Zong Guannan, Mao Wangjia, Wen Ming, Cheng Xiaoyun, Liu Guanghui
Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Ann Hepatol. 2024 Sep 12;30(2):101583. doi: 10.1016/j.aohep.2024.101583.
The impact of sleep on metabolic dysfunction-associated steatotic liver disease (MASLD) in American adults remains unclear. This study aimed to address the relationship of sleep patterns and disorders with MASLD and liver fibrosis comprehensively.
This cross-sectional study included adult participants from the National Health and Nutrition Examination Survey 2017-2020. Multivariate adjusted regression analysis were used to examine the association of sleep with MASLD and liver fibrosis. We further addressed these associations using restricted cubic splines, mediation analysis, stratified analysis and multiple sensitivity analysis.
We enrolled 5368 participants. Certain sleep disorders, sleep duration, high sleep debt and specific sleep-wake time were associated with MASLD. Late workday sleep was a shared risk factor for MASLD and liver fibrosis. Short sleep on workdays and free days favored MASLD, whereas average weekly long sleep protected against MASLD. Workday, free day and average weekly optimal sleep duration was 7.5 h, 8 h and 7.78 h, respectively. Mediation analysis suggested that fasting glucose and high-density lipoprotein cholesterol indirectly mediated the relationship between sleep duration and MASLD, whereas stratified analysis showed that sex influenced the relationship, and that the correlation was only observed in women and specific age groups.
Sleep duration independently affected MASLD but only in women and specific age groups. Moreover, late sleep on workdays was a shared risk factor for MASLD and liver fibrosis. These results suggest targeting sleep behaviors for MASLD prevention and developing age- and sex-specific strategies.
睡眠对美国成年人代谢功能障碍相关脂肪性肝病（MASLD）的影响尚不清楚。本研究旨在全面探讨睡眠模式和睡眠障碍与MASLD及肝纤维化之间的关系。
这项横断面研究纳入了2017 - 2020年国家健康与营养检查调查中的成年参与者。采用多变量调整回归分析来检验睡眠与MASLD及肝纤维化之间的关联。我们还使用受限立方样条、中介分析、分层分析和多重敏感性分析来探讨这些关联。
我们纳入了5368名参与者。某些睡眠障碍、睡眠时间、高睡眠债和特定的睡眠 - 觉醒时间与MASLD相关。工作日晚睡是MASLD和肝纤维化的共同危险因素。工作日和休息日睡眠短有利于MASLD的发生，而平均每周睡眠时间长则可预防MASLD。工作日、休息日和平均每周的最佳睡眠时间分别为7.5小时、8小时和7.78小时。中介分析表明，空腹血糖和高密度脂蛋白胆固醇间接介导了睡眠时间与MASLD之间的关系，而分层分析显示性别影响这种关系，且这种相关性仅在女性和特定年龄组中观察到。
睡眠时间独立影响MASLD，但仅在女性和特定年龄组中如此。此外，工作日晚睡是MASLD和肝纤维化的共同危险因素。这些结果表明，针对睡眠行为预防MASLD以及制定针对年龄和性别的策略具有重要意义。
