Date of Award
1-1-2024
Document Type
Open Access Thesis
Degree Name
Medical Doctor (MD)
Department
Medicine
First Advisor
Vikas Gupta
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) and resultant steatohepatitis (MASH) have been linked to psychiatric comorbidities. The treatment of MASLD/MASH primarily relies upon weight loss, where achieving a 7% total body weight loss is recommended to improve steatohepatitis. We aimed to determine whether likelihood of achieving a 7% total body weight loss (TBWL) in MASLD/MASH patients was significantly different in the presence of a mood and/or anxiety disorder in an interdisciplinary clinic that integrates weight management and hepatology care.We conducted a single center retrospective cohort study of MASLD/MASH patients segregated into those with an ICD-10 diagnosis of a mood and/or anxiety disorder to those without. The primary outcome was reaching a 7% TBWL at 12 months, with univariable and multivariable logistic regression models used to identify treatments predicting a 7% TBWL. Secondary outcomes were noninvasive assessment of steatohepatitis improvement, including change in ALT and fibrosis-4 (FIB-4) scores. Of 567 patients with MASLD/MASH, 366 (64.6%) had a mood and/or anxiety disorder. The presence of psychiatric disease was not a significant predictor of achieving 7% TBWL. There were no significant differences in secondary outcomes between the group of patients with an ICD-10 diagnosis of a mood and/or anxiety disorder compared to those without. Significant predictors of achieving 7% TBWL at 12 months among all patients with MASLD/MASH included semaglutide, phentermine-topiramate, and bariatric surgery. Significant predictors of achieving 7% TBWL at 12 months in patients with MASLD/MASH and a psychiatric comorbidity included semaglutide, topiramate, phentermine- topiramate, and bariatric surgery. Both groups experienced similar improvements in hepatic outcomes. Our findings suggest that obesity management in patients with MASLD/MASH performs similarly in the presence of comorbid mood and/or anxiety disorders. Topiramate and phentermine may be particularly effective in this patient population, yet are underutilized in hepatology practices.
Recommended Citation
Bollinger, Bryan, "The Presence Of Mood And/or Anxiety Disorders Does Not Affect Success Of Weight Management Therapies In Metabolic Dysfunction- Associated Steatotic Liver Disease" (2024). Yale Medicine Thesis Digital Library. 4299.
https://elischolar.library.yale.edu/ymtdl/4299
