Impairment of health-related quality of life among people with type 2 diabetes and advanced liver fibrosis.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
17 Sep 2024
Historique:
received: 20 07 2024
accepted: 03 09 2024
medline: 18 9 2024
pubmed: 18 9 2024
entrez: 17 9 2024
Statut: epublish

Résumé

People with type 2 diabetes mellitus (T2DM) show a high prevalence of steatotic liver disease (SLD), and especially metabolic dysfunction-associated steatotic liver disease (MASLD), with liver fibrosis. Their health-related quality of life (HRQL) is affected by multiple in part overlapping factors and aggravated by metabolic and liver-related comorbidities, including liver fibrosis stage. The aim of this study was to investigate the effect size of advanced fibrosis (AF) on the HRQL in people with T2DM. A total of 149 individuals with T2DM treated at a primary care provider within the German disease management program (DMP) were included in the final analysis. Vibration-controlled transient elastography (VCTE) was used to non-invasively detect steatosis and AF. The EQ-5D-3L questionnaire was used to assess the HRQL. Uni- and multivariable linear regression models were used to identify independent predictors of impaired HRQL. The majority was male (63.1%), and the median age was 67 years (IQR 59; 71). In the entire cohort, the prevalence of MASLD and AF was 70.7% and 19.5%, respectively. People with T2DM and AF had an overall lower HRQL in comparison to those without AF (p < 0.001). Obesity (β: - 0.247; 95% CI - 0.419, - 0.077) and AF (β: - 0.222; 95% CI - 0.383, - 0.051) remained independent predictors of a poor HRQL. In turn, T2DM-related comorbidities were not predictive of an impaired HRQL. Obesity and AF negatively affect the HRQL in patients with SLD and T2DM in primary care. Awareness of liver health and specific interventions may improve patient-reported and liver-related outcomes in people with T2DM.

Identifiants

pubmed: 39289410
doi: 10.1038/s41598-024-72105-8
pii: 10.1038/s41598-024-72105-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

21650

Informations de copyright

© 2024. The Author(s).

Références

Younossi, Z. et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): A systematic review. Hepatology https://doi.org/10.1097/HEP.0000000000000004 (2023).
pubmed: 38112428
Ajmera, V. et al. A prospective study on the prevalence of NAFLD, advanced fibrosis, cirrhosis and hepatocellular carcinoma in people with type 2 diabetes. J. Hepatol. https://doi.org/10.1016/j.jhep.2022.11.010 (2022).
pubmed: 36410554 pmcid: 9975077
Quek, J. et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: A systematic review and meta-analysis. Lancet Gastroenterol. Hepatol. 8, 20–30. https://doi.org/10.1016/S2468-1253(22)00317-X (2023).
pubmed: 36400097
Michel, M. et al. Obesity and harmful alcohol consumption are predictors for advanced liver disease in the disease management program for type 2 diabetes. United Eur. Gastroenterol. J. https://doi.org/10.1002/ueg2.12511 (2024).
Diehl, A. M. & Day, C. Cause, pathogenesis, and treatment of nonalcoholic steatohepatitis. N. Engl. J. Med. 377, 2063–2072. https://doi.org/10.1056/NEJMra1503519 (2017).
pubmed: 29166236
Sanyal, A. J. et al. Prospective study of outcomes in adults with nonalcoholic fatty liver disease. N. Engl. J. Med. 385, 1559–1569. https://doi.org/10.1056/NEJMoa2029349 (2021).
pubmed: 34670043 pmcid: 8881985
Tapper, E. B. & Loomba, R. Noninvasive imaging biomarker assessment of liver fibrosis by elastography in NAFLD. Nat. Rev. Gastroenterol. Hepatol. 15, 274–282. https://doi.org/10.1038/nrgastro.2018.10 (2018).
pubmed: 29463906 pmcid: 7504909
Barbosa, J. V. & Lai, M. Nonalcoholic fatty liver disease screening in type 2 diabetes mellitus patients in the primary care setting. Hepatol. Commun. 5, 158–167. https://doi.org/10.1002/hep4.1618 (2021).
Rabin, R. & de Charro, F. EQ-5D: A measure of health status from the EuroQol group. Ann. Med. 33, 337–343. https://doi.org/10.3109/07853890109002087 (2001).
pubmed: 11491192
Younossi, Z. M. et al. Reduced patient-reported outcome scores associate with level of fibrosis in patients with nonalcoholic steatohepatitis. Clin. Gastroenterol. Hepatol. 17, 2552-2560.e10. https://doi.org/10.1016/j.cgh.2019.02.024 (2019).
pubmed: 30779990
Konerding, U. et al. The validity of the EQ-5D-3L items: An investigation with type 2 diabetes patients from six European countries. Health Qual. Life Outcomes 12, 181. https://doi.org/10.1186/s12955-014-0181-5 (2014).
pubmed: 25479769 pmcid: 4263046
Huber, Y. et al. Improvement of non-invasive markers of NAFLD from an individualised, web-based exercise program. Aliment Pharmacol. Ther. https://doi.org/10.1111/apt.15427 (2019).
pubmed: 31583743
Huber, Y. et al. Health-related quality of life in nonalcoholic fatty liver disease associates with hepatic inflammation. Clin. Gastroenterol. Hepatol. 17, 2085-2092.e1. https://doi.org/10.1016/j.cgh.2018.12.016 (2019).
pubmed: 30580090
Mehta, Z., Cull, C., Stratton, I. & Yudkin, J. Quality of life in type 2 diabetic patients is affected by complications but not by intensive policies to improve blood glucose or blood pressure control (UKPDS 37). U.K. prospective diabetes study group. Diabetes Care 22, 1125–1136. https://doi.org/10.2337/diacare.22.7.1125 (1999).
Wexler, D. J. et al. Correlates of health-related quality of life in type 2 diabetes. Diabetologia 49, 1489–1497. https://doi.org/10.1007/s00125-006-0249-9 (2006).
pubmed: 16752167
Wermeling, P. R., Gorter, K. J., van Stel, H. F. & Rutten, G. E. H. M. Both cardiovascular and non-cardiovascular comorbidity are related to health status in well-controlled type 2 diabetes patients: A cross-sectional analysis. Cardiovasc. Diabetol. 11, 121. https://doi.org/10.1186/1475-2840-11-121 (2012).
pubmed: 23039172 pmcid: 3508839
Gemeinsamer Bundesausschuss. DMP-Anforderungen-Richtlinie: Richtlinie zur Zusammenführung der Anforderungen an strukturierte Behandlungsprogramme nach § 137f Abs. 2 SGB V – DMP-A-RL. (2022). https://www.g-ba.de/downloads/62-492-3454/DMP-A-RL_2023-11-16_iK-2024-07-01.pdf . Accessed 10 July 2024.
International Diabetes Federation (IDF). The IDF consensus worldwide definition of the metabolic syndrome. https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome.html . Accessed 10 July 2024.
Saunders, J. B., Aasland, O. G., Babor, T. F., de Fuente, J. R. & Grant, M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction 88, 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x (1993).
pubmed: 8329970
Berzigotti, A. et al. EASL clinical practice guidelines on non-invasive tests for evaluation of liver disease severity and prognosis—2021 update. J. Hepat. 75, 659–689. https://doi.org/10.1016/j.jhep.2021.05.025 (2021).
Rinella, M. E. et al. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. J. Hepatol. https://doi.org/10.1016/j.jhep.2023.06.003 (2023).
pubmed: 38906627
Hui, Y. et al. Health-related quality of life and its contributors according to a preference-based generic instrument in cirrhosis. Hepatol. Commun. https://doi.org/10.1002/hep4.1827 (2021).
pubmed: 34558226 pmcid: 8870013
Greiner, W., Claes, C., Busschbach, J. J. V. & von Schulenburg, J.-M.G. Validating the EQ-5D with time trade off for the German population. Eur. J. Health Econ. 6, 124–130. https://doi.org/10.1007/s10198-004-0264-z (2005).
pubmed: 19787848
Cohen, J. Statistical Power Analysis for the Behavioral Sciences (Routledge, 2013).
Yilmaz, Y. et al. Impairment of patient-reported outcomes among patients with non-alcoholic fatty liver disease: A registry-based study. Aliment Pharmacol. Ther. https://doi.org/10.1111/apt.17301 (2022).
pubmed: 36369643
Gough, S., Kragh, N., Ploug, U. J. & Hamme, M. Impact of obesity and type 2 diabetes on health-related quality of life in the general population in England. DMSO 2, 179–184. https://doi.org/10.2147/DMSO.S7088 (2009).
Phelan, S. M. et al. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes. Rev. 16, 319–326. https://doi.org/10.1111/obr.12266 (2015).
pubmed: 25752756 pmcid: 4381543
Younossi, Z. M. et al. A disease-specific quality of life instrument for non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: CLDQ-NAFLD. Liver Int. 37, 1209–1218. https://doi.org/10.1111/liv.13391 (2017).
pubmed: 28211165
Michel, M. et al. Effect of hepatic steatosis and associated metabolic comorbidities on health-related quality of life in people living with HIV. Hepatol. Commun. https://doi.org/10.1002/hep4.1958 (2022).
pubmed: 35411570 pmcid: 9315116
Tapper, E. B. & Lai, M. Weight loss results in significant improvements in quality of life for patients with nonalcoholic fatty liver disease: A prospective cohort study. Hepatology 63, 1184–1189. https://doi.org/10.1002/hep.28416 (2016).
pubmed: 26698379
Lean, M. E. et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): An open-label, cluster-randomised trial. Lancet 391, 541–551. https://doi.org/10.1016/S0140-6736(17)33102-1 (2018).
pubmed: 29221645
Rubin, R. R. & Peyrot, M. Quality of life and diabetes. Diabetes Metab. Res. Rev. 15, 205–218 (1999).
pubmed: 10441043
Funuyet-Salas, J., Pérez-San-Gregorio, M. Á., Martín-Rodríguez, A. & Romero-Gómez, M. Quality of life and coping in nonalcoholic fatty liver disease: Influence of diabetes and obesity. Int. J. Environ. Res. Public Health 18, 3503. https://doi.org/10.3390/ijerph18073503 (2021).
pubmed: 33800585 pmcid: 8036804
Moulton, C. D., Pickup, J. C. & Ismail, K. The link between depression and diabetes: The search for shared mechanisms. Lancet Diabetes Endocrinol. 3, 461–471. https://doi.org/10.1016/S2213-8587(15)00134-5 (2015).
pubmed: 25995124
Labenz, C. et al. Nonalcoholic fatty liver disease increases the risk of anxiety and depression. Hepatol. Commun. https://doi.org/10.1002/hep4.1541 (2020).
pubmed: 32923833 pmcid: 7471420
Huber, M. B., Felix, J., Vogelmann, M. & Leidl, R. Health-related quality of life of the general German population in 2015: Results from the EQ-5D-5L. Int. J. Environ. Res. Public Health 14, 426. https://doi.org/10.3390/ijerph14040426 (2017).
pubmed: 28420153 pmcid: 5409627

Auteurs

Maurice Michel (M)

Department of Internal Medicine II, University Medical Centre Saarland, Homburg, Germany.
Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany.

Jesús Funuyet-Salas (J)

Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany.
Loyola University Andalusia, Sevilla, Spain.

Michelle Doll (M)

Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany.

Saleh A Alqahtani (SA)

Liver Transplantation Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA.

Angelo Armandi (A)

Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany.
Department of Medical Sciences, University of Turin, Turin, Italy.

Christian Labenz (C)

Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany.

Peter R Galle (PR)

Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany.

Jörn M Schattenberg (JM)

Department of Internal Medicine II, University Medical Centre Saarland, Homburg, Germany. joern.schattenberg@uks.eu.
Department of Internal Medicine I, University Medical Centre Mainz, Mainz, Germany. joern.schattenberg@uks.eu.
Saarland University, Saarbrücken, Germany. joern.schattenberg@uks.eu.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH