Non-alcoholic Fatty Liver Disease (NAFLD) is associated with impairment of Health Related Quality of Life (HRQOL)

Abstract

Background: NAFLD impacts patient reported outcomes (PROs). Our aim was to assess the impact of NAFLD on patients' HRQOL. Methods: National Health and Nutrition Examination Survey (NHANES) 2001-2011 data were used to identify adult patients with NAFLD [Fatty Liver Index (FLI)>60 in absence of other liver disease and excessive alcohol >20g/day for men, >10g/day for women]. Patients with other chronic diseases (ex. HIV, cancer, end-stage kidney disease) were excluded. Subjects without any of these conditions were healthy controls. HCV RNA (+) patients were HCV-controls. All patients completed NHANES HRQOL-4 questionnaire. Linear regression determined the association between NAFLD and HRQOL components adjusting for age, gender, race, and BMI. Results: Participants with complete data were included (n=9661); 3333 NAFLD (age 51years and BMI 34kg/m2); 346 HCV+ (age 49years; BMI 27kg/m2) and 5982 healthy controls (age 48years and BMI 26kg/m2). The proportion of subjects rating their health as "fair" or "poor" in descending order were HCV controls (30%) NAFLD (20%) and healthy controls (10%) (p<0.001). HRQOL-4 components scores 2-4 were lowest for HCV, followed by NAFLD and then healthy controls (p-values p=0.011 to