Compared to people with diabetes, people with non-alcoholic steatohepatitis (NASH) required more hospital resources and had more trouble performing daily activities, according to study findings published in BMC Gastroenterology.

Arising from the accumulation of fat in the liver, non-alcoholic fatty liver disease (NAFLD) and its more severe form, NASH, are responsible for a growing proportion of advanced liver disease worldwide. As a result of inflammation, NAFLD can lead to liver fibrosis, cirrhosis and even liver cancer. With no approved medical therapies, disease management is dependent on lifestyle changes such as weight loss and exercise.

Elliot Tapper, MD, of the University of Michigan Ann Arbor, and colleagues sought to learn more about the burden of NASH in the United States.

Using the 2016 National Health and Wellness Survey database, they compared the burden of disease in 136 people with NASH, 8,175 people with type 2 diabetes and 96,108 people from the general population. People with diabetes were about 10 years older, on average, than the NASH and general population cohorts.

The researchers used three different measures for comparison: health-related quality of life, health care resource use and work productivity and activity impairment.

Compared with the general population, people with NASH had worse mental and physical health, with more individuals experiencing anxiety and depression. Those with NASH also required more visits with health care professionals, more hospitalizations and more trips to an emergency room. What’s more, they had greater impairment in their work.

In terms of mental health and work impairment, people with NASH fared no worse than those with diabetes. But their physical health was significantly worse, and they needed more medical visits and experienced more disruption in their daily activities.

“This real-world study suggests that burden of disease is higher for all outcomes assessed among NASH compared to matched general [population] controls,” wrote the researchers. “When comparing to type 2 diabetes mellitus, [the] NASH cohort has comparable mental and work-related impairment but worse physical status, daily activities impairment and more health care resource use.”

Click here to read the study in BMC Gastroenterology.

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