ONO Masafumi    Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine    Position
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	The association of insomnia with gastroesophageal reflux symptoms in biopsy-proven nonalcoholic fatty liver disease.
Journal	Formal name：Journal of gastroenterology Abbreviation：J Gastroenterol ISSN code：14355922/09441174
Domestic / Foregin	Domestic
Volume, Issue, Page	49(7),pp.1163-74
Author and coauthor	Taketani Hiroyoshi, Sumida Yoshio, Tanaka Saiyu, Imajo Kento, Yoneda Masato, Hyogo Hideyuki, Ono Masafumi, Fujii Hideki, Eguchi Yuichiro, Kanemasa Kazuyuki, Chayama Kazuaki, Itoh Yoshito, Yoshikawa Toshikazu, Saibara Toshiji, Fujimoto Kazuma, Nakajima Atsushi,
Publication date	2014/07
Summary	BACKGROUND:It is suggested that nonalcoholic fatty liver disease (NAFLD), including nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH), can be associated with insomnia and gastro-esophageal reflux disease (GERD). The relationship between GERD and insomnia in subjects with biopsy-proven NAFLD was investigated.METHODS:This study enrolled 123 patients with biopsy-proven NAFLD. Insomnia was assessed by the Athens Insomnia Scale (AIS), a self-assessment psychometric instrument designed to quantify sleep difficulty based on ICD-10 criteria; AIS scores ≥ 6 were considered positive for insomnia. GERD symptoms were evaluated using a frequency scale for the symptoms of GERD (FSSG); FSSG scores ≥ 8 were considered positive. Logistic regression models were used to evaluate the association of insomnia with GERD, after adjusting for potential confounders. Thirteen patients with GERD were treated with the proton pump inhibitor rabeprazole (RPZ; 10 mg/day), for 12 weeks.RESULTS:Of the 123 patients, 76 (62%) were female and 87 (71%) were obese, with 34 (28%) having AIS scores ≥ 6 and 31 (25%) having FSSG scores ≥ 8. Liver biopsy revealed that 40 patients (33%) had NAFL and 83 (67%) had NASH. FSSG and AIS scores were similar in the two groups. HOMA-IR, FSSG scores and γGT (GGT) concentrations were significantly higher in insomniacs than in non-insomniacs. Logistic regression analysis demonstrated that FSSG score and GGT concentration were independently associated with insomnia. RPZ treatment resulted in significantly reductions in both AIS and FSSG scores.CONCLUSIONS:Nearly 30% of patients with biopsy-proven NAFLD had insomnia, which was related to GGT and GERD and could be relieved by RPZ treatment.
DOI	10.1007/s00535-013-0871-5
PMID	23975270