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Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey.

ABSTRACT: BACKGROUND:The effects of sleep quality on the risk of developing non-alcoholic fatty liver disease (NAFLD) remain uncertain. The purpose of this study was to clarify the association between sleep quality and NAFLD. METHODS:The data of 4828 participants who underwent health check-ups at four hospitals were analysed. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), which comprised seven elements scored from 0 to 3. The global PSQI score and the score for each element were compared between NAFLD and non-NAFLD groups separately by sex. Logistic regression analysis was performed to determine the association between NAFLD and each PSQI score. RESULTS:In both men and women, the mean PSQI score for sleep medication use was significantly higher in non-NAFLD than in NAFLD. With regard to sleep medication use in men, the OR (95% CI) for NAFLD was lower with a score of 3 (OR 0.60, 95%?CI 0.38-0.95) than with a score of 0 on multivariate logistic regression analysis adjusted for age, smoking habits and physical activity. The OR for NAFLD based on daytime dysfunction was also higher with a score of 3 than with a score of 0 in both men (OR 2.82, 95%?CI 1.39-5.75) and women (OR 2.08, 95%?CI 1.10-3.92). After adjustment for body mass index, the sleep latency scores in men and daytime dysfunction in women were associated with NAFLD. CONCLUSION:Sleep quality was associated with NAFLD, and there were sex differences.

SUBMITTER: Takahashi A

PROVIDER: S-EPMC7597499 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey.

Takahashi Atsushi A Anzai Yukio Y Kuroda Masahito M Kokubun Masae M Kondo Yuichiro Y Ogata Takashi T Fujita Masashi M Hayashi Manabu M Imaizumi Hiromichi H Abe Kazumichi K Tanji Nobuo N Ohira Hiromasa H

BMJ open 20201029 10

<h4>Background</h4>The effects of sleep quality on the risk of developing non-alcoholic fatty liver disease (NAFLD) remain uncertain. The purpose of this study was to clarify the association between sleep quality and NAFLD.<h4>Methods</h4>The data of 4828 participants who underwent health check-ups at four hospitals were analysed. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), which comprised seven elements scored from 0 to 3. The global PSQI score and the score for ea ...[more]

PMID: 33122322

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Project description:OBJECTIVE:Non-alcoholic fatty liver disease (NAFLD) is a major public health burden in China, and its prevalence is increasing. This study aimed to determine the risk factors and biomarkers of NAFLD. DESIGN:An observational cross-sectional primary survey. SETTING:Central China. PARTICIPANTS:The study included 1479 participants aged over 18 and below 80 years, not currently being treated for cancer or infectious disease or no surgery in the previous year, and no history of cancer or an infectious disease. Participants underwent clinical examination, metabolomic assay and anthropometric assessment. Univariate and logistic regression analyses were used to evaluate associations between covariates and NAFLD. MAIN OUTCOME MEASURES:Risk factors and metabolic biomarkers including sex, body mass index, hypertension, body fat ratio, blood triglycerides, blood fasting glucose, liver enzyme elevation, uric acid and oleic acid-hydroxy oleic acid (OAHOA). RESULTS:Data from the 447 participants (mean age 44.3±11.9 years) were analysed, and the prevalence of NAFLD was 24.7%. Male sex (OR 3.484, 95%?CI 2.028 to 5.988), body mass index ?24?kg/m2 (OR 8.494, 95%?CI 5.581 to 12.928), body fat ratio (?25 for women, ?20 for men) (OR 1.833, 95%?CI 1.286 to 2.756), triglycerides ?1.7?mmol/L (OR 1.340, 95%?CI 1.006 to 1.785), fasting glucose ?6.1?mmol/L (OR 3.324, 95%?CI 1.888 to 5.850), blood pressure ?140/90?mm Hg or antihypertensive drug treatment (OR 1.451, 95%?CI 1.069 to 1.970), uric acid (?357 ?mol/L for women, ?416 ?mol/L for men) (OR 2.755, 95%?CI 2.009 to 3.778) and OAHOA (<5?nmol/L) (OR 1.340, 95%?CI 1.006 to 1.785) were independent predictors of NAFLD (all P<0.05). These results were verified by all 1479 participants. CONCLUSIONS:NAFLD was common among the study participants. In particular, NAFLD was correlated with uric acid. We identified OAHOA as a novel marker of NAFLD prevalence. It provides a reference on the prevention of NAFLD and related metabolic diseases with the rapid urbanisation, technological advancement and population ageing in China over the recent decades.

Project description:Background and aims: Non-invasive tests (NITs) are needed in clinical practice to replace histology for the identification of liver fibrosis and prognostication in Non-Alcoholic Fatty Liver Disease (NAFLD). Novel collagen-derived fibrogenesis markers including N-terminal type III collagen pro-peptide (PRO-C3) are among the most promising tools in this field. The aim of this study was to assess the diagnostic accuracy of PRO-C3, the derivative ADAPT score, and other NITs for the identification of advanced fibrosis (stages 3-4) and changes over 12 months of follow-up. Methods: In this longitudinal study, 96 patients with biopsy-proven NAFLD were evaluated at baseline, of which 50 underwent a follow-up visit after 12 months. Clinical-biochemical parameters, liver stiffness (LS) by transient elastography, PRO-C3, and other NITs (ADAPT, FIB-4, NFS, APRI) were collected at baseline and follow-up. Results: LS showed the best accuracy for the identification of advanced fibrosis, with Area under the Receiving Operator Curve (AUROC) 0.82 (0.73-0.89) for a cut-off value of 9.4 kPa. Among the other NITs, the ADAPT score showed the best accuracy, with AUROC 0.80 (0.71-0.88) for a cut-off of 5.02 (Se 62%, Sp 89%, PPV 74%, NPV 83%). The comparison between the AUROC of LS with that of ADAPT was not statistically different (DeLong test p value 0.348). At follow-up, LS was slightly reduced, whilst PRO-C3 displayed a significant increase from baseline median 11.2 ng/mL to 13.9 ng/mL at follow-up (p = 0.017). Accordingly, ADAPT score increased from median 5.3 to 6.1 (p = 0.019). The other NITs did not significantly change over 12 months. Conclusions: The ADAPT score shows the best performance among non-invasive scores for the identification of advanced fibrosis, not different from LS. Collagen-derived biomarker PRO-C3 and the derivative score ADAPT display significant changes over time, and may be useful tools for monitoring the progression of liver disease or assessing responses to treatments.

Project description:BackgroundNon-alcoholic fatty liver disease (NAFLD) is the commonest cause of liver disease worldwide and is the hepatic manifestation of metabolic syndrome. Effects of NAFLD on pregnancy is still unclear with few studies showing an association to gestational diabetes and pre-eclampsia. We aimed to describe the association between the NAFLD and pregnancy complications. This is the first study, to our knowledge, in a South Asian population.MethodA cross sectional analytical study was done in Teaching Hospital, Ragama, Sri Lanka. Women carrying a singleton pregnancy, admitted for delivery were assessed for NAFLD with liver ultrasound scan. Data were extracted from interviewer administered questionnaire and antenatal and inpatient records. Pregnancy complications and labour outcomes were compared between the women with NAFLD and women without NAFLD (non-NAFLD).ResultsOut of the 573 women who participated, 18.2% (n = 104) were found to have NAFLD. Out of them, 58 (55.8%), 32(30.8%), and 14(13.5%) had fatty liver grade 1,2 and 3 respectively. Women with NAFLD were 2 times more likely to develop gestational hypertension and pre-eclampsia compared to the women in the non-NAFLD group, after adjusting for BMI, age and Hyperglycaemia in pregnancy [Adjusted OR 2.09, (95% CI 1.07-4.10)]. There was no association between the grade of steatosis and a composite outcome of gestational hypertension and pre-eclampsia, within the NAFLD group. Composite outcome of gestational diabetes mellitus and diabetes in pregnancy diagnosed during pregnancy was a significant complication in the NAFLD group compared to non-NAFLD group in the bivariate analysis (27.2% vs 17.7%; p<0.05), but the significance disappeared after adjusting for confounders. The current study did not demonstrate a significant association between NAFLD with preterm labour, caesarean section rate, low birth weight, and Apgar score of the baby.ConclusionWomen with NAFLD had a 2-fold higher risk of developing gestational hypertension and pre-eclampsia during pregnancy compared to women without NAFLD, after controlling for other confounding variables.

Dataset Information

Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey.

Publications

Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey.

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