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Peer-reviewedCC BY 4.0Nutrients

Circadian Rhythm-Related Characteristics and Adiposity in Relation to CAP-Defined Hepatic Steatosis Among Shift and Non-Shift Workers: A Pilot Study

  • Neslişah Rakıcıoğlu1,2
  • Rüveyda Esra Özkalaycı2
  • Canan Altınsoy2
  • Çağlayan Keklikkıran3,4
  • Eda Kaya4,5
  • Yusuf Yılmaz3,4,6
6 affiliations
  1. 1Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara 06100, Türkiye
  2. 2Department of Nutrition and Dietetics, Faculty of Health Sciences, Recep Tayyip Erdoğan University, Rize 53350, Türkiye
  3. 3Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize 53350, Türkiye
  4. 4The Global NASH Council, Washington, DC 20037, USA
  5. 5Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany
  6. 6Dijitalpark Teknokent, İstanbul 34788, Türkiye
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Abstract

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and linked to shift work. This study aimed to investigate the associations of circadian rhythm, sleep characteristics, anthropometric measures, and adiposity-related parameters with controlled attenuation parameter (CAP) values, and to assess their independent associations and sex-specific discriminatory performance in identifying hepatic steatosis among shift and non-shift workers. Methods: A total of 436 workers (328 men and 108 women), aged 19–64 years, from seven large-scale tea factories in Rize, Türkiye, were included. Social jetlag (SJL) and eating jetlag (EJL) were calculated from workday–free-day differences in sleep and meal timing, respectively, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariable linear regression and sex-specific receiver operating characteristic analyses were performed. Results: Mean SJL (p = 0.017) and the distribution of SJL categories (p = 0.022) differed significantly between female shift and non-shift workers, whereas neither differed in men (p = 0.827 and p = 0.542, respectively). These comparisons are exploratory because SJL and EJL estimates are not directly comparable across rotating shift assignments or between shift and non-shift workers. CAP values and the prevalence of CAP-defined hepatic steatosis did not differ significantly by shift-work status in either sex. CAP was positively correlated with anthropometric and adiposity-related measures, with the strongest adjusted correlations observed for waist circumference, abdominal volume index (AVI), BMI, and body fat mass (all rs = 0.66, p < 0.001). In the fully adjusted regression model, age, BMI, and neck circumference were independently associated with higher CAP values, whereas SJL, EJL, sleep duration, and PSQI total score were not. In sex-specific ROC analyses, waist circumference and AVI showed the highest discriminatory performance in men (both AUC = 0.86), whereas BMI showed the highest discriminatory performance in women (AUC = 0.81). SJL and EJL did not significantly discriminate hepatic steatosis in either sex, while sleep duration showed weak discrimination in women (AUC = 0.63, q = 0.042). Conclusions: Anthropometric and adiposity-related measures were strongly associated with CAP values and showed good sex-specific discriminatory performance for hepatic steatosis. However, SJL findings, particularly comparisons by shift-work status, should be considered exploratory given the limited comparability of SJL and EJL estimates among rotating shift workers and between shift and non-shift workers. These simple, readily obtainable anthropometric measurements and derived adiposity indices may facilitate preliminary risk stratification for hepatic steatosis in occupational settings.

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Cite

BibTeXRIS
BibTeX
@article{rakıcıoglu2026circadian,
  title = {{Circadian Rhythm-Related Characteristics and Adiposity in Relation to CAP-Defined Hepatic Steatosis Among Shift and Non-Shift Workers: A Pilot Study}},
  author = {Neslişah Rakıcıoğlu and Rüveyda Esra Özkalaycı and Canan Altınsoy and Çağlayan Keklikkıran and Eda Kaya and Yusuf Yılmaz},
  journal = {Nutrients},
  year = {2026},
  month = oct,
  doi = {10.3390/nu18213492},
  url = {https://www.mdpi.com/2072-6643/18/21/3492},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Circadian Rhythm-Related Characteristics and Adiposity in Relation to CAP-Defined Hepatic Steatosis Among Shift and Non-Shift Workers: A Pilot Study
AU  - Neslişah Rakıcıoğlu
AU  - Rüveyda Esra Özkalaycı
AU  - Canan Altınsoy
AU  - Çağlayan Keklikkıran
AU  - Eda Kaya
AU  - Yusuf Yılmaz
PY  - 2026
DA  - 2026/10/23
JO  - Nutrients
DO  - 10.3390/nu18213492
UR  - https://www.mdpi.com/2072-6643/18/21/3492
AB  - Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and linked to shift work. This study aimed to investigate the associations of circadian rhythm, sleep characteristics, anthropometric measures, and adiposity-related parameters with controlled attenuation parameter (CAP) values, and to assess their independent associations and sex-specific discriminatory performance in identifying hepatic steatosis among shift and non-shift workers. Methods: A total of 436 workers (328 men and 108 women), aged 19–64 years, from seven large-scale tea factories in Rize, Türkiye, were included. Social jetlag (SJL) and eating jetlag (EJL) were calculated from workday–free-day differences in sleep and meal timing, respectively, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariable linear regression and sex-specific receiver operating characteristic analyses were performed. Results: Mean SJL (p = 0.017) and the distribution of SJL categories (p = 0.022) differed significantly between female shift and non-shift workers, whereas neither differed in men (p = 0.827 and p = 0.542, respectively). These comparisons are exploratory because SJL and EJL estimates are not directly comparable across rotating shift assignments or between shift and non-shift workers. CAP values and the prevalence of CAP-defined hepatic steatosis did not differ significantly by shift-work status in either sex. CAP was positively correlated with anthropometric and adiposity-related measures, with the strongest adjusted correlations observed for waist circumference, abdominal volume index (AVI), BMI, and body fat mass (all rs = 0.66, p < 0.001). In the fully adjusted regression model, age, BMI, and neck circumference were independently associated with higher CAP values, whereas SJL, EJL, sleep duration, and PSQI total score were not. In sex-specific ROC analyses, waist circumference and AVI showed the highest discriminatory performance in men (both AUC = 0.86), whereas BMI showed the highest discriminatory performance in women (AUC = 0.81). SJL and EJL did not significantly discriminate hepatic steatosis in either sex, while sleep duration showed weak discrimination in women (AUC = 0.63, q = 0.042). Conclusions: Anthropometric and adiposity-related measures were strongly associated with CAP values and showed good sex-specific discriminatory performance for hepatic steatosis. However, SJL findings, particularly comparisons by shift-work status, should be considered exploratory given the limited comparability of SJL and EJL estimates among rotating shift workers and between shift and non-shift workers. These simple, readily obtainable anthropometric measurements and derived adiposity indices may facilitate preliminary risk stratification for hepatic steatosis in occupational settings.
SN  - 2072-6643
ER  -