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Sleep and liver function biomarkers in relation to risk of incident liver cancer: a nationwide prospective cohort study

dc.contributor.authorJiahao Song
dc.contributor.authorLieyang Fan
dc.contributor.authorDa Shi
dc.contributor.authorXuefeng Lai
dc.contributor.authorHao Wang
dc.contributor.authorWei Liu
dc.contributor.authorLinling Yu
dc.contributor.authorRuyi Liang
dc.contributor.authorYongfang Zhang
dc.contributor.authorShuhui Wan
dc.contributor.authorYueru Yang
dc.contributor.authorBin Wang
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherAgricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.contributor.otherDepartment of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
dc.date.accessioned2024-06-30T11:24:03Z
dc.date.accessioned2025-10-08T08:27:27Z
dc.date.available2025-10-08T08:27:27Z
dc.date.issued01-06-2024
dc.identifier.urihttp://digilib.fisipol.ugm.ac.id/repo/handle/15717717/35961
dc.description.abstractAbstract Background To assess the largely undetermined separate and joint effects of sleep and liver function biomarkers on liver cancer. Methods Data of 356,894 participants without cancer at baseline in the UK Biobank were analyzed. Sleep score was evaluated using five sleep traits (sleep duration, chronotype, insomnia, snoring, and excessive daytime sleepiness) and dichotomized into healthy or unhealthy sleep. Circulating liver function biomarkers were measured. Cox proportional hazard model was performed to investigate the independent and joint associations of sleep and liver function biomarkers with liver cancer incidence. Results After a median follow-up time of 13.1 years, 394 cases of incident liver cancer were documented. The multivariable-adjusted hazard ratio (HR) for liver cancer was 1.46 (95% confidence interval: 1.15–1.85) associated with unhealthy sleep (vs. healthy sleep), and was 1.17 (1.15–1.20), 1.20 (1.18–1.22), 1.69 (1.47–1.93), 1.06 (1.06–1.07), 1.08 (1.07–1.09), 1.81 (1.37–2.39), or 0.29 (0.18–0.46) associated with each 10-unit increase in alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), or albumin (ALB), respectively. Individuals with unhealthy sleep and high (≥ median) ALT, AST, TBIL, GGT, ALP, or TP or low (< median) ALB level had the highest HR of 3.65 (2.43–5.48), 4.03 (2.69–6.03), 1.97 (1.40–2.77), 4.69 (2.98–7.37), 2.51 (1.75–3.59), 2.09 (1.51–2.89), or 2.22 (1.55–3.17) for liver cancer, respectively. Significant additive interaction of unhealthy sleep with high TP level on liver cancer was observed with relative excess risk due to an interaction of 0.80 (0.19–1.41). Conclusions Unhealthy sleep was associated with an increased risk of liver cancer, especially in participants with lower ALB levels or higher levels of ALT, AST, TBIL, GGT, ALP, or particularly TP.
dc.language.isoEN
dc.publisherBMC
dc.subject.lccMedicine
dc.titleSleep and liver function biomarkers in relation to risk of incident liver cancer: a nationwide prospective cohort study
dc.typeArticle
dc.description.keywordsLiver cancer
dc.description.keywordsSleep
dc.description.keywordsLiver function biomarker
dc.description.keywordsJoint association
dc.description.keywordsProspective cohort study
dc.description.pages1-12
dc.description.doi10.1186/s12916-024-03440-w
dc.title.journalBMC Medicine
dc.identifier.e-issn1741-7015
dc.identifier.oaia3d1a3374e8e4cefb1c92197f23cdb0b
dc.journal.infoVolume 22, Issue 1


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