ENHANCING QUALITY OF LIFE IN THE PATIENTS SUFFERING FROM NON-ALCOHOLIC FATTY LIVER DISEASE THROUGH STANDARD TREATMENT INTERVENTIONS

Main Article Content

Ambreen Asif
Abdul Rashid Dayo
Raj Kumar
Lubna Mushtaque
Tazeem Hussain
Jahangir Liaquat

Keywords

NAFLD, Standard Treatment, Weight Loss, Chronic Liver Disease Questionnaire (CLDQ)

Abstract

Objective: This study endeavours to evaluate the influence of a standardized treatment for non-alcoholic fatty liver disease (NAFLD) on the quality of life of patients, addressing a significant concern in the public health domain.


Study design: A cross-sectional study


Place and Duration: This study was conducted in Lahore General Hospital Lahore from June 2022 to June 2023


Methodology: All participants underwent a standardized treatment protocol. Demographic, physical, and biochemical data were collected alongside NAFLD fat scores and QOL assessments measured using the WHO QOL questionnaire (WHOQOL-BREF) and the Chronic Liver Disease Questionnaire (CLDQ). Evaluations were performed at baseline, after three months of initiating treatment, and after six months of treatment. Patients were categorized into two groups based on weight loss outcomes: those achieving significant weight loss (more than 5%) and those with non-significant weight loss (less than 5%) after six months. Statistical analysis was conducted using SPSS version 26.


Results: The study encompassed 200 patients (104 (52%) women and 96 (48%) men; the mean age was 50.12 ± 2.92 years). Notably, 63 patients (31.5%) achieved significant weight loss, while 136 patients (68%) did not meet the weight loss goal. There were no notable distinctions in demographic characteristics identified between the two groups. Analysis using WHOQOL-BREF and CLDQ revealed substantial enhancements in the group with substantial weight loss in contrast to the group with insignificant weight loss. Regression analysis highlighted significant correlations between WHOQOL-BREF outcomes and NAFLD fat scores, as well as baseline alanine aminotransferase (ALT) levels. The CLDQ outcomes showed significant associations with the presence of the NAFLD activity score, diabetes mellitus, and fibrosis stage.


Conclusion: The conclusion of this study is that adherence to a standardized treatment protocol significantly enhances the quality of life (QOL) for individuals suffering from NAFLD, coupled with a weight loss regimen.

Abstract 108 | PDF Downloads 69

References

1. Younossi Y, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease—Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.
2. Adams J, Browning JD. The natural history of nonalcoholic fatty liver disease: A population-based cohort study. Gastroenterology. 2005;129(1):113–121.
3. Younossi ZM, Blissett D, Blissett R, Henry L, Stepanova M, Younossi Y, et al. The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe. Hepatology. 2016;64(5):1577–1586.
4. Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, et al. Nonalcoholic fatty liver disease: A feature of the metabolic syndrome. Diabetes. 2001;50(8):1844–1850.
5. Targher G, Bertolini L, Rodella S, Zoppini G, Zenari L, Falezza G, et al. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2007;30(5):1212–1218.
6. Ratziu V, Harrison SA, Francque S, Bedossa P, Lehert P, Serfaty L, et al. Elafibranor, an agonist of the peroxisome proliferator-activated receptor-α and -δ, induces resolution of nonalcoholic steatohepatitis without fibrosis worsening. Gastroenterology. 2016;150(5):1147–1159.
7. Ekstedt M, Hagström H, Nasr P, Fredrikson M, Stål P, Kechagias S, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61(5):1547–1554.
8. Romero-Gómez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol. 2017;67(4):829–846.
9. Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328–357. doi: 10.1002/hep.29367.
10. Younossi ZM, Diehl AM, Ong JP. Nonalcoholic fatty liver disease: an agenda for clinical research. Hepatology. 2002 Apr 1;35(4):746-52.
11. Assimakopoulos K, Karaivazoglou K, Tsermpini EE, Diamantopoulou G, Triantos C. Quality of life in patients with nonalcoholic fatty liver disease: A systematic review. Journal of Psychosomatic Research. 2018 Sep 1;112:73-80.
12. Mazzone L, Postorino V, De Peppo L, Della Corte C, Lofino G, Vassena L, Fatta L, Armando M, Bedogni G, Vicari S, Nobili V. Paediatric non-alcoholic Fatty liver disease: impact on patients and mothers’ quality of life. Hepatitis Monthly. 2013 Mar;13(3).
13. Tapper EB, Lai M. Weight loss results in significant improvements in quality of life for patients with nonalcoholic fatty liver disease: a prospective cohort study. Hepatology. 2016 Apr;63(4):1184-9.
14. Sanyal AJ, Chalasani N, Kowdley KV, McCullough A, Diehl AM, Bass NM, Neuschwander-Tetri BA, Lavine JE, Tonascia J, Unalp A, Van Natta M. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. New England Journal of Medicine. 2010 May 6;362(18):1675-85.
15. Chawla KS, Talwalkar JA, Keach JC, Malinchoc M, Lindor KD, Jorgensen R. Reliability and validity of the Chronic Liver Disease Questionnaire (CLDQ) in adults with non-alcoholic steatohepatitis (NASH). BMJ open gastroenterology. 2016 Mar 1;3(1):e000069.
16. David K, Kowdley KV, Unalp A, Kanwal F, Brunt EM, Schwimmer JB, NASH CRN research group. Quality of life in adults with nonalcoholic fatty liver disease: baseline data from the nonalcoholic steatohepatitis clinical research network. Hepatology. 2009 Jun;49(6):1904-12.