Sleep duration and quality in relation to non-alcoholic fatty liver disease in middle-aged workers and their spouses

Apr 13, 2013Journal of hepatology

Sleep length and quality linked to fatty liver disease in middle-aged workers and their spouses

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Abstract

Men with short sleep duration (≤5 hours) have a 28% higher risk and women have a 71% higher risk of non-alcoholic fatty liver disease (NAFLD) compared to those sleeping more than 7 hours.

Short sleep duration is associated with an increased risk of NAFLD in middle-aged individuals.
In men, the odds of NAFLD rise significantly with sleep duration ≤5 hours compared to >7 hours, but this association is not significant after adjusting for body mass index.
Women show a sustained increased risk of NAFLD with short sleep duration even after adjusting for body mass index.
Poor sleep quality is linked to a higher likelihood of NAFLD, with men at a 10% increased risk and women at a 36% increased risk compared to those with good sleep quality.

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BACKGROUND & AIMS: Although accumulated evidence implies that short sleep duration and poor sleep quality may lead to an altered metabolic milieu, potentially triggering the development of non-alcoholic fatty liver disease (NAFLD), no studies have explored this association. This study sought to examine whether short sleep duration or poor sleep quality is associated with NAFLD in the general population.

METHODS: We assessed sleep duration and quality using the Pittsburgh Sleep Quality Index in 69,463 middle-aged workers and their spouses and carried out biochemical and anthropometric measurements. The presence of fatty liver was determined using ultrasonographic findings. Logistic regression models were used to evaluate the association of sleep duration and quality with NAFLD, after adjusting for potential confounders.

RESULTS: After controlling for the relevant confounding factors (age, alcohol intake, smoking, physical activity, systolic blood pressure, education level, marital status, presence of job, sleep apnea, and loud snoring), the adjusted odds ratio (95% confidence interval) for NAFLD comparing sleep duration ≤5 h to the reference (>7h) was 1.28 (1.13-1.44) in men and 1.71 (1.38-2.13) in women. After further adjustments for BMI, this association was not significant in men (OR: 1.03, 95% CI: 0.90-1.19) but remained significant in women (OR: 1.59, 95% CI: 1.23-2.05). The multivariate-adjusted odds ratio comparing participants with poor sleep quality vs. participants with good sleep quality was 1.10 (95% CI 1.02-1.19) and 1.36 (95% CI 1.17-1.59) in men and women, respectively.

CONCLUSIONS: In the middle-aged, general population, short sleep duration, and poor sleep quality were significantly associated with an increased risk of NAFLD. Prospective studies are required to confirm this association.

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Sleep duration and quality in relation to non-alcoholic fatty liver disease in middle-aged workers and their spouses

Abstract

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