1. In this cross-sectional study, the association between sleep time and hepatic steatosis index (HSI) was dependent on body mass index (BMI).
2. However, analyses showed that sleep time may explain 39% of the relationship between body fat distribution and HSI.
Evidence Rating Level: 3 (Average)
It is well known that sleep is a factor associated with adiposity in young people, as inadequate sleep time is associated with an increasing risk of developing overweight or obesity. Overweight and obesity pose health threats, not least of which is non-alcoholic fatty liver disease (NAFLD), which is a leading cause of liver disease in pediatric populations. However, there is limited research into the role that sleep may have on the development of liver disease in young people. Therefore, this study aimed to assess the interplay between sleep, overweight and obesity, and liver disease in children and adolescents.
This cross-sectional study included 854 children and adolescents who participated in a previous longitudinal study. Participants were included if they were 2-18 years old and had overweight or obesity, according to body mass index (BMI) criteria outlined in the International Obesity Task Force. BMI, body circumference, waist circumference, blood pressure, and body fat distribution were assessed. Blood tests were used to evaluate biochemical and hepatic markers, and sleep data was collected via structured interviews. The hepatic steatosis index (HSI) was used to assess hepatic steatosis throughout the study. The primary outcome was the association between sleep, anthropomorphic measures, and HSI.
The results demonstrated a significant inverse correlation between HSI and sleep time. However, the association between sleep time and HSI was dependent on BMI, whereby HSI decreases in children with obesity as sleep time increases. In contrast, sleep demonstrated no effect on HSI in those with overweight. Sleep time influences the relationship between body fat distribution and HSI, as 39% of the association between these factors was mediated by sleep time. However, the study was limited by the low validity of some of the hepatic markers used, which may have impacted the findings. Nonetheless, the present study demonstrated that sleep may be an important factor in preventing liver disease in young patients with overweight or obesity.
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