Sleep duration, sleep quality, and the development of nonalcoholic fatty liver disease: A cohort study
Sleep duration, sleep quality, and the development of nonalcoholic fatty liver disease: A cohort study
INTRODUCTION: The longitudinal relationship between sleep duration, sleep quality, and the risk of nonalcoholic fatty liver disease (NAFLD) is unknown. We aimed to examine the association between sleep duration, sleep quality, and NAFLD development.
METHODS: Using the Pittsburgh Sleep Quality Index, sleep duration and quality were evaluated for 143,306 NAFLD-free Korean adults with a mean age of 36.6 years, who were followed for an average of 4.0 years. Hepatic steatosis (HS) was assessed using ultrasonography and liver fibrosis by the fibrosis-4 index (FIB-4) or the NAFLD fibrosis score. Flexible parametric proportional hazard models were used to determine the hazard ratios (HRs) and 95% confidence intervals.
RESULTS: There were 27,817 subjects with incident HS, of whom 1,471 had incident HS plus intermediate/high FIB-4. Multivariable-adjusted HRs (95% confidence intervals) for incident HS comparing sleep durations of ≤5, 6, 8, and ≥ 9 hours with 7 hours were 1.19 (1.14-1.23), 1.07 (1.04-1.10), 0.98 (0.94-1.02), and 0.95 (0.87-1.03), respectively. The corresponding HRs for incident HS plus intermediate/high FIB-4 were 1.30 (1.11-1.54), 1.14 (1.01-1.29), 1.11 (0.93-1.33), and 1.08 (0.71-1.63). The association between sleep duration and HS plus intermediate/high FIB-4 was inverse in individuals with good sleep quality but tended to be U-shaped in those with poor sleep quality. The results were similar if FIB-4 was replaced by the NAFLD fibrosis score.
DISCUSSION: In young adults, short sleep duration was independently associated with an increased risk of incident NAFLD with or without intermediate/high fibrosis score, suggesting a role for inadequate sleep quantity in NAFLD risk and severity.
e00417
Um, Yoo Jin
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Chang, Yoosoo
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Jung, Hyun-Suk
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Cho, In Young
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Shin, Jun Ho
557c7ccb-2683-48f1-a685-16605928d451
Shin, Hocheol
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Wild, Sarah H
3b9da54e-590d-42b2-89a1-5ee51c2a13d8
Byrne, Christopher D
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
ddfbdb4c-9de6-4ee9-8998-99dcd3518928
19 October 2021
Um, Yoo Jin
a71037f3-3df5-4d12-b6ac-024b953785fd
Chang, Yoosoo
db82bb32-e10a-4c23-9e05-6cddfe994bc9
Jung, Hyun-Suk
ea0ea170-5a79-451c-9d97-2acabdb62c6c
Cho, In Young
ef542a37-77f9-429d-b163-00b602d81c80
Shin, Jun Ho
557c7ccb-2683-48f1-a685-16605928d451
Shin, Hocheol
ea92c4f3-0494-4cc6-bf10-750c3d52d0bc
Wild, Sarah H
3b9da54e-590d-42b2-89a1-5ee51c2a13d8
Byrne, Christopher D
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
ddfbdb4c-9de6-4ee9-8998-99dcd3518928
Um, Yoo Jin, Chang, Yoosoo, Jung, Hyun-Suk, Cho, In Young, Shin, Jun Ho, Shin, Hocheol, Wild, Sarah H, Byrne, Christopher D and Ryu, Seungho
(2021)
Sleep duration, sleep quality, and the development of nonalcoholic fatty liver disease: A cohort study.
Clinical and Translational Gastroenterology, 12 (10), .
(doi:10.14309/ctg.0000000000000417).
Abstract
INTRODUCTION: The longitudinal relationship between sleep duration, sleep quality, and the risk of nonalcoholic fatty liver disease (NAFLD) is unknown. We aimed to examine the association between sleep duration, sleep quality, and NAFLD development.
METHODS: Using the Pittsburgh Sleep Quality Index, sleep duration and quality were evaluated for 143,306 NAFLD-free Korean adults with a mean age of 36.6 years, who were followed for an average of 4.0 years. Hepatic steatosis (HS) was assessed using ultrasonography and liver fibrosis by the fibrosis-4 index (FIB-4) or the NAFLD fibrosis score. Flexible parametric proportional hazard models were used to determine the hazard ratios (HRs) and 95% confidence intervals.
RESULTS: There were 27,817 subjects with incident HS, of whom 1,471 had incident HS plus intermediate/high FIB-4. Multivariable-adjusted HRs (95% confidence intervals) for incident HS comparing sleep durations of ≤5, 6, 8, and ≥ 9 hours with 7 hours were 1.19 (1.14-1.23), 1.07 (1.04-1.10), 0.98 (0.94-1.02), and 0.95 (0.87-1.03), respectively. The corresponding HRs for incident HS plus intermediate/high FIB-4 were 1.30 (1.11-1.54), 1.14 (1.01-1.29), 1.11 (0.93-1.33), and 1.08 (0.71-1.63). The association between sleep duration and HS plus intermediate/high FIB-4 was inverse in individuals with good sleep quality but tended to be U-shaped in those with poor sleep quality. The results were similar if FIB-4 was replaced by the NAFLD fibrosis score.
DISCUSSION: In young adults, short sleep duration was independently associated with an increased risk of incident NAFLD with or without intermediate/high fibrosis score, suggesting a role for inadequate sleep quantity in NAFLD risk and severity.
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Sleep_Duration,_Sleep_Quality,_and_the_Development.14
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Accepted/In Press date: 22 August 2021
Published date: 19 October 2021
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Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.
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Local EPrints ID: 452301
URI: http://eprints.soton.ac.uk/id/eprint/452301
ISSN: 2155-384X
PURE UUID: 9df7915c-73b0-4c31-8f75-2f82b93b9668
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Date deposited: 06 Dec 2021 17:34
Last modified: 17 Mar 2024 02:49
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Author:
Yoo Jin Um
Author:
Yoosoo Chang
Author:
Hyun-Suk Jung
Author:
In Young Cho
Author:
Jun Ho Shin
Author:
Hocheol Shin
Author:
Sarah H Wild
Author:
Seungho Ryu
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