MASLD severity tied to poor cognitive function, HRQoL in patients with obesity

Greater severity in metabolic dysfunction-associated steatotic liver disease (MASLD) may impair cognitive function and health-related quality of life (HRQoL) in patients with overweight or obesity, suggests a study.

The study included 601 overweight/obese patients MASLD and/or type 2 diabetes mellitus. The investigators assessed liver stiffness (LS) by transient elastography and steatosis by controlled attenuation parameter (CAP). They also evaluated cognitive function and HRQoL using the Repeatable Battery for the Assessment of Neuropsychological Status and SF-36 questionnaires.

MASLD-related comorbidities had a significant and clinical impact on cognitive function and HRQoL. Patients with severe steatosis (CAP ≥300 dB/m, n=378) had median cognitive scores dropping into the abnormal range (p=0.056).

Furthermore, statistically significant lower scores were noted in physical functioning (p<0.001), vitality (p=0.0011), general health (p=0.001), and immediate memory (p=0.034). A trend was also observed toward visuospatial/construction scores (p=0.058) lower than CAP <300 dB/m.

Significant or high LS (≥8 kPa, n=69) was associated with lower physical functioning (p<0.001), higher physical limitations (p=0.004), and worse general health (p=0.011) as opposed to low LS (<8 kPa).

Multivariate adjusted analyses revealed the significant association of CAP ≥300 dB/m with cognitive impairment (odds ratio [OR], 1.42, 95 percent confidence interval [CI], 1.0‒2.0; p=0.045), as well as the association between LS ≥8 kPa and higher physical limitations (OR, 1.9, 95 percent CI, 1.1‒3.2; p=0.019).

“Our findings highlight the relationship between MASLD severity and impairment in cognitive function and HRQoL, underscoring its multifactorial nature,” the investigators said.

“Specifically, severe hepatic steatosis may be a risk factor of cognitive decline, whereas significant or high LS seems to greatly affect HRQoL,” they added.