Hepatology internationalJun 18, 2024

Sleep patterns, genetic risk, and chances of liver scarring in people with fatty liver disease

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 31, 2026

Abstract

A total of 592 incident cirrhosis cases were documented among 112,196 NAFLD participants.

Healthy sleep patterns are associated with a reduced risk of cirrhosis in a dose-response manner.
Participants with a favourable sleep score have a hazard ratio of 0.55 for cirrhosis risk compared to those with an unfavourable score.
Multivariable-adjusted hazard ratios indicate that lack of frequent insomnia, sleeping 7-8 hours per day, and absence of excessive daytime dozing behaviors are linked to lower cirrhosis incidence.
Individuals with unfavourable sleep patterns and high genetic risk may experience a higher risk of cirrhosis, with a hazard ratio of 3.16 compared to those with favourable sleep patterns and low genetic risk.
A significant interaction exists between chronotype and genetic risk concerning cirrhosis incidence.

Simplified

BACKGROUND: The associations between sleep patterns or behaviors and the risk of cirrhosis and the influence of genetic susceptibility on these associations among NAFLD participants remain inadequately elucidated.

METHODS: This study conducted a prospective follow-up of 112,196 NAFLD participants diagnosed at baseline from the UK Biobank cohort study. Five sleep behaviors were collected to measure a healthy sleep score. Five genetic variants were used to construct a polygenic risk score. We used Cox proportional hazard model to assess hazard ratios (HR) and 95% confidence intervals (CIs) for incidence of cirrhosis.

RESULTS: During the follow-up, 592 incident cirrhosis cases were documented. Healthy sleep pattern was associated with reduced risk of cirrhosis in a dose-response manner (p < 0.001). Participants with favourable sleep score (versus unfavourable sleep score) had an HR of 0.55 for cirrhosis risk (95% CI 0.39-0.78). Multivariable-adjusted HRs (95% CIs) of cirrhosis incidence for NAFLDs with no frequent insomnia, sleeping for 7-8 h per day, and no excessive daytime dozing behaviors were 0.73 (0.61-0.87), 0.79 (0.66-0.93), and 0.69 (0.50-0.95), respectively. Compared with participants with favourable sleep pattern and low genetic risk, those with unfavourable sleep pattern and high genetic risk had higher risks of cirrhosis incidence (HR 3.16, 95% CI 1.88-5.33). In addition, a significant interaction between chronotype and genetic risk was detected for the incidence of cirrhosis (p for multiplicative interaction = 0.004). trend

CONCLUSION: An association was observed between healthy sleep pattern and decreased risk of cirrhosis among NAFLD participants, regardless of low or high genetic risk.

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Sleep patterns, genetic risk, and chances of liver scarring in people with fatty liver disease

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