Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
Gastroenterology, Watari Hospital, Fukushima, Japan.
BMJ Open. 2020 Oct 29;10(10):e039947. doi: 10.1136/bmjopen-2020-039947.
The effects of sleep quality on the risk of developing non-alcoholic fatty liver disease (NAFLD) remain uncertain. The purpose of this study was to clarify the association between sleep quality and NAFLD.
The data of 4828 participants who underwent health check-ups at four hospitals were analysed. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), which comprised seven elements scored from 0 to 3. The global PSQI score and the score for each element were compared between NAFLD and non-NAFLD groups separately by sex. Logistic regression analysis was performed to determine the association between NAFLD and each PSQI score.
In both men and women, the mean PSQI score for sleep medication use was significantly higher in non-NAFLD than in NAFLD. With regard to sleep medication use in men, the OR (95% CI) for NAFLD was lower with a score of 3 (OR 0.60, 95% CI 0.38-0.95) than with a score of 0 on multivariate logistic regression analysis adjusted for age, smoking habits and physical activity. The OR for NAFLD based on daytime dysfunction was also higher with a score of 3 than with a score of 0 in both men (OR 2.82, 95% CI 1.39-5.75) and women (OR 2.08, 95% CI 1.10-3.92). After adjustment for body mass index, the sleep latency scores in men and daytime dysfunction in women were associated with NAFLD.
Sleep quality was associated with NAFLD, and there were sex differences.
睡眠质量对非酒精性脂肪性肝病（NAFLD）发病风险的影响尚不确定。本研究旨在阐明睡眠质量与 NAFLD 之间的关系。
对在 4 家医院进行健康检查的 4828 名参与者的数据进行了分析。采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量，该指数由 7 个元素组成，评分范围为 0 至 3。分别按性别比较 NAFLD 组和非 NAFLD 组之间 PSQI 总分和各元素评分。采用 logistic 回归分析确定 PSQI 评分与 NAFLD 之间的关系。
在男性和女性中，非 NAFLD 组的睡眠药物使用 PSQI 评分均显著高于 NAFLD 组。就男性的睡眠药物使用而言，多变量 logistic 回归分析调整年龄、吸烟习惯和体力活动后，PSQI 评分 3 分（OR 0.60，95%CI 0.38-0.95）的 NAFLD 比值低于 PSQI 评分 0 分（OR 0.60，95%CI 0.38-0.95）。基于日间功能障碍的 NAFLD 比值也随着男性（OR 2.82，95%CI 1.39-5.75）和女性（OR 2.08，95%CI 1.10-3.92）PSQI 评分 3 分高于 PSQI 评分 0 分而升高。调整体重指数后，男性的睡眠潜伏期评分和女性的日间功能障碍与 NAFLD 相关。
睡眠质量与 NAFLD 相关，且存在性别差异。
