Younossi Zobair, Aggarwal Priya, Shrestha Ichhya, Fernandes João, Johansen Pierre, Augusto Margarida, Nair Sunita
Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
Inova Medicine, Inova Health System, Falls Church VA, USA.
JHEP Rep. 2022 Jun 15;4(9):100525. doi: 10.1016/j.jhepr.2022.100525. eCollection 2022 Sep.
BACKGROUND & AIMS: Non-alcoholic steatohepatitis (NASH) is associated with increased mortality and a high clinical burden. NASH adversely impacts patients' health-related quality of life (HRQoL), but published data on the humanistic burden of disease are limited. This review aimed to summarise and critically evaluate studies reporting HRQoL or patient-reported outcomes (PROs) in populations with NASH and identify key gaps for further research.
Medline, EMBASE, the Cochrane Library and PsycINFO were searched for English-language publications published from 2010 to 2021 that reported HRQoL/PRO outcomes of a population or subpopulation with NASH.
Twenty-five publications covering 23 unique studies were identified. Overall, the data showed a substantial impact of NASH on HRQoL, particularly in terms of physical functioning and fatigue, with deterioration of physical and mental health as NASH progresses. Prevalent symptoms, including fatigue, abdominal pain, anxiety/depression, cognition problems, and poor sleep quality, adversely impact patients' ability to work and perform activities of daily living and the quality of relationships. However, some patients fail to attribute symptoms to their disease because of a lack of patient awareness and education. NASH is associated with high rates of comorbidities such as obesity and type 2 diabetes, which contribute to reduced HRQoL. Studies were heterogeneous in terms of diagnostic methods, population, outcomes, follow-up time, and measures of HRQoL/utility. Most studies were rated 'moderate' at quality assessment, and all evaluable studies had inadequate control of confounders.
NASH is associated with a significant HRQoL burden that begins early in the disease course and increases with disease progression. More robust studies are needed to better understand the humanistic burden of NASH, with adequate adjustment for confounders that could influence outcomes.
Non-alcoholic steatohepatitis (NASH) has a significant impact on quality of life, with individuals experiencing worse physical and mental health compared with the general population. NASH and its symptoms, which include tiredness, stomach pain, anxiety, depression, poor focus and memory, and impaired sleep, affect individuals' relationships and ability to work and perform day-to-day tasks. However, not all patients are aware that their symptoms may be related to NASH. Patients would benefit from more education on their disease, and the importance of good social networks for patient health and well-being should be reinforced. More studies are needed to better understand the patient burden of NASH.
非酒精性脂肪性肝炎（NASH）与死亡率增加及高临床负担相关。NASH对患者的健康相关生活质量（HRQoL）产生不利影响，但已发表的关于该疾病人文负担的数据有限。本综述旨在总结并批判性评价报告NASH患者人群中HRQoL或患者报告结局（PROs）的研究，并确定进一步研究的关键差距。
检索Medline、EMBASE、Cochrane图书馆和PsycINFO，查找2010年至2021年发表的报告NASH患者人群或亚人群HRQoL/PRO结局的英文出版物。
确定了25篇涵盖23项独特研究的出版物。总体而言，数据显示NASH对HRQoL有重大影响，尤其是在身体功能和疲劳方面，随着NASH进展，身心健康会恶化。常见症状，包括疲劳、腹痛、焦虑/抑郁、认知问题和睡眠质量差，对患者的工作能力、日常生活活动能力及人际关系质量产生不利影响。然而，由于患者缺乏认知和教育，一些患者未将症状归因于其疾病。NASH与肥胖和2型糖尿病等高合并症发生率相关，这导致HRQoL降低。研究在诊断方法、人群、结局、随访时间以及HRQoL/效用测量方面存在异质性。大多数研究在质量评估中被评为“中等”，所有可评估研究对混杂因素的控制均不足。
NASH与显著的HRQoL负担相关，该负担在疾病进程早期就已出现，并随疾病进展而增加。需要更有力的研究来更好地理解NASH的人文负担，对可能影响结局的混杂因素进行充分调整。
非酒精性脂肪性肝炎（NASH）对生活质量有重大影响，与一般人群相比，患者的身心健康状况更差。NASH及其症状，包括疲劳、胃痛、焦虑、抑郁、注意力和记忆力差以及睡眠受损，会影响个人的人际关系、工作能力和日常任务执行能力。然而，并非所有患者都意识到其症状可能与NASH有关。患者将从更多关于其疾病的教育中受益，应加强良好社交网络对患者健康和福祉的重要性。需要更多研究来更好地理解NASH的患者负担。
