Performance of chronic liver disease questionnaire-metabolic dysfunction-associated steatohepatitis (CLDQ-MASH) against non-invasive tests
Recommended Citation
Younossi Z, Yilmaz Y, Yu M, El-Kassas M, Fernández MI, Eguchi Y, Papatheodoridis G, Wai-Sun Wong V, Duseja AK, Singal AK, Hamid SS, Bugianesi E, Isakov V, Romero-Gómez M, Chan W, Alswat KA, Fan J, Gordon SC, Roberts S, George J, Méndez-Sánchez N, Keklikkiran C, Tcaciuc E, Andrei R, Lam B, Henry L, Racila A, Stepanova M, Alqahtani S. Performance of chronic liver disease questionnaire-metabolic dysfunction-associated steatohepatitis (CLDQ-MASH) against non-invasive tests. J Hepatol 2025; 82:S681-S682.
Document Type
Conference Proceeding
Publication Date
5-1-2025
Publication Title
J Hepatol
Abstract
Background and aims: Patients with more advanced histologic fibrosis due to metabolic dysfunction-associated steatotic liver disease (MASLD) can experience health-related quality of life (HRQL) impairment. Most HRQL instruments that have been validated in MASLD were evaluated against liver biopsy. However, non-invasive tests (NITs) are increasingly being used in clinical practice and clinical research. Our aim was to assess correlations of NIT scores with HRQL scores using a newly validated HRQL instrument for MASH (Chronic Liver Disease Questionnaire – Metabolic Dysfunction-Associated Steatohepatitis, CLDQ-MASH). Method: The data from MASLD MASH patients enrolled in the Global NASH MASH Registry were used, including NIT scores (FIB-4, Enhanced Liver Function or ELF, liver stiffness measurement (LSM) by transient elastography) and HRQL assessed by the CLDQ-MASH (7 domains) instrument. The NIT cutoff values with the strongest association (the greatest effect size) with the total CLDQ-MASH score were identified. Results: There were 8504 MASLD patients with NIT and HRQL data included: mean (SD) age 54 (12) years, 45% male, 62% obesity (BMI > 30), 50% type 2 diabetes, FIB-4 score 1.59 (1.25), ELF score 10.0 (1.0), LSM 12.4 (10.2) kPa. All studied NITs were significantly negatively correlated with Activity (correlation coefficient (r) −0.04 to −0.12), Fatigue (r = −0.04 to −0.06), Sleep (r = −0.04 to −0.05), and Systemic symptoms (r = −0.06 to −0.11) domains of CLDQ-MASH; FIB-4 and LSM were additionally correlated with Worry (r = −0.08 to −0.13), and LSM with Digestive symptoms (r = −0.07) domain scores (all p < 0.01). For FIB-4, the cutoff with the strongest association with HRQL was 1.60 (34% of the sample met the cutoff ); as a result, patients with FIB-4 ≥ 1.60 had significantly lower HRQL scores in 5 7 domains of CLDQ-MASH including Activity, Fatigue, Sleep, Systemic symptoms, and Worry (mean score impairment up to −0.23 on a 1–7 scale, p < 0.0001) while the domains of Digestive symptoms and Emotional health were not associated with FIB-4 at any cutoff (all p > 0.05). For ELF, the cutoff for the strongest association with HRQL was 10.8 (met by 22%): MASLD patients who met the cutoff had lower scores in all 7 domains of CLDQ-MASH (score impairment up to − 0.37, all p < 0.01). For LSM, the cutoff with the greatest effect size for association with HRQL was 26.5 kPa (met by 7%): in patients who met the cutoff, all CLDQ-MASH scores were significantly lower by up to −0.57 (all p < 0.01). Conclusion: NIT scores in MASLD correlate negatively with HRQL as assessed by CLDQ-MASH. This indicates that higher NIT scores consistent with higher disease severity correlate with more HRQL impairment. The NIT cutoffs commonly used for the diagnosis of advanced fibrosis return the strongest association with HRQL impairment in MASLD. This suggests that CLDQ-MASH can be used in conjunction with NITs in clinical research in MASH MASLD.
Volume
82
First Page
S681
Last Page
S682
