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Wang, M. ; Flexeder, C. ; Teupser, D.* ; Harris, C. ; Lorbeer, R.* ; Bamberg, F.* ; Rospleszcz, S. ; Nano, J. ; Schikowski, T.* ; Thorand, B. ; Peters, A. ; Standl, M.

Accelerometry-assessed sleep and liver health in adolescents and adults: Links to liver enzymes, MASLD, and MRI-derived liver fat.

Sleep Med. 138:108686 (2025)
Publ. Version/Full Text Research data DOI PMC
Open Access Hybrid
Creative Commons Lizenzvertrag
BACKGROUND: To investigate associations of accelerometry-assessed sleep characteristics with liver enzymes and liver fat in adolescents and adults. METHODS: We analyzed data from four German cohorts: GINIplus and LISA (n = 1132, 14-16 years), KORA-Fit (n = 1318, 53-74 years), and KORA-MRI (n = 108, 48-67 years). Eleven accelerometry-assessed sleep characteristics captured sleep quantity, efficiency, fragmentation, latency, and timing. Liver enzymes included alanine aminotransferase (ALT), aspartate aminotransferase, and gamma-glutamyl transferase (GGT). Adult liver fat markers were steatotic liver disease (SLD) and metabolic dysfunction-associated SLD (MASLD, plus ≥1 cardiometabolic risk factor and without excessive alcohol intake), defined by fatty liver index (FLI, ≥60) or 3T-Magnetic Resonance Imaging (MRI) derived proton density fat fraction (PDFF, ≥5 %). Linear and logistic regression models were evaluated. RESULTS: Time awake per hour after sleep onset (WASO/h) was associated with higher ALT both in adolescents (percentage change [95 % confidence interval, CI] per interquartile range [IQR]: 3.82 [0.86, 6.87]) and adults (3.05 [0.38, 5.78]). In adults, WASO/h was associated with increased odds of SLD-FLI (odds ratio [95 %CI] per IQR: 1.47 [1.26, 1.71]), MASLD-FLI (1.61 [1.34, 1.94]), SLD-PDFF (2.10 [1.16, 3.78]), and MASLD-PDFF (3.32 [1.47, 7.52]). Similar results were observed for poor sleep efficiency and sleep fragmentation index. However, these associations lost significance after body mass index (BMI) adjustment. Significant interactions between WASO/h and BMI groups were observed for ALT, GGT, and SLD-FLI. CONCLUSIONS: Objectively measured sleep fragmentation was associated with increased liver enzymes in adolescents and hepatic steatosis in adults, with BMI potentially mediating or modifying these associations.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Accelerometry ; Liver Enzymes ; Mri ; Metabolic Dysfunction-associated Steatotic Liver Disease ; Obesity ; Sleep Fragmentation; Wake Identification; Association; Apnea; Population; Quality; Markers
ISSN (print) / ISBN 1389-9457
e-ISSN 1878-5506
Journal Sleep Medicine
Quellenangaben Volume: 138, Issue: , Pages: , Article Number: 108686 Supplement: ,
Publisher Elsevier
Publishing Place Radarweg 29, 1043 Nx Amsterdam, Netherlands
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)
Grants European Research Council (ERC) under the European Union
Federal Ministry for Environment
Commission of the European Communities
Helmholtz Zentrum Mnchen-German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF)
State of Bavaria
University Hospital of Augsburg
German Research Foundation
Centre for Diabetes Research (DZD e. V., Neuherberg, Germany)
Siemens Healthcare
scholarship under the State Scholarship Fund by the China Scholarship Council
Research Institute at Marien-Hospital Wesel