基于 2017-2018 年全国健康与营养调查的结果，成年人中睡眠障碍和糖尿病与代谢功能障碍相关的脂肪性肝病和肝纤维化之间的相互作用。

Interaction between trouble sleeping and diabetes on metabolic dysfunction-associated fatty liver disease and liver fibrosis in adults results from the National Health and Nutrition Examination Survey 2017-2018.

机构信息

Department of Oncology, Zibo Central Hospital, Zibo, Shandong, China.

出版信息

Eur J Gastroenterol Hepatol. 2024 Dec 1;36(12):1437-1446. doi: 10.1097/MEG.0000000000002860. Epub 2024 Sep 27.

DOI:10.1097/MEG.0000000000002860

PMID:39373628

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11527372/

Abstract

BACKGROUND

Metabolic dysfunction-associated fatty liver disease (MAFLD), trouble sleeping, and diabetes, as major public health problems, were closely related. The study examined the interaction between trouble sleeping and diabetes on MAFLD and liver fibrosis in adults with MAFLD.

METHODS

The data were obtained from the National Health and Nutrition Examination Survey 2017-2018. Multivariate logistic regression model and subgroup analyses were conducted to assess the relationship between either trouble sleeping or diabetes on MAFLD and liver fibrosis. Relative excess risk due to interaction (RERI), attributable proportion of interaction (AP), and synergy index (S) were utilized to assess the additive interaction.

RESULTS

Ultimately, 3747 participants were included, with 2229 known MAFLD subjects. Compared with participants without diabetes, those with diabetes had a higher risk of MAFLD [odds ratio (OR) = 5.55; 95% confidence interval (CI) = 4.07-7.56] and liver fibrosis risk (OR = 3.61; 95% CI = 2.67-4.89). We also found a significant association of trouble sleeping with an increased risk of MAFLD (OR = 1.54; 95% CI = 1.17-2.02) and liver fibrosis risk (OR = 1.51; 95% CI = 1.06-2.16), compared with those without trouble sleeping. Moreover, there was a significant interaction between diabetes and trouble sleeping on MAFLD [RERI = 1.76 (95% CI: -0.22 to 3.73), AP = 0.35 (95% CI: 0.08-0.63), S = 1.80 (95% CI: 1.02-3.16)] and liver fibrosis risk [RERI = 1.79 (95% CI: 0.37-3.21), AP = 0.44 (95% CI: 0.20-0.69), S = 2.44 (95% CI: 1.18-5.08)].

CONCLUSION

The findings highlight that trouble sleeping and diabetes had a synergistic effect on MAFLD and liver cirrhosis. The study highlights the importance of addressing both trouble sleeping and diabetes management in adults to mitigate the risk of MAFLD and liver fibrosis.

摘要

背景

代谢相关脂肪性肝病（MAFLD）、睡眠障碍和糖尿病是三大公共卫生问题，它们之间存在密切关联。本研究旨在探讨睡眠障碍和糖尿病与 MAFLD 及其肝纤维化之间的交互作用。

方法

数据来源于 2017-2018 年全国健康与营养调查。采用多变量逻辑回归模型和亚组分析评估睡眠障碍或糖尿病与 MAFLD 及 MAFLD 患者肝纤维化之间的关系。应用相对 excess risk due to interaction（RERI）、attributable proportion of interaction（AP）和 synergy index（S）评估相加交互作用。

结果

最终纳入 3747 名参与者，其中 2229 名为 MAFLD 已知患者。与无糖尿病者相比，糖尿病患者 MAFLD（比值比[OR] = 5.55；95%置信区间[CI] = 4.07-7.56）和肝纤维化风险（OR = 3.61；95%CI = 2.67-4.89）更高。此外，我们还发现与无睡眠障碍者相比，睡眠障碍者 MAFLD（OR = 1.54；95%CI = 1.17-2.02）和肝纤维化风险（OR = 1.51；95%CI = 1.06-2.16）风险更高。此外，糖尿病和睡眠障碍对 MAFLD（RERI = 1.76；95%CI：-0.22 至 3.73）和肝纤维化风险（RERI = 1.79；95%CI：0.37 至 3.21）均存在显著交互作用（AP = 0.35；95%CI = 0.08-0.63；S = 1.80；95%CI = 1.02-3.16）和 S = 2.44；95%CI = 1.18-5.08）。