Association between Circadian Dissonance and MAFLD in employed adults: a longitudinal study in Southwestern China

Abstract

Objectives: Circadian system is an essential physiological regulator of mammals, and circadian dissonance may be associated with the risk of metabolic disorders. However, evidence regarding its role in the development of metabolic-associated fatty liver disease (MAFLD) is scarce, particularly in employed adults. Methods: We conducted a longitudinal study of 1,309 employed adults in Southwestern China with a five-year follow-up from 2017 to 2021. MAFLD was assessed by the presence of hepatic steatosis using abdominal ultrasonography,overweight/obese status, diabetes mellitus, metabolic dysregulation, or elevation of high-sensitivity C-reactive protein. Circadian dissonance was assessed by the sleep chronotype questionnaire. The logistic random effects model was applied to analyze the 5-year panel data to estimate the association between circadian dissonance and MAFLD, and the potential effect modification of demographics on such association. Results: The MAFLD prevalence of participants was 38.7% at baseline and showed an increasing trend during follow-up (p for trends <0.001). We observed that severe circadian dissonance was positively associated with MAFLD (OR: 1.75, 95% CI: 1.09, 2.81). Participants who were minority had a higher risk of developing MAFLD (OR: 2.83, 95% CI: 1.09, 7.33), and those who had an undergraduate education or above had a lower risk (OR: 0.60, 95% CI: 0.40, 0.90). Participants’ follow-up year (OR: 1.81, 95% CI: 1.70, 1.94), higher level of AST (OR: 1.01, 95% CI: 1.01, 1.02),and higher level of ALT (OR: 1.03, 95% CI: 1.02, 1.03) were positively associated with the risk of MAFLD. Conclusions: Severe circadian dissonance may increase the odds of MAFLD in employed adults. Improving circadian rhythms could reduce the risk of MAFLD and increase life expectancy among employed adults.