TY - JOUR
T1 - Influence of Comorbidities on Health-Related Quality of Life in Alcohol-Related Liver Disease
T2 - A Population-Based Survey
AU - Dombestein Elde, Karen
AU - Jepsen, Peter
AU - Von Wowern, Natasja
AU - Winther-Jensen, Matilde
AU - Eliasen, Marie Holm
AU - Christensen, Anne Illemann
AU - Madsen, Lone Galmstrup
AU - Askgaard, Gro
N1 - Copyright © 2024. Published by Elsevier Inc.
PY - 2025/6
Y1 - 2025/6
N2 - BACKGROUND AND AIMS: Extrahepatic comorbidities are common in alcohol-related liver disease (ALD). We examined associations between burden of comorbidities, alcohol, and smoking with low health-related quality of life (HRQoL) among patients with ALD.METHODS: Patients with ALD and matched comparators were identified among respondents of the Danish National Health Survey waves in 2010-2017. Survey data included generic measures of physical and mental HRQoL (12-Item Short Form Health Survey), comorbidities, alcohol and smoking. Low HRQoL in ALD was defined as ≥1.5 SD worse than the average HRQoL in the comparators. Odds ratios (ORs) of low HRQoL were estimated with multivariable logistic regression, adjusting for potential confounders.RESULTS: We included 772 ALD patients, 53% of whom had cirrhosis; 37% had low physical HRQoL and 22% had low mental HRQoL. Disc herniation (found in 21%), osteoarthritis (36%), chronic obstructive pulmonary disease (11%), cancer (6%), stroke (1%), and psychiatric disease (9%) were associated with low physical and/or mental HRQoL, whereas alcohol use disorder (24%), diabetes (19%), acute myocardial infarction (1%), hypertension (34%), and osteoporosis (12%) were not. For example, osteoarthritis was associated with low physical (OR, 2.17; 95% confidence interval, 1.54-3.05) and low mental (OR, 1.91; 95% confidence interval, 1.27-2.88) HRQoL. For lifestyle factors, drinking ≥20 units/week was associated with low physical and smoking ≥20 cigarettes/day with low mental HRQoL when compared with abstainers and nonsmokers, respectively.CONCLUSIONS: Common comorbidities including chronic obstructive pulmonary disease, musculoskeletal disease, and psychiatric disease are associated with low HRQoL in ALD, independent of liver disease severity, and so are alcohol consumption and smoking. These findings highlight the importance of multidisciplinary management of patients with ALD.
AB - BACKGROUND AND AIMS: Extrahepatic comorbidities are common in alcohol-related liver disease (ALD). We examined associations between burden of comorbidities, alcohol, and smoking with low health-related quality of life (HRQoL) among patients with ALD.METHODS: Patients with ALD and matched comparators were identified among respondents of the Danish National Health Survey waves in 2010-2017. Survey data included generic measures of physical and mental HRQoL (12-Item Short Form Health Survey), comorbidities, alcohol and smoking. Low HRQoL in ALD was defined as ≥1.5 SD worse than the average HRQoL in the comparators. Odds ratios (ORs) of low HRQoL were estimated with multivariable logistic regression, adjusting for potential confounders.RESULTS: We included 772 ALD patients, 53% of whom had cirrhosis; 37% had low physical HRQoL and 22% had low mental HRQoL. Disc herniation (found in 21%), osteoarthritis (36%), chronic obstructive pulmonary disease (11%), cancer (6%), stroke (1%), and psychiatric disease (9%) were associated with low physical and/or mental HRQoL, whereas alcohol use disorder (24%), diabetes (19%), acute myocardial infarction (1%), hypertension (34%), and osteoporosis (12%) were not. For example, osteoarthritis was associated with low physical (OR, 2.17; 95% confidence interval, 1.54-3.05) and low mental (OR, 1.91; 95% confidence interval, 1.27-2.88) HRQoL. For lifestyle factors, drinking ≥20 units/week was associated with low physical and smoking ≥20 cigarettes/day with low mental HRQoL when compared with abstainers and nonsmokers, respectively.CONCLUSIONS: Common comorbidities including chronic obstructive pulmonary disease, musculoskeletal disease, and psychiatric disease are associated with low HRQoL in ALD, independent of liver disease severity, and so are alcohol consumption and smoking. These findings highlight the importance of multidisciplinary management of patients with ALD.
KW - Adult
KW - Aged
KW - Alcohol Drinking
KW - Comorbidity
KW - Denmark/epidemiology
KW - Female
KW - Health Surveys
KW - Humans
KW - Liver Diseases, Alcoholic/epidemiology
KW - Male
KW - Middle Aged
KW - Quality of Life
KW - Smoking
UR - http://www.scopus.com/inward/record.url?scp=85211482849&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2024.09.035
DO - 10.1016/j.cgh.2024.09.035
M3 - Journal article
C2 - 39515548
SN - 1542-3565
VL - 23
SP - 1174-1182.e6
JO - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
IS - 7
ER -