Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Nutrients. 2019 Feb 2;11(2):322. doi: 10.3390/nu11020322.
The relevance of sleep patterns in the onset or evolution of nonalcoholic fatty liver disease (NAFLD) is still poorly understood. Our aim was to investigate the association between sleep characteristics and hepatic status indicators in obese people with NAFLD compared to normal weight non-NAFLD controls. Ninety-four overweight or obese patients with NAFLD and 40 non-NAFLD normal weight controls assessed by abdominal ultrasonography were enrolled. Hepatic status evaluation considered liver stiffness determined by Acoustic Radiation Force Impulse elastography (ARFI) and transaminases. Additionally, anthropometric measurements, clinical characteristics, and biochemical profiles were determined. Sleep features were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Hepatic status parameters, anthropometric measurements, and clinical and biochemical markers differed significantly in NAFLD subjects compared to controls, as well as sleep efficiency, sleep disturbance score, and sleep quality score. In the NAFLD group, a higher prevalence of short sleep duration ( = 0.005) and poor sleep quality ( = 0.041) were found. Multivariate-adjusted odds ratio (95% confidence interval) for NAFLD considering sleep disturbance was 1.59 (1.11⁻2.28). Regression models that included either sleep disturbance or sleep quality predicted up to 20.3% and 20.4% of the variability of liver stiffness, respectively, and after adjusting for potential confounders. Current findings suggest that sleep disruption may be contributing to the pathogenesis of NAFLD as well as the alteration of the liver may be affecting sleep patterns. Consequently, sleep characteristics may be added to the list of modifiable behaviors to consider in health promotion strategies and in the prevention and management of NAFLD.
睡眠模式与非酒精性脂肪性肝病（NAFLD）发病或进展的相关性仍知之甚少。我们的目的是研究与正常体重非 NAFLD 对照组相比，肥胖的 NAFLD 患者的睡眠特征与肝状态指标之间的关系。共纳入 94 名经腹部超声检查诊断为超重或肥胖的 NAFLD 患者和 40 名非 NAFLD 正常体重对照组。肝状态评估包括通过声辐射力脉冲弹性成像（ARFI）测定的肝硬度和转氨酶。此外，还测定了人体测量学测量值、临床特征和生化特征。使用匹兹堡睡眠质量指数（PSQI）评估睡眠特征。NAFLD 患者的肝状态参数、人体测量学测量值和临床及生化标志物与对照组有显著差异，此外，睡眠效率、睡眠障碍评分和睡眠质量评分也有显著差异。在 NAFLD 组中，发现短睡眠时间（ = 0.005）和睡眠质量差（ = 0.041）的患病率较高。考虑到睡眠障碍，NAFLD 的多变量调整后比值比（95%置信区间）为 1.59（1.11⁻2.28）。纳入睡眠障碍或睡眠质量的回归模型分别可以预测肝硬度的 20.3%和 20.4%的变异性，并且在调整了潜在混杂因素后也是如此。目前的研究结果表明，睡眠中断可能是 NAFLD 发病机制的原因之一，而肝脏的改变也可能影响睡眠模式。因此，睡眠特征可以添加到可改变行为列表中，以考虑在健康促进策略以及 NAFLD 的预防和管理中。
