CONTEXT
Accumulating evidence implies that sleep disturbance is involved in metabolic disorders.
OBJECTIVE
We comprehensively evaluated the association between various dimensions of sleep behaviors and the risk for metabolic-dysfunction associated fatty liver disease (MAFLD).
METHODS
In this cross-sectional study of 5,011 participants with self-reported sleep behaviors and radiologically diagnosed MAFLD, a comprehensive healthy sleep score was generated to evaluate the associations between sleep behaviors and MAFLD risk using multivariate logistic regression adjusting for demographics, lifestyles, medication and metabolic comorbidities. Furthermore, mediation analysis was utilized to assess to which extent obesity explain the effect of sleep quality on MAFLD risk.
RESULTS
Late bedtime, snoring and daytime napping for over 30 minutes significantly associated with increased risks of MAFLD, with odds ratios [OR] (95%CI) of 1.37 (1.10-1.70), 1.59 (1.33-1.91), and 1.17 (1.02-1.35), respectively after full adjustments including obesity. Participants with disturbance in nighttime sleep and prolonged daytime napping showed the highest risk for MAFLD (OR=2.38, 95%CI:1.73-3.27). Each additional increase of healthy sleep score was associated with a 16% reduction in MAFLD risk. Further stratified analysis revealed that people with a sedentary lifestyle and central obesity experienced more prominent adverse effects from poor sleep quality than others. Moreover, obesity accounted for only 20.77% of the total effect of sleep quality on MAFLD risk.
CONCLUSIONS
Sleep behaviors, both cumulatively and individually, are associated with MAFLD risk. Public health awareness and strategies should be encouraged to curb MAFLD.