睡眠时间与非酒精性脂肪肝关联的系统综述和更新的Meta分析

目的 系统评价睡眠时间与非酒精性脂肪肝发生之间的关联。方法 计算机检索中国知网（CNKI）、万方、维普数据库（VIP）、PubMed和Web of Science中英文数据库，收集建库至2020年2月27日公开发表的关于睡眠时间和非酒精性脂肪肝关联的文献。采用比值比（OR）或相对危险度（RR）作为效应指标进行Meta分析。结果 纳入15篇符合要求的文献，共计样本量150481例，其中病例数为44070例。分类Meta分析结果显示，短睡眠时间可增加非酒精性脂肪肝的患病风险（OR/RR=1.12，95%CI:1.02～1.23），且在非酒精性脂肪肝的诊断方法上存在层间异质性（P=0.040）。长睡眠时间与非酒精性脂肪肝患病风险无统计学关联（OR/RR=1.08，95%CI:0.93～1.26）。剂量-反应Meta分析结果显示，睡眠时间与非酒精性脂肪肝患病风险呈U型关联（P=0.0015）。Begg检验和Egger检验均未发现发表偏倚。结论 短睡眠时间可增加非酒精性脂肪肝的患病风险，长睡眠时间与非酒精性脂肪肝的发生未见统计学关联。

Association of sleep duration and nonalcoholic fatty liver disease: a systematic review and updated meta-analysis

To analyze the association between sleep duration and risk of nonalcoholic fatty liver disease ( NAFLD). Methods The databases of CNKI，WanFang，VIP，PubMed and Web of Science were searched for eligible studies regardingthe relationship between sleep duration and risk of NAFLD until February 27，2020. Odds ratio ( OＲ) or relative risk ( ＲＲ)were used as indicator for the meta － analysis. Ｒesults A total of 15 studies were included in the meta － analysis，involving150 481 participants，among which there were 44 070 NAFLD patients. The categorical meta － analysis revealed that short sleepduration was associated with increased risk of NAFLD ( OＲ/ＲＲ = 1. 12，95% CI: 1. 02 ～ 1. 23) . Meta regression analysisshowed that the diagnostic method of NAFLD ( P = 0. 040 ) was the source of heterogeneity. There was no statisticallysignificant association between long sleep duration and NAFLD ( OＲ/ＲＲ = 1. 08，95% CI: 0. 93 ～ 1. 26，I2 = 89. 6% ) . Dose －response meta － analysis showed that sleep duration and NAFLD presented a U － shaped relationship ( P = 0. 0015) . There wasno publication bias found in Begg’s test and Egger’s test. Conclusion Short sleep duration increases the risk of NAFLD，while long sleep duration is not