

  • 10.14309/ajg.0000000000000375


  • eng

Conference Location

  • United States