Fatigue linked to worse clinical prognosis, quality of life in patients with NAFLD
Click Here to Manage Email Alerts
LONDON — Lower fatigue scores at baseline correlated with adverse clinical events among patients with advanced nonalcoholic steatohepatitis, according to research presented at the International Liver Congress.
“Fatigue is very common in patients with NAFLD. In other diseases, fatigue is associated with adverse outcomes, including higher mortality,” Zobair M. Younossi, MD, MPH, president of Inova Medicine Services and professor and chair of the department of medicine at Inova Fairfax Medical Campus, told Healio. “Our aim was to see if, among well-defined NASH patients with advanced fibrosis, clinically significant fatigue is associated with liver complications.”
In a post-hoc cohort study, Younossi and colleagues analyzed 1,679 patients (mean age, 58 years; 40% men) with advanced NASH, of whom 802 had bridging fibrosis (F3) and 877 had compensated fibrosis (F4). Researchers quantified fatigue at baseline using the fatigue domain of the CLDQ-NASH tool, in which a lower score on a 1 to 7 scale indicated worse fatigue, and used Cox proportional hazard model to determine the relationship between baseline fatigue and time to liver-related clinical events.
According to study results, mean baseline CLDQ-NASH scores were 4.77 ± 1.36 among patients classified F3 and 4.56 ± 1.44 among patients classified F4. During a median follow-up of 16 months, 15% of patients with F3 and 31% of patients with F4 had liver-related clinical events; these patients had higher aspartate transaminase, lower platelet counts and elevated noninvasive test scores for fibrosis at baseline compared with patients who remained stable at follow-up.
In addition, patients who experienced liver-related clinical events at follow-up had lower baseline fatigue scores in progressed F3 (4.47 ± 1.36) vs. stable F3 (4.83 ± 1.35) as well as in progressed F4 (3.74 ± 1.31) vs. stable F4 (4.59 ± 1.43).
Multivariate analysis further confirmed lower fatigue scores (per 1 fatigue point) correlated with an increased risk for liver-related events among all patients (HR = 0.84; 95% CI, 0.75-0.93). Broken down by fibrosis type, HRs were 0.85 for F3 patients and 0.67 for F4 patients.
“Our data shows that fatigue does have important prognostic implications and is associated with clinical events,” Younossi said. “Among patients with NAFLD, those with significant fatigue not only will suffer from impairment of quality of life but also potentially have worse clinical prognosis.”
Collapse
Younossi Z, et al. Poster FRI097. Presented at: International Liver Congress; June 22-26, 2022; London (hybrid meeting).
Read more about
Click Here to Manage Email Alerts