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Quality of life in patients with primary biliary cholangitis: A cross-geographical comparison
J Transl Autoimmun. 2021 Jan 6;4:100081. doi: 10.1016/j.jtauto.2021.100081. eCollection 2021.
Lorenzo Montali1, Andrea Gragnano1, Massimo Miglioretti1, Alessandra Frigerio1, Luca Vecchio1, Alessio Gerussi23, Laura Cristoferi23, Vincenzo Ronca23, Daphne D'Amato23, Sarah Elizabeth O'Donnell23, Clara Mancuso23, Martina Lucà23, Minami Yagi4, Anna Reig5, Laura Jopson6, Sesé Pilar5, Dave Jones6, Albert Pares5, George Mells7, Atsushi Tanaka4, Marco Carbone23, Pietro Invernizzi23
1Department of Psychology, University of Milan Bicocca, Milan, Italy.
2Division of Gastroenterology, Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy.
3European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy.
4Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
5Liver Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain.
6Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK.
7Department of Medical Genetics, University of Cambridge, Cambridge, UK.
Background & aims: Several symptoms impair the quality of life (QoL) of patients with primary biliary cholangitis (PBC). They are reported to vary significantly in different countries. Aim of our study was to explore whether there is a geographical clustering that accounts for symptoms in PBC.
Methods: Data was analysed from four cohorts of PBC patients from the UK, Spain, Japan and Italy using the PBC-27 scale.
Results: Overall, 569 patients from four cohorts were identified, including 515 females (90.5%) with a mean age of 61 years. The analysis provided evidence for strict factorial invariance of the scale, a robust indicator of its validity for cross-cultural research. The mean of the fatigue domain of British patients was significantly greater than that of the Japanese (p ?< ?0.05), Italian (p ?< ?0.05), and Spanish patients (p ?< ?0.001). The mean of the cognitive domain after 54 years of age, was significantly greater in the British patients than in the Japanese (p ?< ?0.05) and Spanish patients (p ?< ?0.01). However, after 69 years of age, there were not significant differences between countries. The mean of the emotion domain after 54 years of age, was greater in the British that in the Spanish (p ?< ?0.01) and Italian patients (p ?< ?0.01).
Conclusions: Differences in the four countries concerning fatigue, cognitive and emotional dysfunction were found. The association of latitude and symptoms might provide new insights into the role of sun exposure, genetics and/or cultural component into disease phenotype in PBC.