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Chen S, Zhang T, Gao H, Zhang J. Association between weekend catch-up sleep and chronic kidney disease: insights from NHANES 2017-2020. Ren Fail 2025; 47:2461682. [PMID: 39910840 PMCID: PMC11803762 DOI: 10.1080/0886022x.2025.2461682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 01/24/2025] [Accepted: 01/28/2025] [Indexed: 02/07/2025] Open
Abstract
OBJECTIVE This study aimed to explore the association between weekend catch-up sleep (WCS) and chronic kidney disease (CKD) in American adults. METHODS Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2017 to 2020, this study encompassed 4,934 individuals aged 20 years and above. We assessed the risk of CKD in relation to WCS. To evaluate CKD risk across various WCS durations, participants were categorized into four groups based on WCS length: < 1 h (reference group), ≥ 1 h and < 2 h, ≥ 2 h and < 3 h, and ≥ 3 h. RESULTS In the fully adjusted multivariate logistic regression model, the odds ratio (OR) of CKD to WCS response was 0.86 (95% CI = 0.61-1.22; p = 0.31). In addition, only CKD was significantly associated with WCS duration between 2-3 h (OR = 0.44, 95% CI = 0.21-0.88, p = 0.03). Subgroup analyses showed stronger negative associations (p < 0.05) for men and women with a WCS of 2-3 h, adults under 60 years of age with a WCS of 2-3 h, those with less than 1 h of catch-up sleep on weekends and a body mass index (BMI) of 25-29.9, those with a BMI of less than 25 or greater than or equal to 30 with a WCS of 2-3 h, and those with less than 7 h of sleep on weekdays and 2-3 h of catch-up sleep on weekends. CONCLUSION Our findings suggest that when weekday sleep duration is < 7 h, WCS in 2-3 h is strongly associated with a lower prevalence of CKD.
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Affiliation(s)
- Sheng Chen
- Graduate School, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Ting Zhang
- Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Hongjun Gao
- Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Jianqiang Zhang
- Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
- The First People’s Hospital of Nanning, Nanning, China
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Valencia O, López C, Vanegas-Duarte E, Fillizola C, Bejarano Ramírez DF, Cortés Mejía NA, Vera Torres A. Risk Factors Related to the Development of Nonalcoholic Fatty Liver: A Systematic Review. Can J Gastroenterol Hepatol 2025; 2025:9964486. [PMID: 40264655 PMCID: PMC12014263 DOI: 10.1155/cjgh/9964486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 12/05/2024] [Indexed: 04/24/2025] Open
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) has a major impact on public health owing to its high morbidity and mortality due to its close relationship with several conditions, including metabolic syndrome, cirrhosis, and cancer. Therefore, this review aimed to systematically compile and summarize the scientific literature on early risk factors for NAFLD development. Methods: A systematic review of population-based cohort studies was conducted. Studies reporting the risk factors associated with nonalcoholic steatohepatitis (NASH) and NAFLD were screened. Results: The search yielded 987 unique records, of which 196 articles were selected after title and abstract screening. A total of 39 articles were read in full text after quality analysis using Downs and Black criteria; 10 of the studies were excluded due to heterogeneity or inconclusive results. Finally, 30 publications were included in this systematic review. The review revealed that clinical conditions such as obesity, weight change, psoriasis, polycystic ovary syndrome, diabetes, thyroid disorders, and elevated serum uric acid levels increase the risk of developing nonalcoholic fatty liver. In addition, lifestyle factors such as sedentary behavior, active or passive smoking, poor sleep quality, and consumption of carbonated beverages are associated with this condition. Conclusions: Evidence was found on the association between different clinical and lifestyle risk factors and NAFLD. This supports the need for preventive, diagnostic, and therapeutic strategies to improve the metabolic, hepatic, and oncological outcomes related to this condition.
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Affiliation(s)
- Omaira Valencia
- Population Health, Fundación Santa Fe de Bogota, Bogota, Colombia
| | - Carolina López
- Population Health, Fundación Santa Fe de Bogota, Bogota, Colombia
| | | | | | - Diana Fernanda Bejarano Ramírez
- Transplant and Hepatobiliary Surgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Epidemiology and Biostatistics Group, Graduate School of Epidemiology and Biostatistics, CES University, Medellín, Colombia
| | - Nicolás Andrés Cortés Mejía
- Division of Anesthesiology, Critical Care Medicine and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alonso Vera Torres
- Transplant and Hepatobiliary Surgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Le L, Lan Z, Chen C. Association between weekend catch-up sleep and depression in US adults. BMC Public Health 2025; 25:439. [PMID: 39905350 PMCID: PMC11792364 DOI: 10.1186/s12889-025-21551-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/20/2025] [Indexed: 02/06/2025] Open
Abstract
BACKGROUND Depression is one of the most prevalent mental disorders and causes a serious economic and medical burden on society. This research assessed the correlation between weekend catch-up sleep (WCS) and depression in US adults aged ≥ 20 years. METHODS Cross-sectional data were obtained from individuals with complete WCS and Patient Health Questionnaire (PHQ-9) data who participated in the 2017-2020 National Health and Nutrition Examination Survey (NHANES). A logistic regression analysis was conducted to evaluate the possible independent conjunction between depression and WCS. Subgroup analysis and interaction tests have been carried out. RESULTS A total of 7,795 individuals with an average PHQ-9 level of 3.27 ± 4.25 were analyzed. The prevalence of depression was 9.11% overall, and participants in the quartile 3 (WCS 1-2 h) tended to have lowest rates of depression (Quartile 1: 9.49%; Quartile 2: 9.95%; Quartile 3: 7.03%; Quartile 4: 8.75%; p = 0.014). The incidence of depression was found to be less correlated with 1-2 h of WCS (OR = 0.74, 95% CI: 0.55, 0.99). Individuals with less than one hour or more than two hours of WCS did not have a significantly different risk of depression than individuals without WCS. CONCLUSIONS Moderate catch-up sleep on weekends was linked to a decreased likelihood of depression.
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Affiliation(s)
- Lingying Le
- Department of Neurology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
| | - Ziwei Lan
- Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chenxi Chen
- Department of Plastic Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China.
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Pirahesh K, Zarrinnia A, Nikniaz L, Nikniaz Z. Association between sleep duration and risk of nonalcoholic fatty liver disease: A systematic review and meta-analysis. Prev Med Rep 2025; 50:102968. [PMID: 39897736 PMCID: PMC11783128 DOI: 10.1016/j.pmedr.2025.102968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Revised: 01/06/2025] [Accepted: 01/07/2025] [Indexed: 02/04/2025] Open
Abstract
Introduction Considering that both long and short sleep duration may have an association with nonalcoholic fatty liver disease (NAFLD), in this meta-analysis, we analyzed the dose-response association between sleep duration and NAFLD along with meta-analyses of the differences in mean sleep duration between NAFLD patients and healthy controls, and linear meta-analysis of the association between sleep duration and NAFLD. Methods PubMed (665 articles), Scopus (442 articles), and Web of Sciences (200 articles) were searched from inception until November 2023. Observational studies were included if they assess the association between sleep duration and NAFLD or compare the mean sleep duration between patients with NAFLD and healthy population. All studies done in humans without restriction on sex, age, and language were included. The methological quality of studies was assessed by Joanna Briggs Institute (JBI) tools. The meta-analysis was conducted using STATA. Results Thirty-one studies that included 836,117 participants were included in this systematic review. The results indicated no significant differences between NAFLD patients and healthy controls regarding mean sleep duration [Mean difference: -7.08, 95 % CI: -20.10, 5.94]. The subgroup meta-analysis did not show any significant differences between groups. The long versus short sleep duration meta-analysis showed a significant association between sleep duration and NAFLD (OR: 0.8 [95 % CI, 0.74-0.91]). The results of the dose-response meta-analysis do not suggest a linear or nonlinear relationship between sleep duration and NAFLD (p-value = 0.9). Conclusion The highest category of sleep duration was associated with a lower risk of NAFLD. However, no dose-response association was observed.
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Affiliation(s)
- Kasra Pirahesh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Zarrinnia
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Students` Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Hsiao C, Huang WC, Hsueh MC, Chang CC, Liao Y, Lin KP. Can weekend catch-up sleep decrease the risk of cognitive dysfunction in older adults? Sleep Breath 2024; 28:2303-2310. [PMID: 38878158 DOI: 10.1007/s11325-024-03074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 05/16/2024] [Accepted: 06/03/2024] [Indexed: 10/04/2024]
Abstract
PURPOSE This study investigated whether weekend catch-up sleep was related to a decreased risk of cognitive dysfunction in older Taiwanese adults by using self-reported diaries and objective accelerometer measurements. METHODS This cross-sectional study enrolled participants who were aged ≥ 65 years and had the capability to walk independently from a medical center in Taipei City, Taiwan, between September 2020 and December 2022. Self-reported sleep diaries and tri-axial accelerometers were used to record and measure sleep-related data for 7 consecutive nights. Weekend catch-up sleep was defined as the mean of weekend sleep time minus the mean of weekdays sleep time. Mini-Mental State Examination (MMSE) was evaluated the risk of cognitive dysfunction. The association between weekend catch-up sleep and the MMSE score was examined using a binary logistic regression model. RESULTS A total of 215 older adults (53.0% female; 80.5 ± 7.1 years old; 11.6% at risk of cognitive dysfunction) were included. In the adjusted model (adjusted for sex, education level, moderate-to-vigorous physical activity and total accelerometer wear time), both the self-reported sleep diaries (odds ratio [OR] = 0.26, 95% confidence interval [CI] = 0.09-0.69, P = 0.007) and the accelerometer data (OR = 0.27, 95% CI = 0.10-0.70, P = 0.007) indicated that weekend catch-up sleep could decrease the risk of cognitive dysfunction by 73-74%. CONCLUSION The study findings suggest that there is an association between weekend catch-up sleep and lower risk for cognitive decline. The causal relationship between weekend catch-up sleep and cognitive function in older adults should be further investigated in a study with longitudinal design.
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Affiliation(s)
- Chi Hsiao
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
| | - Wan-Chi Huang
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Chih-Ching Chang
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Kun-Pei Lin
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No.1, Changde St., Zhongzheng Dist, 10048, Taipei City, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Li Y, Tan S. Sleep factors were associated with a higher risk of MAFLD and significant fibrosis. Sleep Breath 2024; 28:1381-1391. [PMID: 38514588 DOI: 10.1007/s11325-024-03017-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE The relationships of sleep factors separately and jointly with metabolic associated fatty liver disease (MAFLD) and significant fibrosis remain unclear. We intended to explore the relationships in the United States. METHODS This cross-sectional study included 4477 individuals from the National Health and Nutrition Examination Survey from 2017 to 2018. Information regarding each sleep factor (sleep duration, trouble sleeping, snoring, excessive daytime sleep, and sleep apnea symptoms) was obtained through questionnaires. MAFLD was diagnosed by transient elastography according to the consensus definitions. Multivariable logistic regression models were employed to explore relationships of sleep factors separately and jointly with MAFLD and significant fibrosis. RESULTS Participants having a poor sleep pattern was associated with higher MAFLD and significant fibrosis risk, and poor sleep pattern was related to about threefold (OR, 3.67; 95% CI, 1.82-7.37) increased risk of MAFLD remarkably. When examining specific factors of sleep patterns individually, trouble sleeping (OR, 1.53; 95% CI, 1.10-2.12), snoring (OR, 2.11; 95% CI, 1.40-3.19), excessive daytime sleep (OR, 1.57; 95% CI, 0.93-2.62), and sleep apnea symptoms (OR, 1.87; 95% CI, 1.13-3.10) were positively associated with the odds of MAFLD (all P < 0.05). However, sleep duration was not independently correlated with MAFLD or significant fibrosis. Sleep patterns showed similar relationships with MAFLD, regardless of all age, sex, physical activity, and shift work groups. CONCLUSIONS Poor sleep pattern was linked with a considerably higher risk of MAFLD and significant fibrosis.
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Affiliation(s)
- Yaxin Li
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, China
| | - Shiyun Tan
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, China.
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Sletten TL, Weaver MD, Foster RG, Gozal D, Klerman EB, Rajaratnam SMW, Roenneberg T, Takahashi JS, Turek FW, Vitiello MV, Young MW, Czeisler CA. The importance of sleep regularity: a consensus statement of the National Sleep Foundation sleep timing and variability panel. Sleep Health 2023; 9:801-820. [PMID: 37684151 DOI: 10.1016/j.sleh.2023.07.016] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To develop and present consensus findings of the National Sleep Foundation sleep timing and variability panel regarding the impact of sleep timing variability on health and performance. METHODS The National Sleep Foundation assembled a panel of sleep and circadian experts to evaluate the scientific evidence and conduct a formal consensus and voting procedure. A systematic literature review was conducted using the NIH National Library of Medicine PubMed database, and panelists voted on the appropriateness of 3 questions using a modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting. RESULTS The literature search and panel review identified 63 full text publications to inform consensus voting. Panelists achieved consensus on each question: (1) is daily regularity in sleep timing important for (a) health or (b) performance? and (2) when sleep is of insufficient duration during the week (or work days), is catch-up sleep on weekends (or non-work days) important for health? Based on the evidence currently available, panelists agreed to an affirmative response to all 3 questions. CONCLUSIONS Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.
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Affiliation(s)
- Tracey L Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Russell G Foster
- Sleep & Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David Gozal
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Till Roenneberg
- Institutes for Occupational, Social, and Environmental Medicine and Medical Psychology, LMU Munich, Munich, Germany
| | - Joseph S Takahashi
- Department of Neuroscience, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Howard Hughes Medical Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Fred W Turek
- Center for Sleep and Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, Illinois, USA
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Michael W Young
- Laboratory of Genetics, The Rockefeller University, New York City, New York, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
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Association between weekend catch-up sleep and dyslipidemia among Korean workers. Sci Rep 2023; 13:925. [PMID: 36650276 PMCID: PMC9845206 DOI: 10.1038/s41598-023-28142-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Within competitive sociocultural environments, most Korean workers are likely to shorten their sleep duration during the weekday. Short sleep duration is associated with dyslipidemia; however, studies on the correlation between various sleep patterns and dyslipidemia are still lacking. In hence this study aimed to investigate the association between weekend catch-up sleep (CUS) and dyslipidemia among South Korean workers. Our study used data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES). The analysis covered 4,085 participants, excluding those who were diagnosed with dyslipidemia and not currently participating in economic activities. Weekend CUS was calculated as the absolute difference between self-reported weekday and weekend sleep duration. Dyslipidemia was diagnosed based on the levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides in blood samples collected after 9-12 h of fasting. After adjusting for sociodemographic, economic, health-related, and sleep-related factors, a negative association of weekend CUS with dyslipidemia was observed in male workers (odds ratio: 0.76, 95% confidence interval: 0.61-0.95). Further, workers with total sleep duration of 7-8 h, night workers, and white-collar workers with CUS were at relatively low risk of dyslipidemia compared to the non-CUS group. Less than 2 h of weekend CUS was negatively related to dyslipidemia in Korean workers, especially males. This suggests that sleeping more on weekends for workers who had a lack of sleep during the week can help prevent dyslipidemia.
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Liu H, Huang S, Xu M, Zhao D, Wang X, Zhang L, Chen D, Du J, Yu R, Li H, Ye H. The association between sleep duration, quality, and nonalcoholic fatty liver disease: A cross-sectional study. Open Med (Wars) 2023; 18:20230670. [PMID: 36950534 PMCID: PMC10025511 DOI: 10.1515/med-2023-0670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 01/14/2023] [Accepted: 02/13/2023] [Indexed: 03/24/2023] Open
Abstract
Sleep can affect nonalcoholic fatty liver disease (NAFLD). We investigated the association between sleep duration, sleep quality, and NAFLD. From January to December 2018, 1,073 patients (age: 37.94 ± 10.88, Body Mass Index (BMI): 22.85 ± 3.27) were enrolled. Pittsburgh Sleep Quality Index Questionnaire and Munich Chronotype Questionnaire were used to assess sleep duration, quality, and habits. Ultrasonography was used to diagnose NAFLD. Multivariate logistic regression models were used to calculate the odds ratio (OR) and 95% confidence interval (CI) of the risk of NAFLD by different types of sleep duration and sleep quality. No significant differences in sleep time, sleep quality, and sleep habits between the NAFLD and the non-NAFLD groups were observed (P > 0.05). There was no correlation between sleep duration and NAFLD in the whole cohort. After adjusting for age, exercise, fasting plasma glucose, and BMI, the group with long sleep duration showed a decreased risk of NAFLD in men (OR = 0.01, 95% CI: 0.001-0.27, P = 0.032). However, in all four adjusted models, no correlation between sleep duration, quality, and NAFLD was found in women. In conclusion, sleep duration was significantly and negatively associated with NAFLD in men but not women. Prospective studies are required to confirm this association.
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Affiliation(s)
- Huiwei Liu
- Department of Gastroenterology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
| | - Shiliang Huang
- Department of Gastroenterology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
| | - Mengdan Xu
- Department of Gastroenterology, Cixi People’s Hospital, Cixi, Zhejiang 315300, P.R. China
| | - Dan Zhao
- Department of Gastroenterology, Cixi People’s Hospital, Cixi, Zhejiang 315300, P.R. China
| | - Xinxue Wang
- School of Medicine, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
| | - Liangshun Zhang
- Department of Gastroenterology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
| | - Dahua Chen
- Department of Gastroenterology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
| | - Jinman Du
- Physical Examination Center, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
| | - Rongbin Yu
- Department of Preventation and Care, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
| | - Hong Li
- Department of Hepatobiliary Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, P.R. China
| | - Hua Ye
- Department of Gastroenterology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, P.R. China
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