Abstract
Background: Short sleep duration significantly increases the risk of liver disease. This study aims to investigate the relationship between weekend catch-up sleep (WCS) duration and hepatic steatosis in adults with varying weekday sleep durations in the United States. Methods: A cross-sectional analysis was conducted using adult participants from NHANES 2017 to March 2020. Anthropometry measurements, clinical features, biochemical parameters, and sleep duration (weekdays and weekends) were recorded. The controlled attenuation parameter (CAP) was utilized to evaluate the degree of liver steatosis. Student's t-test and Mann-Whitney U test were used for unpaired samples. Adjusted multi-variable logistic regression analysis was employed to evaluate the relationship between weekend catch-up sleep and hepatic steatosis. Results: Weekend sleep habits varied based on age, obesity, race, education level, and marital status. Individuals with insufficient weekday sleep (<6 hours) and inadequate WCS (<1 hour) exhibited a significant increase in liver CAP values and a markedly higher probability of hepatic steatosis. In contrast WCS >1 hour effectively reduced the probability of hepatic steatosis. Individuals who adequately compensated for sleep on weekends had lower ratios of AST/ALT, total bilirubin and creatinine levels. Among different BMI populations, WCS was significantly associated with liver health in those with insufficient weekday sleep (<6 hours), whereas in individuals with adequate or sufficient weekday sleep (≥6 hours), WCS only reduced the progression of steatosis in individuals with normal BMI (<25). Conclusion: Adequate weekend catch-up sleep was associated with a lower the incidence of hepatic steatosis in individuals with insufficient weekday sleep duration.