School of Medicine, Nankai University, Tianjin 300071, China.
Big Data Center for Children's Medical Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China.
Prev Med. 2024 Oct;187:108116. doi: 10.1016/j.ypmed.2024.108116. Epub 2024 Aug 18.
While short sleep duration is linked to higher risk of non-alcoholic fatty liver disease (NAFLD), the combined effects of sleep timing and sleep duration on NAFLD are less explored.
In this cross-sectional study of 39,471 participants from Beijing-Tianjin-Hebei region of China, self-reported sleep information and ultrasonography-diagnosed NAFLD were obtained from Jan 2018 to Jan 2020. Sleep timing was categorized based on sleep midpoint: early-type (before 2:00 AM), intermediate-type (2:00-2:30 AM), and late-type (after 2:30 AM). We used multivariable logistic regression to explore the relationship between sleep timing, duration, and NAFLD. We analyzed sleep midpoint and duration categorically and continuously, and conducted stratification analyses by age, sex, body mass index, hypertension, diabetes, and dyslipidemia.
Intermediate-type (OR: 1.15, 95% confidence interval: 1.05-1.26) and late-type sleep timing (OR: 1.08, 1.00-1.16) were associated with higher NAFLD risk compared to early-type. Additionally, longer sleep duration was linked to lower risk (OR: 0.92, 0.90-0.95 per hour increase). Notably, intermediate to late-type sleepers with normal sleep duration (7 to <8 h) exhibited a 20% higher NAFLD risk compared to early-type sleepers with the same duration (OR: 1.20, 1.04-1.39). The increased NAFLD risk associated with intermediate to late sleep timing was particularly evident in men, hypertension, and prediabetes or diabetes participants.
Intermediate to late sleep timing, even with normal sleep duration, is associated with increased NAFLD risk. These findings underscore the importance of considering both sleep timing and sleep duration for NAFLD prevention, especially in men and individuals with cardiometabolic conditions.
尽管睡眠时间短与非酒精性脂肪性肝病（NAFLD）的风险增加有关，但睡眠时间和睡眠时间对 NAFLD 的综合影响尚未得到充分探索。
本研究在北京-天津-河北地区进行了一项横断面研究，共纳入了 39471 名参与者，于 2018 年 1 月至 2020 年 1 月期间收集了他们的睡眠信息和超声诊断的 NAFLD 数据。根据睡眠中点将睡眠时间分为三类：早睡型（凌晨 2 点之前）、中睡型（凌晨 2 点至 2 点 30 分）和晚睡型（凌晨 2 点 30 分之后）。我们使用多变量逻辑回归模型来探讨睡眠时间、时长与 NAFLD 之间的关系。我们分别对睡眠中点和时长进行了分类和连续分析，并按年龄、性别、体重指数、高血压、糖尿病和血脂异常进行了分层分析。
与早睡型相比，中睡型（比值比 [OR]：1.15，95%置信区间 [CI]：1.05-1.26）和晚睡型（OR：1.08，1.00-1.16）与更高的 NAFLD 风险相关。此外，睡眠时间较长与较低的风险相关（每增加 1 小时，OR：0.92，0.90-0.95）。值得注意的是，中睡型至晚睡型且睡眠时间正常（7 至＜8 小时）的人群与具有相同睡眠时间的早睡型人群相比，NAFLD 风险增加了 20%（OR：1.20，1.04-1.39）。中睡型至晚睡型睡眠与 NAFLD 风险增加之间的关联在男性、高血压以及糖尿病前期或糖尿病患者中尤为明显。
即使睡眠时间正常，中睡型至晚睡型的睡眠时间也与 NAFLD 风险增加相关。这些发现强调了考虑睡眠时间和睡眠时长来预防 NAFLD 的重要性，尤其是在男性和存在心血管代谢疾病的人群中。
