Interaction between trouble sleeping and diabetes on metabolic dysfunction-associated fatty liver disease and liver fibrosis in adults results from the National Health and Nutrition Examination Survey 2017-2018.

IF 2.3 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY European Journal of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2024-09-27 DOI:10.1097/MEG.0000000000002860

Cui Zhang, Lili Cao, Bo Xu, Wei Zhang

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Abstract

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD), trouble sleeping, and diabetes, as major public health problems, were closely related. The study examined the interaction between trouble sleeping and diabetes on MAFLD and liver fibrosis in adults with MAFLD.

Methods: The data were obtained from the National Health and Nutrition Examination Survey 2017-2018. Multivariate logistic regression model and subgroup analyses were conducted to assess the relationship between either trouble sleeping or diabetes on MAFLD and liver fibrosis. Relative excess risk due to interaction (RERI), attributable proportion of interaction (AP), and synergy index (S) were utilized to assess the additive interaction.

Results: Ultimately, 3747 participants were included, with 2229 known MAFLD subjects. Compared with participants without diabetes, those with diabetes had a higher risk of MAFLD [odds ratio (OR) = 5.55; 95% confidence interval (CI) = 4.07-7.56] and liver fibrosis risk (OR = 3.61; 95% CI = 2.67-4.89). We also found a significant association of trouble sleeping with an increased risk of MAFLD (OR = 1.54; 95% CI = 1.17-2.02) and liver fibrosis risk (OR = 1.51; 95% CI = 1.06-2.16), compared with those without trouble sleeping. Moreover, there was a significant interaction between diabetes and trouble sleeping on MAFLD [RERI = 1.76 (95% CI: -0.22 to 3.73), AP = 0.35 (95% CI: 0.08-0.63), S = 1.80 (95% CI: 1.02-3.16)] and liver fibrosis risk [RERI = 1.79 (95% CI: 0.37-3.21), AP = 0.44 (95% CI: 0.20-0.69), S = 2.44 (95% CI: 1.18-5.08)].

Conclusion: The findings highlight that trouble sleeping and diabetes had a synergistic effect on MAFLD and liver cirrhosis. The study highlights the importance of addressing both trouble sleeping and diabetes management in adults to mitigate the risk of MAFLD and liver fibrosis.

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2017-2018年全国健康与营养调查结果显示，睡眠困难与糖尿病对成人代谢功能障碍相关性脂肪肝和肝纤维化的相互影响。

背景：代谢功能障碍相关性脂肪肝（MAFLD）、睡眠障碍和糖尿病作为主要的公共健康问题，三者密切相关。本研究探讨了失眠和糖尿病对成人代谢功能障碍相关性脂肪肝和肝纤维化的相互影响：数据来自2017-2018年全国健康与营养调查。进行多变量逻辑回归模型和亚组分析，以评估睡眠障碍或糖尿病对MAFLD和肝纤维化的关系。利用相互作用导致的相对超额风险（RERI）、相互作用的可归因比例（AP）和协同指数（S）来评估相加相互作用：最终纳入了 3747 名参与者，其中有 2229 名已知的 MAFLD 受试者。与非糖尿病患者相比，糖尿病患者的 MAFLD 风险更高[比值比 (OR) = 5.55；95% 置信区间 (CI) = 4.07-7.56]，肝纤维化风险更高（OR = 3.61；95% CI = 2.67-4.89）。我们还发现，与没有睡眠障碍的人相比，睡眠障碍与 MAFLD 风险增加（OR = 1.54；95% CI = 1.17-2.02）和肝纤维化风险增加（OR = 1.51；95% CI = 1.06-2.16）有明显关联。此外，糖尿病和失眠对 MAFLD 有明显的交互作用[RERI = 1.76 (95% CI: -0.22 to 3.73)，AP = 0.35 (95% CI: 0.08-0. 63)，S = 1.80]。63），S = 1.80（95% CI：1.02-3.16）]和肝纤维化风险[RERI = 1.79（95% CI：0.37-3.21），AP = 0.44（95% CI：0.20-0.69），S = 2.44（95% CI：1.18-5.08）]：研究结果表明，睡眠障碍和糖尿病对 MAFLD 和肝硬化有协同作用。该研究强调了解决成人睡眠障碍和糖尿病管理问题以降低MAFLD和肝纤维化风险的重要性。

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来源期刊

European Journal of Gastroenterology & Hepatology 医学-胃肠肝病学

CiteScore

4.40

自引率

4.80%

发文量

269

审稿时长

1 months

期刊介绍： European Journal of Gastroenterology & Hepatology publishes papers reporting original clinical and scientific research which are of a high standard and which contribute to the advancement of knowledge in the field of gastroenterology and hepatology. The journal publishes three types of manuscript: in-depth reviews (by invitation only), full papers and case reports. Manuscripts submitted to the journal will be accepted on the understanding that the author has not previously submitted the paper to another journal or had the material published elsewhere. Authors are asked to disclose any affiliations, including financial, consultant, or institutional associations, that might lead to bias or a conflict of interest.