Circadian Misalignment Rather Than Sleep Duration is Associated with MAFLD: A Population-Based Propensity Score-Matched Study

Abstract

Background and Aims Circadian misalignment (CM) leads to metabolic disorder. Metabolic (dysfunction) associated fatty liver disease (MAFLD) is a novel definition for fatty liver disease that requires the presence of metabolic dysfunction. As the association between CM and MAFLD remains unclear, this study is designed to explore whether there is an association between CM and MAFLD. Methods NHANES 2017–2018 database was used in this study. Liver steatosis and fibrosis were diagnosed by Fibroscan ® . CM was defined by the presence of mistimed sleep, late sleep or irregular chronotype. Propensity score matching (PSM) was used to match subjects for their age and gender. Results A total of 4552 participants were included in the study, with 2089 (45.89%) identified as MAFLD and 894 (19.64%) as CM. Participants with CM were significantly younger than those without (46.06 ± 18.06 vs 50.93 ± 17.78, p<0.001). PSM for age and gender resulted in 894 participants with CM and 892 with non-CM. CM group had higher body mass index, liver enzymes, glucose and lipid levels. The prevalence of MAFLD was higher in the CM group than the non-CM group (45.41% vs 28.48%, p<0.001). The presence of CM increased the risk of MAFLD by more than twofold. Short sleep duration (<6 hours) was not independently associated with MAFLD or fibrosis if additionally adjusting for CM. Conclusion CM is independently associated with MAFLD, while short sleep duration (<6 hours) is not an independent risk factor for MAFLD or liver fibrosis after adjusting for CM.

Association of Serum Vitamin C With NAFLD and MAFLD Among Adults in the United States

“…MAFLD was defined on the basis of steatosis with at least one of the following conditions: (i) body mass index (BMI) ≥ 25 kg/m 2 ; (ii) type 2 diabetes which was defined as having a self-reported history of diagnosis with type 2 diabetes or glycohemoglobin ≥ 6.5% (22); (iii) at least 2 of metabolic risk abnormalities below, which included: (i) waist circumference ≥88 cm for women and ≥102 cm for men, (ii) high blood pressure (≥130/85 mmHg) or drug treatment for hypertension, (iii) plasma triglycerides ≥1.70 mmol/L or drug treatment for hyperglyceridemia, (iv) plasma HDL-cholesterol <1.0 mmol/L for men and <1.3 mmol/L for women or drug treatment for hypercholesterolemia, (v) prediabetes (fasting glucose 5.6-6.9 mmol/L or hemoglobin A1c 5.7-6.4%, (vi) homeostasis model assessment of insulin resistance score ≥2.5, and (vii) plasma high sensitivity C-reactive protein (CRP) level >2 mg/L (3,23). Significant LF and LC were defined as LSM ≥ 6.3 KPa (fibrosis grade ≥ F1) and LSM ≥ 12.5 KPa (fibrosis grade ≥ F4), respectively (19,24).…”

Association of Cholecystectomy With Liver Fibrosis and Cirrhosis Among Adults in the USA: A Population-Based Propensity Score-Matched Study

“…Moreover, LF was defined as F0-F4, with the cutoff values of median liver stiffness (LSM) being 6.3, 8.3, 10.5 and 12.5 (KPa), respectively (16). Furthermore, Significant LF and LC was defined as LSM ≥ 6.3 KPa (fibrosis grade ≥ F1) and LSM ≥ 12.5 KPa (fibrosis grade ≥ F4), respectively (16,17). levels, Body Mass Index (BMI), and the poverty income ratio were also evaluated through interviews.…”

Which Is More Important for Health: Sleep Quantity or Sleep Quality?

“…Disturbance of sleep phase has been known to be associated with chronotype [ 78 ]. Chronotype is reported to be associated with sleepiness [ 79 ], sleep-onset duration and sleep efficiency during the first two years of life [ 80 ], and metabolic dysfunction [ 81 , 82 ]. Timing of sleep and chronotype are also important issues to be investigated in terms of both private and public health.…”