Cardiovascular Risk Assessment in Non-Alcoholic Fatty Liver Disease: Association of Sleep Disturbance with Cardiovascular Risk
Keywords:
cardiovascular disease risk, nonalcoholic fatty liver disease, sleepAbstract
OBJECTIVE: To assess the association between sleep disturbance and CVD risk in patients of Non-Alcoholic Fatty Liver Disease.
METHODOLOGY: This cross-sectional study was conducted at the University of Sindh, Jamshoro, Sindh, Pakistan, from August 2023 to July 2024. We used purposive, non-probability sampling to recruit 196 NAFLD patients who met the selection criteria. NAFLD was diagnosed on ultrasound following non-invasive guidelines of liver disease (NILDA). Patients with viral hepatitis, chronic liver disease other than fatty changes, malignancy, thyroid dysfunction, and alcohol were excluded from this study. Sleep quality was assessed using the Insomnia Severity Index, and the 10-year cardiovascular (CVD) risk was quantified using the Framingham risk score. The data were analyzed using IBM SPSS version 27.0, and p-values < 0.05 were considered statistically significant.
RESULTS: Among 196 patients of NAFLD, 19.9% had normal sleep, 16.8% had subthreshold insomnia, 39.3% had moderate insomnia, and 24.0% had severe insomnia. The Insomnia Severity Index was positively correlated with 10-year CVD risk (p-value < 0.01). In unadjusted analysis, sleep disturbance in NAFLD patients was significantly associated with higher CVD risk (COR = 1.19, 95% CI: 1.10–1.29, p < 0.01). After adjusting for potential confounders, sleep disturbance remained independently associated with higher CVD risk. (AOR = 1.15, 95% CI: 1.05–1.27, p < 0.01).
CONCLUSION: It is concluded that there is a higher 10- year CVD risk in NAFLD patients with sleep disturbance
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