Gerber LH, Weinstein AA, Mehta R, Younossi ZM. Importance of fatigue and its measurement in chronic liver disease. World J Gastroenterol 2019; 25(28): 3669-3683 [PMID: 31391765 DOI: 10.3748/wjg.v25.i28.3669]
Corresponding Author of This Article
Lynn H Gerber, MD, Professor, Department of Medicine, Fairfax Medical Campus, Inova Health System, 3300 Gallows Rd, Falls Church, VA 22042, United States. ngerber1@gmu.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jul 28, 2019; 25(28): 3669-3683 Published online Jul 28, 2019. doi: 10.3748/wjg.v25.i28.3669
Importance of fatigue and its measurement in chronic liver disease
Lynn H Gerber, Ali A Weinstein, Rohini Mehta, Zobair M Younossi
Lynn H Gerber, Zobair M Younossi, Department of Medicine, Beatty Center for Liver and Obesity Research, Inova Health System, Falls Church, VA 22042, United States
Ali A Weinstein, Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA 22030, United States
Rohini Mehta, Beatty Center for Liver and Obesity Research, Inova Health System, Falls Church, VA 22042, United States
Author contributions: Gerber LH, Weinstein AA and Younossi ZM participated in the conceptualization of the paper; Gerber LH, Weinstein AA and Rohini M drafted the manuscript; Gerber LH, Weinstein AA, Rohini M and Younossi ZM edited and finalized the manuscript.
Conflict-of-interest statement: Authors have no conflict of interest to disclose.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Lynn H Gerber, MD, Professor, Department of Medicine, Fairfax Medical Campus, Inova Health System, 3300 Gallows Rd, Falls Church, VA 22042, United States. ngerber1@gmu.edu
Telephone: +1-703-7764027 Fax: +1-703-7764388
Received: April 6, 2019 Peer-review started: April 8, 2019 First decision: May 30, 2019 Revised: June 10, 2019 Accepted: June 22, 2019 Article in press: June 23, 2019 Published online: July 28, 2019
Core Tip
Core tip: Fatigue is prevalent, persistent and complex in people with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. Fatigue can be analyzed in terms of peripheral and central fatigue, increasing precision of evaluation while elucidating causes and improving treatment. The liver is central to the pathogenesis of fatigue, which in our view, is dependent upon energy regulation. Biosignatures for fatigue are being tested that reflect metabolic and inflammatory pathways of relevance. Non-pharmacological treatments including weight loss, aerobic and resistance exercise are effective in treating fatigue in non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. Pharmacological agents to date have not been shown to have a significant/reliable effect in reducing fatigue.
