Article record

睡眠障碍作为肝硬化和肝细胞癌的新兴危险因素：队列研究的系统综述与荟萃分析

Sleep disorders as an emerging risk factor for liver cirrhosis and hepatocellular carcinoma: a systematic review and meta-analysis of cohort studies.

综述 Meta鼻科IF 3.1Q2

文献信息

PMID	42907764
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Tzu-Rong Peng 查看其他 5 位作者 Ta-Wei Wu；Hung-Hong Lin；Chao-Chuan Wu；Shuang-Yu Hsu；Ching-Sheng Hsu
作者单位	Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan. 查看其他 9 条单位信息 School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, 11031, Taiwan.；Tzu Chi University, Hualien, Taiwan.；Department of Pharmacy and Master Program, Tajen University, Pingtung, Taiwan.；Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.；Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, 23142, Taiwan.；School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan.；Center for Digestive Medicine, Department of Medical Research, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 88, Sec. 1, Fengxing Road, Tanzi District, Taichung City, 42743, Taiwan (R.O.C.).；Center for Digestive Medicine, Department of Medical Research, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 88, Sec. 1, Fengxing Road, Tanzi District, Taichung City, 42743, Taiwan (R.O.C.). hsu.chingsheng@gmail.com.；School of Post-Baccalaureate Chinese Medicine and School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan. hsu.chingsheng@gmail.com.
期刊	BMC gastroenterology
SCI 分区	Q2
IF	3.1
研究类型	综述 Meta · 临床
所属专科	鼻科

中文摘要

背景： 睡眠障碍日益被认为是代谢功能障碍和慢性肝病的促成因素，但其与肝细胞癌（HCC）和肝硬化的关联仍不明确。我们开展了一项系统综述与荟萃分析，以评估睡眠障碍与肝脏相关结局之间的关系。
方法： 遵循PRISMA指南（PROSPERO：CRD420261342781），我们检索了PubMed、Embase、Web of Science和Cochrane Library截至2026年2月的评估睡眠障碍与肝脏结局的队列研究。采用随机效应模型合并校正风险比（HR）或比值比（OR）。进行了亚组和敏感性分析，并使用ROBINS-I评估偏倚风险。
结果： 共纳入13项队列研究。总体而言，睡眠障碍与肝脏相关结局风险增加相关（HR 1.49；95% CI 1.22-1.81；I² = 96%）。失眠与风险增加显著相关（HR 1.39；95% CI 1.28-1.49），而阻塞性睡眠呼吸暂停显示出非显著趋势（HR 1.80；95% CI 0.91-3.58）。睡眠障碍与HCC风险升高（HR 1.42；95% CI 1.15-1.77）和未特指肝癌风险升高（HR 1.26；95% CI 1.01-1.57）相关，但与肝硬化无关。敏感性分析结果稳健，未发现显著发表偏倚。
结论： 睡眠障碍，尤其是失眠，与HCC和肝脏相关结局风险增加相关。这些发现强调睡眠障碍是肝病进展中潜在的可改变危险因素。

英文摘要

BACKGROUND: Sleep disorders are increasingly recognized as contributors to metabolic dysfunction and chronic liver disease, but their associations with hepatocellular carcinoma (HCC) and cirrhosis remain unclear. We conducted a systematic review and meta-analysis to evaluate the relationship between sleep disorders and liver-related outcomes.
METHODS: Following PRISMA guidelines (PROSPERO: CRD420261342781), we searched PubMed, Embase, Web of Science, and the Cochrane Library through February 2026 for cohort studies assessing sleep disorders and liver outcomes. Adjusted hazard ratios (HRs) or odds ratios (ORs) were pooled using random-effects models. Subgroup and sensitivity analyses were performed, and risk of bias was assessed using ROBINS-I.
RESULTS: Thirteen cohort studies were included. Overall, sleep disorders were associated with an increased risk of liver-related outcomes (HR 1.49; 95% CI 1.22-1.81; I² = 96%). Insomnia was significantly associated with increased risk (HR 1.39; 95% CI 1.28-1.49), whereas obstructive sleep apnea showed a non-significant trend (HR 1.80; 95% CI 0.91-3.58). Sleep disorders were linked to higher risks of HCC (HR 1.42; 95% CI 1.15-1.77) and unspecified liver cancer (HR 1.26; 95% CI 1.01-1.57), but not cirrhosis. Findings were robust in sensitivity analyses, with no significant publication bias.
CONCLUSIONS: Sleep disorders, particularly insomnia, are associated with increased risks of HCC and liver-related outcomes. These findings highlight sleep disturbances as potentially modifiable risk factors in liver disease progression.