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Clinical Research

Evening chronotype is associated with severe NAFLD in obesity

International Journal of Obesity volume 46, pages 1638–1643 (2022)Cite this article

Subjects

Abstract

Background/objectives

Chronotype, i.e., the individual attitude to carry out the daily activities at a certain time of the day, has been reported to play a role in metabolic diseases. Thus, the aim of our study was to investigate the association of non-alcoholic fatty liver disease (NAFLD) with chronotype categories in individuals with obesity.

Subjects/methods

In this cross-sectional study, participants underwent to anthropometric, biochemical, and the Visceral Adiposity Index (VAI) assessment. Chronotype categories were assessed by the Horne–Ostberg Morningness–Eveningness Questionnaire (MEQ). The following indirect indices of NAFLD were calculated: Liver Fat Equation (LFE), Hepatic Steatosis Index (HSI) and Index of Non-alcoholic steatohepatitis (ION).

Results

The study population consisted of 87 participants (40.3 ± 12.3 years; BMI 45.6 ± 6.3 kg/m2; 64F/23M). According to the chronotype score, 31.0% were morning (MC), 36.8% were intermediate (IC), and 32.2% evening chronotype (EC). Individuals with IC were significantly younger than those with MC and EC (p = 0.002 and p = 0.047, respectively). EC presented significantly higher BMI (p < 0.001), waist circumference (p = 0.007), and hip circumference (p = 0.001) than MC. Moreover, EC had higher BMI (p < 0.001) and waist circumference (p = 0.011) than IC. All participants presented NAFLD (HSI ≥ 36 and LFE ≥ 5). Nevertheless, only individuals with EC were above the threshold of non-alcoholic steatohepatitis evaluated as ION index (ION ≥ 50). Individuals with EC presented significantly higher VAI (p = 0.036), LFE (p = 0.034), HSI (p < 0.001) and ION (p = 0.014) than MC, also after the adjustment for age, gender, and BMI.

Conclusion

EC is associated with more severe NAFLD independently of age, gender, and BMI than MC and IC in individuals with obesity.

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Fig. 1: Visceral Adiposity Index and indirect indices of NAFLD according to chronotype categories.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the study participants.

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Author notes

  1. These authors contributed equally: Claudia Vetrani, Luigi Barrea.

Authors and Affiliations

  1. Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia ed Andrologia, Università Federico II, Napoli, Italy

    Claudia Vetrani, Ludovica Verde, Annamaria Docimo, Giulia de Alteriis, Silvia Savastano, Annamaria Colao & Giovanna Muscogiuri

  2. Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, 80143, Napoli, Italy

    Luigi Barrea

  3. Italian Centre for the Care and Well-Being of Patients with Obesity (C.I.B.O), University of Naples “Federico II”, Naples, Italy

    Luigi Barrea, Silvia Savastano, Annamaria Colao & Giovanna Muscogiuri

  4. “San Giovanni di Dio e Ruggi D’Aragona” University Hospital, Scuola Medica Salernitana, Salerno, Italy

    Gerardo Sarno

  5. UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy

    Annamaria Colao & Giovanna Muscogiuri

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Contributions

CV, LB, and GM were responsible for conceptualization; CV and LB conducted the statistical analysis and wrote the manuscript; LV, GS, AD, and GdA contributed to the methodology, including data collection and data management. SS, AC, and GM provided a critical review of the paper. All authors contributed to the critical review and agreed on the final version of the paper.

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Correspondence to Giovanna Muscogiuri.

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Vetrani, C., Barrea, L., Verde, L. et al. Evening chronotype is associated with severe NAFLD in obesity. Int J Obes 46, 1638–1643 (2022). https://doi.org/10.1038/s41366-022-01159-3

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