Health Related Quality of Life Comparison Among Patients With Autoimmune Liver Diseases and Non-Alcoholic Fatty Liver Disease.

Abstract

Purpose: The purpose of this study was to characterize health related quality of life in a cohort of patients with autoimmune liver disease compared to patients with non-alcoholic fatty liver disease. Furthermore, we aimed to understand which demographic, clinical, or biochemical markers correlated with marked impairment in quality of life, and which domains were differentially affected by these separate disease entities. Methods: This was a prospective cross-sectional study enrolling patients with autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis. Data was extracted from a separate well-established database for non-alcoholic fatty liver disease from the same hospital site. Patients were administered the well validated and reliable chronic liver disease questionnaire form at each of their patient visits and had labs collected on the same day. This questionnaire consists of 29 items classified in 6 domains including abdominal, fatigue, systemic, activity, emotional and worry related symptoms. Diagnosis data was established from chart review. All patients had a prior fibro scan or biopsy documented in the online medical record. Data entry for each visit was acquired from chart review and included demographic data, liver function tests, autoimmune serologies, medication, presence of cirrhosis and complications and other factors pertinent to quality of life. Results: Using the CLDQ, the unadjusted results show patients with autoimmune liver disease have significantly more fatigue compared to patients with non-alcoholic fatty liver disease, while patients with NAFLD have significantly worse impairment in the worry domain. When adjusted for other variables, this loses significance. Conclusions: Our results indicate patients with autoimmune hepatitis, when compared to patients with NAFLD, experience significantly more fatigue, driving their impairment in quality of life. In particular, the difference in fatigue remained significant after adjusting for age, platelet count, BMI and fibrosis stage.