Royse Kathryn E, El-Serag Hashem B, Chen Liang, White Donna L, Hale Lauren, Sangi-Haghpeykar Haleh, Jiao Li
1 Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine , Houston, Texas.
2 Center for Innovations in Quality, Effectiveness and Safety (iQuEST), Michael E. DeBakey VA Medical Center , Houston, Texas.
J Womens Health (Larchmt). 2017 Dec;26(12):1270-1277. doi: 10.1089/jwh.2017.6412. Epub 2017 Sep 21.
Sleep duration has been associated with nonalcoholic fatty liver disease, but its association with liver cancer remains unknown.
In the prospective Women's Health Initiative Study, 139,368 postmenopausal women reported sleep habits at baseline (1993-1998). We ascertained 175 incident liver cancer cases during an average 13.8 years of follow-up through August 2014. We used multivariable Cox proportional hazard regression models to estimate a hazard ratio (HR) and its 95% confidence interval (95% CI) for risk of liver cancer in association with nocturnal sleep duration.
Compared to women reporting 6-8 hours of sleep, the HR for liver cancer was 1.94 (95% CI 1.07-3.53) for women reporting ≥9 hours of sleep. Among the obese women, the HR associated with ≥9 hours of sleep was 3.18 (95% CI 1.84-8.60). The HR was 0.93 (95% CI 0.34-2.53) among nonobese women (p value for interaction = 0.18). Short sleep duration (≤5 hours) was not associated with liver cancer risk.
Long sleep duration was associated with a moderate increase in liver cancer risk in obese postmenopausal women in the United States. Larger study is needed to confirm our observation on effect modification by adiposity status.
睡眠时间与非酒精性脂肪性肝病有关，但其与肝癌的关联尚不清楚。
在前瞻性的女性健康倡议研究中，139368名绝经后女性在基线时（1993 - 1998年）报告了睡眠习惯。在截至2014年8月的平均13.8年随访期间，我们确定了175例新发肝癌病例。我们使用多变量Cox比例风险回归模型来估计夜间睡眠时间与肝癌风险相关的风险比（HR）及其95%置信区间（95%CI）。
与报告睡眠6 - 8小时的女性相比，报告睡眠≥9小时的女性患肝癌的HR为1.94（95%CI 1.07 - 3.53）。在肥胖女性中，与睡眠≥9小时相关的HR为3.18（95%CI 1.84 - 8.60）。在非肥胖女性中，HR为0.93（95%CI 0.34 - 2.53）（交互作用p值 = 0.18）。短睡眠时间（≤5小时）与肝癌风险无关。
在美国肥胖绝经后女性中，长睡眠时间与肝癌风险适度增加有关。需要更大规模的研究来证实我们关于肥胖状态对效应修饰作用的观察结果。
