Sleep Efficiency and Physical Capacity in Adults With Metabolic Dysfunction‐Associated Steatotic Liver Disease ( MASLD ): A Cross‐Sectional Study

Sleep efficiency and physical capacity are important factors in metabolic health among adults with metabolic dysfunction-associated steatotic liver disease and may be influenced by common pathophysiological mechanisms. This study evaluated the association between physical capacity and objectively measured sleep efficiency in adults with metabolic dysfunction-associated steatotic liver disease. In this cross-sectional study, 136 adults were enrolled. Physical capacity was assessed using the Global Physical Capacity Score, hepatic steatosis was quantified using FibroScan, and sleep efficiency was assessed using wrist actigraphy. Linear and logistic regression analyses were performed after adjustment for potential confounding factors. Overall, 61.8% of participants had impaired sleep efficiency (< 85%). In the fully adjusted logistic regression model, participants with a Global Physical Capacity Score ≥ 6 had significantly lower odds of impaired sleep efficiency (odds ratio 0.42, 95% confidence interval 0.19-0.95; p = 0.037); when physical capacity was analysed as a continuous variable, the association was in the same direction but not statistically significant (odds ratio per 1-point increase 0.79, 95% confidence interval 0.61-1.03; p = 0.077). Stratified analyses showed a significant association among women (odds ratio 0.26, 95% confidence interval 0.07-0.92; p = 0.037; continuous model: odds ratio per 1-point increase 0.74, 95% confidence interval 0.51-1.06; p = 0.095), whereas no significant association was observed among men. Higher multidimensional physical capacity was associated with better objectively measured sleep efficiency. Assessment of physical capacity may therefore provide additional information when evaluating sleep-related risk in this population.