Quality of life in adults with nonalcoholic fatty liver disease: Baseline data from the nonalcoholic steatohepatitis clinical research network
Authors: Kristin David, Kris V. Kowdley, Aynur Unalp, Fasiha Kanwal, Elizabeth M. Brunt, Jeffrey B. Schwimmer, Stephanie Abrams, Diana Arceo, Denise Espinosa, Leanel Fairly, Arthur McCullough, Diane Bringman, Srinivasan Dasarathy, Carol Hawkins, Yao Chang Liu, Nicholette Rogers, Margaret Stager, Kevin Edwards, Ruth Sargent, Melissa Coffey, Karen Murray, Melissa Young, Parvathi Mohan, Kavita Nair, Anna Mae Diehl, Marcia Gortfried, Cynthia Guy, Paul Killenberg, Samantha Kwan, Yi Ping Pan, Dawn Piercy, Melissa Smith, Prajakta Bhimalli, Naga Chalasani, Oscar W. Cummings, Lydia Lee, Linda Ragozzino, Raj Vuppalanchi, Ann Scheimann, Michael Torbenson, Ann Klipsch, Jean Molleston, Girish Subbarao, Sarah Endicott Barlow, Jose Derdoy, Joyce Hoffmann, Debra King, Joan Siegner, Susan Stewart, Brent A. Tetri, Judy Thompson, Cynthia Behling, Manual Celedon, Lisa Clark, Janis Durelle, Tarek Hassanein, Joel E. Lavine, Susana Mendoza, Claude Sirlin, Tanya Stein, Allison Tobin, Kiran Bambha, Nathan M. Bass, Linda D. Ferrell, Danuta Filipowski, Raphael Merriman, Mark Pabst, Monique Rosenthal, Philip Rosenthal, Tessa Steel, Sherry Boyett, Daphne Bryan, Melissa J. Contos, Michael Fuchs, Martin Graham, Amy Jones, Velimir A.C. Luketic, Bimalijit Sandhu, Arun J. Sanyal, Carol Sargeant, Kimberly Selph, Melanie White, Grace Gyurkey, Jody Mooney, James Nelson, Sarah Roberts, Cheryl Saunders, Alice Stead, Chia Wang, Matthew Yeh, Elizabeth Brunt, David Kleiner, Gilman D. Grave, Terry T.K. Huang, Edward Doo, James E. Everhart, Jay H. Hoofnagle, Patricia R. Robuck, Leonard Seeff, Patricia Belt, Fred Brancati, Jeanne Clark, Ryan Colvin, Michele Donithan, Mika Green, Rosemary Hollick, Milana Isaacson, Wana Kim, Alison Lydecker, Laura Miriel, Alice Sternberg, James Tonascia, Mark Van Natta, Laura Wilson, Katherine Yates
Journal: Hepatology (2009)

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States. The association between NAFLD and quality of life (QOL) remains unclear. These data are important to estimate the burden of illness in NAFLD. The aim was to report QOL scores of adults with NAFLD and examine the association between NAFLD severity and QOL. QOL data were collected from adults with NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network using the Short Form 36 (SF-36) survey, and scores were compared with normative U.S. population scores. Liver biopsy histology was reviewed by a central pathology committee. A total of 713 subjects with NAFLD (male = 269, female = 444) were included. Mean age of subjects was 48.3 years; 61% had definite nonalcoholic steatohepatitis (NASH), and 28% had bridging fibrosis or cirrhosis. Diabetes was present in 27% of subjects. Subjects with NAFLD had worse physical (mean, 45.2) and mental health scores (mean, 47.6) compared with the U.S. population with (mean, 50) and without (physical, 55.8; mental, 52.5) chronic illness. Subjects with NASH reported lower physical health compared with subjects with fatty liver disease without NASH (44.5 versus 47.1, P = 0.02). Subjects with cirrhosis had significantly (P < 0.001) poorer physical health scores (38.4) than subjects with no (47.6), mild (46.2), moderate (44.6), or bridging fibrosis (44.6). Cirrhosis was associated with poorer physical health after adjusting for potential confounders. Mental health scores did not differ between participants with and without NASH or by degree of fibrosis. Conclusion: Adults with NAFLD have a significant decrement in QOL. Treatment of NAFLD should incorporate strategies to improve QOL, especially physical health. (HEPATOLOGY 2009.)