Chronotype and FibroScan-Derived Liver Markers in Adults with Obesity: Preliminary Evidence from a Cross-Sectional Study.

Background/

Objectives

Chronotype describes individual preferences regarding the timing of sleep, food intake, and other daily activities and is commonly evaluated using the Morningness-Eveningness Questionnaire (MEQ). Individuals with a morning chronotype generally prefer earlier sleep-wake schedules, whereas those with an evening chronotype exhibit delayed circadian timing and achieve peak alertness later in the day. Previous evidence has linked evening chronotype to an elevated risk of obesity and metabolic dysfunction; however, its association with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), particularly with hepatic steatosis and fibrosis, has not yet been fully elucidated.

Methods

This cross-sectional study included 119 medication-naïve adults, predominantly with obesity (mean age 41.5 ± 11.9 years; 58 men, 49%), recruited at the Nutrition Center of the National Institute of Gastroenterology "Saverio de Bellis." Hepatic steatosis (controlled attenuation parameter [CAP] > 275 dB/m) and liver fibrosis (liver stiffness > 8.2 kPa) were assessed by transient elastography (FibroScan).

Results

Hepatic steatosis was detected in 62% of participants (n = 74), whereas fibrosis was identified in 15% (n = 18). When chronotype was analyzed as a continuous variable, no significant correlations were observed with either CAP (r = 0.017, p = 0.852) or liver stiffness measurements (r = -0.045, p = 0.629). Although these associations did not reach statistical significance, the corresponding confidence intervals remained compatible with small-to-moderate effect sizes, particularly for fibrosis, reflecting the limited number of participants with fibrotic disease.

Conclusions

In this sample, chronotype was not significantly associated with FibroScan-derived measures of hepatic steatosis or fibrosis. Associations with selected metabolic and behavioral characteristics were identified, although these findings require confirmation in adequately powered longitudinal investigations. To our knowledge, only a limited number of studies have explored these relationships using objective FibroScan-derived measurements in medication-naïve individuals. Consequently, the present findings should be considered hypothesis-generating and warrant validation in larger prospective cohorts.