MASLD Is Associated With Decreased General Health Perception, Quality of Life and Work Productivity in a Low Fibrosis Population

Abstract

Background Data on quality of life in a low fibrosis prevalence metabolic dysfunction-associated steatotic liver disease (MASLD) cohort are scarce, as previous research has focused on advanced fibrosis and cirrhosis. This study examined the association between steatosis and general and mental health, as well as productivity in patients in primary care and a diabetes population. Methods Three cohort studies were conducted in Belgian and Dutch primary care and a Belgian hospital. Liver stiffness (> 12 kPa) and steatosis (> 275 dB/m) were measured using vibration-controlled transient elastography and controlled attenuation parameter (CAP). Participants completed questionnaires measuring anxiety (GAD-7), depression (PHQ-9), work productivity (WPAI-SHP), and general health (SF-36), and data were analysed with Spearman correlation. Results Of 311 participants, 142 (45.7%) and 15 (4.7%) had steatosis and fibrosis. Individuals with steatosis had a higher BMI (30.5 kg/m(2) vs. 25.5 kg/m(2), p < 0.001), increased liver stiffness (5.7 kPa vs. 4.6 kPa, p < 0.001), lower general health scores (SF-36, p < 0.001) and physical functioning (SF-36, p = 0.024) compared to those without. No significant differences were found for depression (p = 0.955) or anxiety (p = 0.557). Absenteeism was more prevalent in the steatosis group (p = 0.016), though the reasons for absenteeism were mostly unrelated to steatosis. Higher CAP values were negatively correlated with physical functioning (r = -0.193, p < 0.001), energy/fatigue (r = -0.112, p = 0.049), and general health (r = -0.235, p < 0.001) in the total cohort. Conclusion Steatosis does not appear to affect anxiety or depression, but does negatively affect general health perception and physical activity. Further investigation is needed to determine whether a potential relationship between work productivity and steatosis exists.