Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Metabolic Liver Disease Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany.
Nutrients. 2023 Jul 23;15(14):3257. doi: 10.3390/nu15143257.
Late chronotype, the individual's aptitude to perform daily activities late in the day, has been associated with low adherence to the Mediterranean diet (MedDiet) and metabolic syndrome. The aim of this work was to investigate the potential association of chronotype and adherence to the MedDiet with the liver fibrosis risk in patients with non-alcoholic fatty liver disease (NAFLD). Liver stiffness was assessed in 126 patients by FibroScan530. Significant (F ≥ 2) and advanced (F ≥ 3) hepatic fibrosis were defined according to liver stiffness values ≥7.1 kPa and ≥8.8 kPa, respectively. Chronotype (MSFsc) was defined by the Munich Chronotype Questionnaire, and adherence to the MedDiet was defined by the Mediterranean diet score (MDS). Overall, the median age was 55 (46-63) years, and 57.9% of participants were male. The principal comorbidities were type-2 diabetes mellitus (T2DM) (26.1%), arterial hypertension (53.1%), dyslipidaemia (63.4%), obstructive sleep apnoea (5.5%) and depression (5.5%). Most subjects (65.0%) had intermediate + late chronotype and showed higher mid-sleep on workdays ( < 0.001) and on work-free days ( < 0.001) compared to those with early chronotype. In the logistic regression model, intermediate + late chronotype ( = 0.024), MDS ( = 0.019) and T2DM ( = 0.004) were found to be significantly and independently associated with the risk of both F ≥ 2 And F ≥ 3. We observed that the intermediate + late chronotype and low adherence to the MedDiet were associated with both significant and advanced liver fibrosis in patients with NAFLD.
晚型，即个体在一天中较晚的时候进行日常活动的能力，与地中海饮食（MedDiet）和代谢综合征的低依从性有关。本研究旨在探讨个体的时间型与地中海饮食的依从性与非酒精性脂肪性肝病（NAFLD）患者肝纤维化风险的潜在关联。通过 FibroScan530 评估了 126 例患者的肝硬度。根据肝硬度值≥7.1kPa 和≥8.8kPa 分别定义显著（F≥2）和晚期（F≥3）肝纤维化。采用慕尼黑时间型问卷（Munich Chronotype Questionnaire）定义时间型（MSFsc），采用地中海饮食评分（Mediterranean diet score，MDS）定义地中海饮食的依从性。患者的中位年龄为 55（46-63）岁，57.9%为男性。主要合并症包括 2 型糖尿病（T2DM）（26.1%）、动脉高血压（53.1%）、血脂异常（63.4%）、阻塞性睡眠呼吸暂停（5.5%）和抑郁（5.5%）。大多数患者（65.0%）为中间+晚型，与早型相比，工作日（ < 0.001）和非工作日（ < 0.001）的中位入睡时间较晚。在逻辑回归模型中，中间+晚型（ = 0.024）、MDS（ = 0.019）和 T2DM（ = 0.004）与 F≥2 和 F≥3 的风险显著独立相关。我们发现，中间+晚型和地中海饮食依从性低与 NAFLD 患者的显著和晚期肝纤维化均有关。
