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. 2021 Jan 6:4:100081.
doi: 10.1016/j.jtauto.2021.100081. eCollection 2021.

Quality of life in patients with primary biliary cholangitis: A cross-geographical comparison

Lorenzo Montali  1 , Andrea Gragnano  1 , Massimo Miglioretti  1 , Alessandra Frigerio  1 , Luca Vecchio  1 , Alessio Gerussi  2   3 , Laura Cristoferi  2   3 , Vincenzo Ronca  2   3 , Daphne D'Amato  2   3 , Sarah Elizabeth O'Donnell  2   3 , Clara Mancuso  2   3 , Martina Lucà  2   3 , Minami Yagi  4 , Anna Reig  5 , Laura Jopson  6 , Sesé Pilar  5 , Dave Jones  6 , Albert Pares  5 , George Mells  7 , Atsushi Tanaka  4 , Marco Carbone  2   3 , Pietro Invernizzi  2   3
Affiliations

Quality of life in patients with primary biliary cholangitis: A cross-geographical comparison

Lorenzo Montali et al. J Transl Autoimmun. .

Abstract

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.

Keywords: Autoimmunity; Cholestasis; Fatigue; Liver.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Graphical counterpart of the equation of the model used in the CFAs for PBC-27 in the present study. The latent factors are free to co-vary.
Fig. 2
Fig. 2
Estimated means for Cognition (above), Emotion (in the middle) and Other symptoms (below) in the four countries at 69 and 54 years of age adjusted for albumin, alkaline phosphatase, alanine aminotransferase and bilirubin.
Fig. 3
Fig. 3
Distribution of the level of Itch (left) and Social (right) with the results of the post hoc comparisons. Note: groups that do not share a letter are significantly different.
See this image and copyright information in PMC

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