Evening chronotype associated with more severe NAFLD for adults with obesity
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Evening chronotype was associated with more severe nonalcoholic fatty liver disease independent of age, sex and BMI compared with morning chronotype among adults with obesity, according to data published in International Journal of Obesity.
“Our study demonstrated that subjects with obesity that are not aligned to circadian rhythm are more prone to develop NAFLD,” Giovanna Muscogiuri, MD, of the department of clinical medicine and surgery in the endocrinology, diabetology and andrology unit at University Federico II, the Italian Centre for the Care and Well-Being of Patients with Obesity at the University of Naples and UNESCO Chair of ‘Education for Health and Sustainable Development’, Italy, told Healio. “There is evidence that clock genes and circadian rhythm could have some role in liver function. Thus, we expected that derangements in this sense could play some metabolic disruption at hepatic level.”
Muscogiuri and colleagues conducted a cross-sectional study with 87 adults with obesity (mean age, 40.3 years; 73.5% women; mean BMI, 46.5 kg/m2) who were patients at the Italian Centre for the Care and Well-Being of Patients with Obesity at the Federico II University Hospital. Researchers recorded anthropometric, biochemical and visceral adiposity index data, assessed chronotype categories with the Home-Ostberg morningness-eveningness questionnaire and calculated nonalcoholic fatty liver disease (NAFLD) indices through the liver fat equation, hepatic steatosis index and index of nonalcoholic steatohepatitis (NASH).
Among the participants, 31% were morning chronotype, 36.8% were intermediate chronotype and 32.2% were evening chronotype. All participants presented with NAFLD.
Those with intermediate chronotype were younger compared with those with morning (P = .002) and evening chronotype (P = .047). Participants with evening chronotype had higher BMI (P < .001), waist circumference (P = .007) and hip circumference (P = .001) compared with morning chronotype and higher BMI (P < .001) and waist circumference (P = .011) compared with intermediate chronotype.
Only participants with evening chronotype were above the threshold for NASH as evaluated by the index of NASH. Compared with participants with morning chronotype, those with evening chronotype scored higher on visceral adiposity index (P = .036), liver fat equation (P = .034), hepatic steatosis index (P < .001) and index of NASH (P = .014) after adjustment for age, sex and BMI.
Obesity is a risk factor for NAFLD, and “the relationship between chronotype and obesity might be explained by hormonal, behavioral and lifestyle features that deeply impact circadian rhythm and body weight management,” the researchers wrote.
According to Muscogiuri, the researchers are currently planning an intervention trial on these results.
“We have already in mind to treat misaligned patients with therapeutic approaches that have already demonstrated some effects on circadian rhythm,” Muscogiuri said.
For more information:
Giovanna Muscogiuri, can be reached at giovanna.muscogiuri@gmail.com
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