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J Womens Health (Larchmt). 2017 Dec;26(12):1270-1277. doi: 10.1089/jwh.2017.6412. Epub 2017 Sep 21.

Sleep Duration and Risk of Liver Cancer in Postmenopausal Women: The Women's Health Initiative Study.

Royse KE1,2, El-Serag HB1,2,3,4, Chen L1,2, White DL1,2,3,4,5, Hale L6, Sangi-Haghpeykar H7, Jiao L1,2,3,4,5.

Author information

1
1 Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine , Houston, Texas.
2
2 Center for Innovations in Quality, Effectiveness and Safety (iQuEST), Michael E. DeBakey VA Medical Center , Houston, Texas.
3
3 Texas Medical Center Digestive Disease Center , Houston, Texas.
4
4 Dan L. Duncan Cancer Center , Baylor College of Medicine, Houston, Texas.
5
5 Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center , Houston, Texas.
6
6 Program in Public Health, School of Medicine, Family, Population and Preventive Medicine, Stony Brook University , Stony Brook, New York.
7
7 Department of Obstetrics and Gynecology, Baylor College of Medicine , Houston, Texas.

Abstract

BACKGROUND:

Sleep duration has been associated with nonalcoholic fatty liver disease, but its association with liver cancer remains unknown.

MATERIAL AND METHODS:

In the prospective Women's Health Initiative Study, 139,368 postmenopausal women reported sleep habits at baseline (1993-1998). We ascertained 175 incident liver cancer cases during an average 13.8 years of follow-up through August 2014. We used multivariable Cox proportional hazard regression models to estimate a hazard ratio (HR) and its 95% confidence interval (95% CI) for risk of liver cancer in association with nocturnal sleep duration.

RESULTS:

Compared to women reporting 6-8 hours of sleep, the HR for liver cancer was 1.94 (95% CI 1.07-3.53) for women reporting ≥9 hours of sleep. Among the obese women, the HR associated with ≥9 hours of sleep was 3.18 (95% CI 1.84-8.60). The HR was 0.93 (95% CI 0.34-2.53) among nonobese women (p value for interaction = 0.18). Short sleep duration (≤5 hours) was not associated with liver cancer risk.

CONCLUSION:

Long sleep duration was associated with a moderate increase in liver cancer risk in obese postmenopausal women in the United States. Larger study is needed to confirm our observation on effect modification by adiposity status.

KEYWORDS:

WHI; circadian rhythm; liver cancer; obesity; risk factor; sleep

PMID:
28933583
PMCID:
PMC6037184
DOI:
10.1089/jwh.2017.6412
[Indexed for MEDLINE]
Free PMC Article

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