{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:30:24Z","timestamp":1790281824415,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1S73421N"],"award-info":[{"award-number":["1S73421N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1802154N"],"award-info":[{"award-number":["1802154N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018216","name":"Ziekenhuis Oost-Limburg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018216","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Data on quality of life in a low fibrosis prevalence metabolic dysfunction\u2010associated steatotic liver disease (MASLD) cohort are scarce, as previous research has focused on advanced fibrosis and cirrhosis. This study examined the association between steatosis and general and mental health, as well as productivity in patients in primary care and a diabetes population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three cohort studies were conducted in Belgian and Dutch primary care and a Belgian hospital. Liver stiffness (&gt;\u200912\u2009kPa) and steatosis (&gt;\u2009275\u2009dB\/m) were measured using vibration\u2010controlled transient elastography and controlled attenuation parameter (CAP). Participants completed questionnaires measuring anxiety (GAD\u20107), depression (PHQ\u20109), work productivity (WPAI\u2010SHP), and general health (SF\u201036), and data were analysed with Spearman correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 311 participants, 142 (45.7%) and 15 (4.7%) had steatosis and fibrosis. Individuals with steatosis had a higher BMI (30.5\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      vs. 25.5\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), increased liver stiffness (5.7\u2009kPa vs. 4.6\u2009kPa,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), lower general health scores (SF\u201036,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and physical functioning (SF\u201036,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024) compared to those without. No significant differences were found for depression (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.955) or anxiety (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.557). Absenteeism was more prevalent in the steatosis group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), though the reasons for absenteeism were mostly unrelated to steatosis. Higher CAP values were negatively correlated with physical functioning (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.193,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), energy\/fatigue (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.112,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049), and general health (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.235,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in the total cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Steatosis does not appear to affect anxiety or depression, but does negatively affect general health perception and physical activity. Further investigation is needed to determine whether a potential relationship between work productivity and steatosis exists.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70604","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:21:15Z","timestamp":1773742875000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<scp>MASLD<\/scp>\n                    Is Associated With Decreased General Health Perception, Quality of Life and Work Productivity in a Low Fibrosis Population"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4850-6011","authenticated-orcid":false,"given":"L. J. M.","family":"Heyens","sequence":"first","affiliation":[{"name":"Faculty of Health and Life Sciences\/LCRC Hasselt University  Diepenbeek Belgium"},{"name":"School of Nutrition and Translational Research in Metabolism, NUTRIM Maastricht University  Maastricht the Netherlands"},{"name":"Department of Future Health, LCRC(\u2010MHU) Ziekenhuis Oost\u2010Limburg  Genk Belgium"},{"name":"Department of Gastroenterology Ziekenhuis Oost\u2010Limburg  Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Van Steenkiste","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology AZ Maria Middelares  Gent Belgium"},{"name":"Department of Gastroenterology and Hepatology Antwerp University Hospital  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Struyve","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ziekenhuis Oost\u2010Limburg  Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Francque","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Antwerp University Hospital  Antwerp Belgium"},{"name":"Laboratory of Experimental Medicine and Paediatrics University of Antwerp  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. H.","family":"Koek","sequence":"additional","affiliation":[{"name":"School of Nutrition and Translational Research in Metabolism, NUTRIM Maastricht University  Maastricht the Netherlands"},{"name":"Department of Gastroenterology and Hepatology Maastricht University Medical Centre\u2014MUMC+  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-5664","authenticated-orcid":false,"given":"G.","family":"Robaeys","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences\/LCRC Hasselt University  Diepenbeek Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the MASLD Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002484"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-021-01884-5"},{"issue":"4","key":"e_1_2_13_5_1","first-page":"384","article-title":"Non\u2010Alcoholic Fatty Liver Disease: A Clinical Update","volume":"5","author":"Pappachan J. 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