Stigma in steatotic liver disease: A survey of patients from Saudi Arabia

Bibliographic Details
Title:	Stigma in steatotic liver disease: A survey of patients from Saudi Arabia
Authors:	Saleh A. Alqahtani, Khalid Alswat, Mohamed Mawardi, Faisal M. Sanai, Faisal Abaakhail, Saad Alghamdi, Waleed K. Al-Hamoudi, Fatema Nader, Maria Stepanova, Zobair M. Younossi
Source:	The Saudi Journal of Gastroenterology, Vol 30, Iss 5, Pp 335-341 (2024)
Publisher Information:	Wolters Kluwer Medknow Publications, 2024.
Publication Year:	2024
Collection:	LCC:Diseases of the digestive system. Gastroenterology
Subject Terms:	fatty, nafld, sex, Diseases of the digestive system. Gastroenterology, RC799-869
More Details:	Background: A recent name change of nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated fatty liver disease (MAFLD) to metabolic dysfunction-associated steatotic liver disease was primarily driven by potential stigma associated with the terminology. This stigma can be different between patients and healthcare providers and differ according to geographic regions of the world. Our aim was to better understand stigma and disease burden among patients with NAFLD enrolled in the global survey from Saudi Arabia (SA). Methods: Members of the Global NASH Council created a 68-item survey about patients’ experience with NAFLD, covering history of stigmatization and discrimination due to the disease, various aspects of the disease burden [(Liver Disease Burden (LDB), 35 items, 7 domains], and perception of various diagnostic terms for NAFLD. Patients whose country of residence was SA were asked to complete the survey. Results: The survey was completed by 804 patients with NAFLD from SA. Of all enrolled patients, 17% ever disclosed having NAFLD/nonalcoholic steatohepatitis (NASH) to family/friends. The most commonly used term for the disease was “fatty liver” (96% used it at least sometimes, 79% frequently or always). There were 3.7% who reported experiencing stigma or discrimination (at least sometimes) due to obesity/overweight versus only 2.7% due to NAFLD. Female patients reported a history of stigmatization or discrimination more frequently than males: 5.9% versus 3.0% due to obesity (P = 0.06) and 5.4% versus 1.8% due to NAFLD (P = 0.01). There were 43% of patients who reported ever missing or avoiding a visit to a primary care provider due to NAFLD (48% male vs 28% female, P < 0.0001). The greatest social-emotional burden among patients with NAFLD (by LDB) was being or being identified as a person with liver disease (10% agree, 4% male vs 26% female) and feeling like they could not do anything about their liver disease (6.4% agree, 3% male vs 16% female). Regarding how patients perceived diagnostic terms, there were no substantial differences between “fatty liver disease”, “NAFLD”, “NASH”, and “MAFLD”. Conclusion: Stigmatization in terms of disease burden, disease-related stigma, and perception of various diagnostic terms are rarely observed in patients with NAFLD in SA. In comparison to male patients, female patients with NAFLD reported more commonly a history of stigmatization and discrimination and a significantly greater disease burden. The findings will help inform policymakers to develop programs to increase awareness and provide education about stigma related to NAFLD.
Document Type:	article
File Description:	electronic resource
Language:	English
ISSN:	1319-3767 1998-4049
Relation:	https://journals.lww.com/sjga/fulltext/2024/30050/stigma_in_steatotic_liver_disease__a_survey_of.9.aspx; https://doaj.org/toc/1319-3767; https://doaj.org/toc/1998-4049
DOI:	10.4103/sjg.sjg_122_24
Access URL:	https://doaj.org/article/828bc2bf207f48429acd48f959b18d93
Accession Number:	edsdoj.828bc2bf207f48429acd48f959b18d93
Database:	Directory of Open Access Journals
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More Details
ISSN:	13193767 19984049
DOI:	10.4103/sjg.sjg_122_24
Published in:	The Saudi Journal of Gastroenterology
Language:	English