{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:32:45Z","timestamp":1780317165288,"version":"3.54.1"},"reference-count":39,"publisher":"Baishideng Publishing Group Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Hepatol"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Fatigue is common and debilitating in primary biliary cholangitis (PBC) without clear relation to disease stage; mechanisms remain unclear. Circadian disruption is reported in end-stage liver disease, but evidence in non-cirrhotic PBC, and links to fatigue, is scarce.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To investigate the severity and phenotype of fatigue, daytime sleepiness, and chronotype in non-cirrhotic PBC, and compare findings with matched healthy controls (HC) and non-cirrhotic primary sclerosing cholangitis (PSC).<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>Participants completed the Fatigue Impact Scale, Epworth Sleepiness Scale, and Morningness-Eveningness Questionnaire Self-Assessment. Demographics, sleep habits, employment, and fatigue subtype (mental vs  muscular) were recorded. In PBC\/PSC, PBC-40 fatigue\/itch domains and disease characteristics were analyzed. Group comparisons and multivariable models evaluated associations of fatigue phenotype and chronotype with demographic\/disease variables.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>We enrolled 152 individuals: 61 PBC, 30 PSC, and 61 HC. Global fatigue scores did not differ across groups. Muscular fatigue predominated in PBC\/PSC, whereas HC more often reported mental fatigue; this pattern persisted after stratifying by employment and sex. In adjusted analyses, HC had lower odds of muscular fatigue than PBC [odd ratio (OR) = 0.30, 95% confidence interval (CI): 0.14-0.63; P  = 0.002]; PSC did not differ from PBC (OR = 1.25, 95%CI: 0.44-3.71; P  = 0.681). Older age independently increased the odds of muscular fatigue (OR = 1.04 per year, 95%CI: 1.01-1.07; P  = 0.016). Daytime sleepiness was low and similar between groups. Morningness-Eveningness Questionnaire Self-Assessment scores clustered in the intermediate range; age, not disease, predicted greater morningness.<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>In non-cirrhotic PBC, fatigue shows a predominantly muscular phenotype independent of demographics\/occupation and decoupled from conventional disease metrics. Chronotype and daytime alertness appear largely preserved, with age driving modest morningness. Findings support integrating fatigue phenotyping into assessment, prioritizing muscle-targeted interventions, and using carefully selected controls and objective endpoints in future studies.<\/jats:p>","DOI":"10.4254\/wjh.v18.i2.114206","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T02:36:03Z","timestamp":1770863763000},"source":"Crossref","is-referenced-by-count":1,"title":["Fatigue and circadian rhythm in non-cirrhotic primary biliary cholangitis: An exploratory comparison with primary sclerosing cholangitis and healthy controls"],"prefix":"10.4254","volume":"18","author":[{"given":"Armando","family":"Curto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Tanturli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco 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