Associations between Longer Habitual Day Napping and Non-Alcoholic Fatty Liver Disease in an Elderly Chinese Population

Abstract

ContextBoth longer habitual day napping and Non-Alcoholic Fatty Liver Disease (NAFLD) are associated with diabetes and inflammation, but the association between day napping and NAFLD remains unexplored.ObjectiveTo investigate the association between the duration of habitual day napping and NAFLD in an elderly Chinese population and to gain insight into the role of inflammatory cytokines in this association.Design and SettingWe conducted a series of cross-sectional studies of the community population in Chongqing, China, from 2011 to 2012.ParticipantsAmong 6998 participants aged 40 to 75 years, 6438 eligible participants were included in the first study and analyzed to observe the association between day napping duration and NAFLD. In a separate study, 80 non-nappers and 90 nappers were selected to identify the role of inflammatory cytokines in this association. Logistic regression models were used to examine the odds ratios (ORs) of day nap duration with NAFLD.ResultsDay nappers had a significantly higher prevalence of NAFLD (P<0.001). Longer day napping duration was associated in a dose-dependent manner with NAFLD (P trend <0.001). After adjustment for potential confounders, the ORs were 1.67 (95% CI 1.13–2.46) for those reporting 0.5–1 h and 1.49 (95% CI 1.01–2.19) for those reporting >1 h of day napping compared with individuals who did not take day naps (all P<0.05). Longer-duration day nappers had higher levels of IL-6 and progranulin (PGRN) but lower levels of Secreted frizzled-related protein-5 (SFRP5, all P trend <0.001). After adjusting for IL-6, PGRN, and SFRP5, the association between day napping duration and NAFLD disappeared (all P>0.05).ConclusionLonger day napping duration is associated with a higher prevalence of NAFLD, and inflammatory cytokines may be an essential link between day napping and NAFLD.

Short sleep duration and longer daytime napping are associated with non‐alcoholic fatty liver disease in Chinese adults

“…A longer daytime nap duration (>0.5 h) was significantly associated with a higher risk of prevalent NAFLD. A similar study by Qu et al reported the same finding . In that study, the diagnostic criterion for NAFLD primarily depended on an FLI >60.…”

“…A similar study by Qu et al reported the same finding. 34 In that study, the diagnostic criterion for NAFLD primarily depended on an FLI >60. However, approximately 30% of patients have indeterminate results for the diagnosis of NAFLD, with an FLI score between cut-off values (i.e.…”

Exercising the hepatobiliary‐gut axis. The impact of physical activity performance

“…53 A sedentary behaviour might act as an independent risk factor for NAFLD 54 and lower levels of physical activity are found in patients with NAFLD. 57 Maintenance of ideal weight or weight loss in overweight/obese patients via lifestyle interventions has become an established strategy also to prevent or treat NAFLD, 52,58,59 although the goal might be difficult to achieve in the ambulatory care setting. 57 Maintenance of ideal weight or weight loss in overweight/obese patients via lifestyle interventions has become an established strategy also to prevent or treat NAFLD, 52,58,59 although the goal might be difficult to achieve in the ambulatory care setting.…”

“…55,56 Also, reduced physical activity such as longer habitual day napping was independently associated with NAFLD. 57 Maintenance of ideal weight or weight loss in overweight/obese patients via lifestyle interventions has become an established strategy also to prevent or treat NAFLD, 52,58,59 although the goal might be difficult to achieve in the ambulatory care setting. 60 Reducing weight by ≥10% can contribute to the nonalcoholic steatohepatitis (NASH) resolution and fibrosis improvement, while a modest weight loss >5%-7% also produces important benefits on the components of the NAFLD activity score.…”

Daytime napping and mortality from all causes, cardiovascular disease, and cancer: a meta-analysis of prospective cohort studies

“…Recently, daytime napping has been linked with a series of adverse health outcomes, including nonalcoholic fatty liver disease [10], diabetes mellitus [2,11], breast cancer [12], and mortality [9,13]. The napping-mortality association has received significant attention, but it remains controversial.…”