People with sedentary lifestyles and unhealthy sleep behaviors could develop fatty liver disease, according to new research published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Fatty liver disease is the leading chronic liver disease worldwide, affecting about a quarter of the adult population. This type of liver disease is fueled by metabolic disorders such as obesity and type 2 diabetes. Fatty liver disease may progress to end-stage liver disease, posing a major health and economic burden to society. “People with poor nighttime sleep and prolonged daytime napping have the highest risk for developing fatty liver disease,” said Yan Liu, Ph.D., of the Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Sun Yat-sen University in Guangzhou, China. “Our study found a moderate improvement in sleep quality was related to a 29% reduction in the risk for fatty liver disease.”

The researchers analyzed self-reported sleep behaviors from 5,011 Chinese adults with fatty liver disease and found late bedtime, snoring and daytime napping for over 30 minutes were significantly associated with an increased risk of fatty liver disease. A moderate improvement in sleep quality led to a 29% reduction in fatty liver disease risk. People with a sedentary lifestyle and central obesity experienced more prominent adverse effects from poor sleep quality than others.

“Our study provides evidence that even a moderate improvement in sleep quality is sufficient to reduce the risk for fatty liver disease, especially in those with unhealthy lifestyles,” Liu said. “Given that large proportions of subjects suffering from poor sleep quality are underdiagnosed and undertreated, our study calls for more research into this field and strategies to improve sleep quality.”

Other authors of this study include: Jialu Yang, Shiyun Luo, Rui Li, Jingmeng Ju, Zhuoyu Zhang, Jiahua Fan and Min Xia of the Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Sun Yat-sen University; and Jichuan Shen, Minying Sun and Wei Zhu of the Guangzhou Center for Disease Control and Prevention in Guangzhou, China.

The study received funding from the National Key R&D Program of China, Sun Yat-sen University, the Key Project of Medicine Discipline of Guangzhou, the Basic Research Project of the Key Laboratory of Guangzhou and the Natural Science Foundation of the Guangdong Province.

The manuscript, “Sleep Factors in Relation to Metabolic-Dysfunction Associated Fatty Liver Disease in Middle-Aged and Elderly Chinese,” was published online, ahead of print.