每日睡眠时间与代谢功能障碍相关脂肪变性肝病和不良肝脏结局风险的关系

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2025-02-19 DOI:10.1016/j.diabet.2025.101628

Qian Wang , Huiyi Chen , Huiling Deng , Minyi Zhang , Haoyue Hu , Haotong Ouyang , Lien Ma , Ruiyan Liu , Jian Sun , Guifang Hu , Kaifeng Wang

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引用次数: 0

摘要

背景：代谢功能障碍相关脂肪变性肝病（MASLD）是世界范围内最常见的肝脏疾病，在全球范围内造成了巨大的疾病负担。睡眠时间是否与MASLD、肝硬化、肝细胞癌（HCC）和肝脏相关死亡率的风险相关仍未得到充分研究。方法：从英国生物样本库中共纳入489261名既往无肝脏疾病的中老年人。主要结局是MASLD，次要结局包括肝硬化、HCC和通过相关医院记录和死亡登记确定的肝脏相关死亡率。在基线调查中自我报告睡眠时间，分为≤5、6、7、8和≥9小时。结果：在13.8（1.5）年的中位（IQR）随访期间，确定了7133例MASLD， 5527例肝硬化，1126例HCC和1125例肝脏相关死亡病例。在调整潜在混杂因素后，睡眠时间≤5、6、7、8和≥9小时的MASLD的hr [95% ci]分别为1.44[1.32;1.57]、1.17[1.09;1.24]、1.00（参考文献）、1.05[0.99；1.11]和1.35[1.24;1.46]。在肝硬化、HCC和肝脏相关死亡率方面也观察到类似的趋势。此外，在没有异常体重指数（超重和肥胖）、高血压或失眠的参与者中，睡眠时间与MASLD之间的u型关联更为明显（P为相互作用）。结论：短睡眠时间和长睡眠时间都与MASLD、肝硬化、HCC和肝脏相关死亡率的风险增加有关。每天保持7至8小时的适度睡眠时间对于预防这种不断升级的公共卫生问题至关重要。

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Association of daily sleep duration with risk of metabolic dysfunction-associated steatotic liver disease and adverse liver outcomes

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide, leading to substantial disease burden globally. Whether sleep duration is associated with the risk of MASLD, cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality remains underexplored.

Methods

A total of 489,261 middle-aged and older adults from the UK Biobank without prior liver diseases were included. The primary outcome was MASLD, with secondary outcomes, including cirrhosis, HCC, and liver-related mortality ascertained through linked hospital records and death registries. Sleep duration was self-reported at baseline survey and categorized into ≤ 5, 6, 7, 8 and ≥ 9 hours.

Results

During a median (IQR) follow-up of 13.8 (1.5) years, 7,133 MASLD, 5,527 cirrhosis, 1,126 HCC, and 1,125 liver-related mortality cases were identified. After adjusting for potential confounders, the HRs [95% CIs] of MASLD were 1.44 [1.32;1.57], 1.17 [1.09;1.24], 1.00 (reference), 1.05 [0.99;1.11] and 1.35 [1.24;1.46] for ≤ 5, 6, 7, 8 and ≥ 9 hours of sleep duration, respectively. Similar trends were also observed for cirrhosis, HCC, and liver-related mortality. In addition, the U-shaped association between sleep duration and MASLD was more pronounced among participants without abnormal body mass index (overweight and obese), hypertension or insomnia (P for interaction <0.05).

Conclusions

Both short and long sleep duration are associated with an increased risk of MASLD, cirrhosis, HCC, and liver-related mortality. Maintaining a moderate sleep duration of 7 to 8 hours per day could be crucial to prevent against this escalating public health concern.

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.