Association between chronotype and metabolic-associated fatty liver disease in employed adults: A longitudinal study in Southwestern China

The circadian system is an essential physiological regulator of mammals, and sleep chronotype may be associated with the risk of metabolic disorders. However, evidence regarding the role of sleep chronotype in the development of metabolic-associated fatty liver disease (MAFLD) is scarce, particularl...

Full description

Saved in:
Bibliographic Details
Published inChronobiology international Vol. 40; no. 12; pp. 1557 - 1565
Main Authors Fu, Yao, Yu, Bin, Yang, Bo, Pan, Jia, Feng, Chuanteng, Jia, Peng, Zeng, Honglian, Yang, Shujuan
Format Journal Article
LanguageEnglish
Published England 02.12.2023
Subjects
Adult
Animals
China
Chronotype
Circadian Rhythm
Humans
Longitudinal Studies
Mammals
Non-alcoholic Fatty Liver Disease
China
MAFLD
Chronotype
longitudinal study
employed adults
logistic random effects model
Online AccessGet full text

Cover

Abstract The circadian system is an essential physiological regulator of mammals, and sleep chronotype may be associated with the risk of metabolic disorders. However, evidence regarding the role of sleep chronotype in the development of metabolic-associated fatty liver disease (MAFLD) is scarce, particularly in employed adults. We conducted a longitudinal study of 1,309 employed adults in Southwestern China with a five-year follow-up from 2017 to 2021. MAFLD was assessed by the presence of hepatic steatosis using abdominal ultrasonography, overweight/obese status, diabetes mellitus, metabolic dysregulation, or elevation of high-sensitivity C-reactive protein. Chronotype was assessed by the Morning and Evening Questionnaire-5 (MEQ-5). The logistic random effects model was applied to analyze the 5-year panel data to estimate the association between chronotype and MAFLD, and the potential effect modification of demographics on such association. The MAFLD prevalence of participants was 38.6% at baseline and showed an increasing trend during follow-up (p for trends < 0.05). Compared with morning chronotype, evening chronotype was positively associated with MAFLD (OR = 2.19, 95%CI: [1.09, 4.40]) after controlled for covariates. Age, sex, ethnicity, and educational level did not modify the association between chronotype and MAFLD. These findings suggest that improving circadian rhythms could reduce the risk of MAFLD and chronic disease burden among employed adults.
AbstractList The circadian system is an essential physiological regulator of mammals, and sleep chronotype may be associated with the risk of metabolic disorders. However, evidence regarding the role of sleep chronotype in the development of metabolic-associated fatty liver disease (MAFLD) is scarce, particularly in employed adults. We conducted a longitudinal study of 1,309 employed adults in Southwestern China with a five-year follow-up from 2017 to 2021. MAFLD was assessed by the presence of hepatic steatosis using abdominal ultrasonography, overweight/obese status, diabetes mellitus, metabolic dysregulation, or elevation of high-sensitivity C-reactive protein. Chronotype was assessed by the Morning and Evening Questionnaire-5 (MEQ-5). The logistic random effects model was applied to analyze the 5-year panel data to estimate the association between chronotype and MAFLD, and the potential effect modification of demographics on such association. The MAFLD prevalence of participants was 38.6% at baseline and showed an increasing trend during follow-up (p for trends < 0.05). Compared with morning chronotype, evening chronotype was positively associated with MAFLD (OR = 2.19, 95%CI: [1.09, 4.40]) after controlled for covariates. Age, sex, ethnicity, and educational level did not modify the association between chronotype and MAFLD. These findings suggest that improving circadian rhythms could reduce the risk of MAFLD and chronic disease burden among employed adults.
The circadian system is an essential physiological regulator of mammals, and sleep chronotype may be associated with the risk of metabolic disorders. However, evidence regarding the role of sleep chronotype in the development of metabolic-associated fatty liver disease (MAFLD) is scarce, particularly in employed adults. We conducted a longitudinal study of 1,309 employed adults in Southwestern China with a five-year follow-up from 2017 to 2021. MAFLD was assessed by the presence of hepatic steatosis using abdominal ultrasonography, overweight/obese status, diabetes mellitus, metabolic dysregulation, or elevation of high-sensitivity C-reactive protein. Chronotype was assessed by the Morning and Evening Questionnaire-5 (MEQ-5). The logistic random effects model was applied to analyze the 5-year panel data to estimate the association between chronotype and MAFLD, and the potential effect modification of demographics on such association. The MAFLD prevalence of participants was 38.6% at baseline and showed an increasing trend during follow-up (p for trends < 0.05). Compared with morning chronotype, evening chronotype was positively associated with MAFLD (OR = 2.19, 95%CI: [1.09, 4.40]) after controlled for covariates. Age, sex, ethnicity, and educational level did not modify the association between chronotype and MAFLD. These findings suggest that improving circadian rhythms could reduce the risk of MAFLD and chronic disease burden among employed adults.The circadian system is an essential physiological regulator of mammals, and sleep chronotype may be associated with the risk of metabolic disorders. However, evidence regarding the role of sleep chronotype in the development of metabolic-associated fatty liver disease (MAFLD) is scarce, particularly in employed adults. We conducted a longitudinal study of 1,309 employed adults in Southwestern China with a five-year follow-up from 2017 to 2021. MAFLD was assessed by the presence of hepatic steatosis using abdominal ultrasonography, overweight/obese status, diabetes mellitus, metabolic dysregulation, or elevation of high-sensitivity C-reactive protein. Chronotype was assessed by the Morning and Evening Questionnaire-5 (MEQ-5). The logistic random effects model was applied to analyze the 5-year panel data to estimate the association between chronotype and MAFLD, and the potential effect modification of demographics on such association. The MAFLD prevalence of participants was 38.6% at baseline and showed an increasing trend during follow-up (p for trends < 0.05). Compared with morning chronotype, evening chronotype was positively associated with MAFLD (OR = 2.19, 95%CI: [1.09, 4.40]) after controlled for covariates. Age, sex, ethnicity, and educational level did not modify the association between chronotype and MAFLD. These findings suggest that improving circadian rhythms could reduce the risk of MAFLD and chronic disease burden among employed adults.
Author Feng, Chuanteng
Fu, Yao
Yang, Shujuan
Yang, Bo
Yu, Bin
Pan, Jia
Jia, Peng
Zeng, Honglian
Author_xml – sequence: 1
  givenname: Yao
  surname: Fu
  fullname: Fu, Yao
  organization: West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
– sequence: 2
  givenname: Bin
  surname: Yu
  fullname: Yu, Bin
  organization: Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
– sequence: 3
  givenname: Bo
  surname: Yang
  fullname: Yang, Bo
  organization: Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
– sequence: 4
  givenname: Jia
  surname: Pan
  fullname: Pan, Jia
  organization: Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
– sequence: 5
  givenname: Chuanteng
  surname: Feng
  fullname: Feng, Chuanteng
  organization: Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
– sequence: 6
  givenname: Peng
  surname: Jia
  fullname: Jia, Peng
  organization: School of Resource and Environmental Sciences, Wuhan University, Wuhan, China, Hubei Luojia Laboratory, Wuhan, China, School of Public Health, Wuhan University, Wuhan, China, International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
– sequence: 7
  givenname: Honglian
  surname: Zeng
  fullname: Zeng, Honglian
  organization: Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
– sequence: 8
  givenname: Shujuan
  surname: Yang
  fullname: Yang, Shujuan
  organization: West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China, Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China, International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
BackLink https://www.ncbi.nlm.nih.gov/pubmed/38012067$$D View this record in MEDLINE/PubMed
BookMark eNqFkcFu1DAQhi1URLeFRwD5yCXLxE4cB06rFRSkShxazpFjT1gjx15shyqvwFM3abccuPQ0I833j0bzXZAzHzwS8raEbQkSPkBTMaiZ3DJgfMuYrHkpXpBNWbO6ENDwM7JZmWKFzslFSr8AlqDgr8g5l1AyEM2G_N2lFLRV2QZPe8x3iJ7qQww-5PmIVHlDR8yqD87qQp1gNHRQOc_U2T8YqbEJVUJqPcXx6MK8zJWZXE4f6Y664H_aPBnrlaNpaeYVvAlTPtxhyhg93R-W4WvyclAu4ZtTvSQ_vny-3X8trr9ffdvvrgvNWJULjVyVPQc9cOxZo2TDwfRMm4HplhslhgpEVbcDYqsZGM1b1fMKewFCyEryS_L-ce8xht_TckE32qTROeUxTKljsq0aVsumWtB3J3TqRzTdMdpRxbl7-t8C1I-AjiGliMM_pIRu9dQ9eepWT93J05L79F9O2_wgIUdl3TPpe6FQmlk
CitedBy_id crossref_primary_10_1016_j_ypmed_2024_108116
Cites_doi 10.1002/(SICI)1096-9136(199807)15:7<539:AID-DIA668>3.0.CO;2-S
10.1016/j.jhep.2020.03.039
10.1111/obr.12308
10.1093/jn/nxab391
10.1016/S2468-1253(19)30039-1
10.1111/liv.13896
10.1016/j.jhep.2018.05.036
10.1111/pedi.13003
10.3109/07420528.2013.837478
10.1016/S0140-6736(18)31772-0
10.1016/j.jhep.2021.10.016
10.1016/j.dld.2015.07.154
10.1002/hep.32207
10.3109/07420528.2012.719971
10.1016/j.sleep.2023.11.020
10.3390/ijms21155214
10.1016/j.dsx.2020.09.026
10.1111/jsr.12307
10.1136/oem.51.9.638
10.1111/joim.12924
10.1007/s10620-005-2719-1
10.1126/science.1195027
10.1093/aje/152.12.1192
10.1016/S0016-5085(98)70599-2
10.1007/s12072-020-10094-2
10.1152/ajpgi.1990.258.5.G653
10.1038/nrgastro.2016.160
10.1007/s11010-010-0636-x
10.1016/j.jhep.2018.06.025
10.1177/2042018820947550
10.3390/ijerph18126355
10.2147/NSS.S329894
10.1073/pnas.0506982103
10.3390/ijerph17061818
10.1073/pnas.95.1.282
10.1111/liv.14902
10.1016/j.jad.2022.10.014
10.1037/met0000347
10.2147/NSS.S290465
10.1093/sleep/zsy029
10.1111/jsr.12266
10.14218/JCTH.2021.00173
10.1016/j.jsmc.2016.10.012
10.1177/0748730416657921
10.1093/hmg/ddh261
10.3390/nu15143257
10.1016/j.jhep.2010.04.008
10.1136/oemed-2018-105273
10.1016/j.jml.2007.11.007
10.1080/00273171.2021.1889946
10.1016/j.ccell.2016.10.007
10.21037/hbsn-2022-07
10.1016/j.lanwpc.2021.100252
10.1210/jc.2014-3754
ContentType Journal Article
DBID AAYXX
CITATION
CGR
CUY
CVF
ECM
EIF
NPM
7X8
DOI 10.1080/07420528.2023.2285316
DatabaseName CrossRef
Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
MEDLINE - Academic
DatabaseTitle CrossRef
MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
MEDLINE - Academic
DatabaseTitleList MEDLINE
MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
Biology
EISSN 1525-6073
EndPage 1565
ExternalDocumentID 38012067
10_1080_07420528_2023_2285316
Genre Research Support, Non-U.S. Gov't
Journal Article
GeographicLocations China
GeographicLocations_xml – name: China
GroupedDBID ---
00X
03L
0BK
0R~
29B
30N
36B
4.4
53G
5GY
5RE
AAGDL
AAHIA
AAJMT
AALDU
AAMIU
AAPUL
AAPXX
AAQRR
AAYXX
ABCCY
ABFIM
ABIVO
ABJNI
ABLIJ
ABLKL
ABPAQ
ABXUL
ABXYU
ACGEJ
ACGFS
ACKOT
ACTIO
ADCVX
ADGTB
ADRBQ
ADXPE
ADYSH
AEISY
AENEX
AEOZL
AEPSL
AEYOC
AFKVX
AFRVT
AGDLA
AHDZW
AIJEM
AIYEW
AIZAD
AJWEG
AKBVH
AKOOK
ALMA_UNASSIGNED_HOLDINGS
ALQZU
AMPGV
AQRUH
AWYRJ
BABNJ
BLEHA
CCCUG
CITATION
CS3
DGEBU
DKSSO
DU5
EBS
EMOBN
F5P
H13
HZ~
IPNFZ
KRBQP
KWAYT
KYCEM
LJTGL
M4Z
O9-
P2P
RIG
RNANH
ROSJB
RTWRZ
TBQAZ
TDBHL
TFDNU
TFL
TFT
TFW
TQWBC
TTHFI
TUROJ
V1S
ZGOLN
~02
~1N
CGR
CUY
CVF
ECM
EIF
NPM
TASJS
7X8
ID FETCH-LOGICAL-c224t-ce3a1b30cf3eb27a8730db2cdf2c93da6f406459fee9c20dc39ab34eb60668483
ISSN 0742-0528
1525-6073
IngestDate Fri Jul 11 10:11:52 EDT 2025
Mon Jul 21 06:04:05 EDT 2025
Tue Jul 01 01:20:53 EDT 2025
Thu Apr 24 23:07:50 EDT 2025
IsPeerReviewed true
IsScholarly true
Issue 12
Keywords MAFLD
Chronotype
longitudinal study
employed adults
logistic random effects model
Language English
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c224t-ce3a1b30cf3eb27a8730db2cdf2c93da6f406459fee9c20dc39ab34eb60668483
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
PMID 38012067
PQID 2894725874
PQPubID 23479
PageCount 9
ParticipantIDs proquest_miscellaneous_2894725874
pubmed_primary_38012067
crossref_primary_10_1080_07420528_2023_2285316
crossref_citationtrail_10_1080_07420528_2023_2285316
ProviderPackageCode CITATION
AAYXX
PublicationCentury 2000
PublicationDate 2023-12-02
PublicationDateYYYYMMDD 2023-12-02
PublicationDate_xml – month: 12
  year: 2023
  text: 2023-12-02
  day: 02
PublicationDecade 2020
PublicationPlace England
PublicationPlace_xml – name: England
PublicationTitle Chronobiology international
PublicationTitleAlternate Chronobiol Int
PublicationYear 2023
References e_1_3_7_41_1
e_1_3_7_20_1
e_1_3_7_45_1
e_1_3_7_22_1
e_1_3_7_43_1
e_1_3_7_24_1
e_1_3_7_49_1
e_1_3_7_26_1
e_1_3_7_47_1
e_1_3_7_28_1
e_1_3_7_51_1
e_1_3_7_30_1
e_1_3_7_32_1
e_1_3_7_55_1
e_1_3_7_11_1
e_1_3_7_34_1
e_1_3_7_53_1
e_1_3_7_13_1
e_1_3_7_36_1
e_1_3_7_15_1
e_1_3_7_38_1
e_1_3_7_57_1
e_1_3_7_17_1
e_1_3_7_19_1
e_1_3_7_2_1
e_1_3_7_4_1
e_1_3_7_6_1
e_1_3_7_40_1
e_1_3_7_44_1
e_1_3_7_23_1
e_1_3_7_42_1
e_1_3_7_25_1
e_1_3_7_48_1
e_1_3_7_27_1
e_1_3_7_46_1
e_1_3_7_29_1
e_1_3_7_52_1
e_1_3_7_50_1
e_1_3_7_10_1
e_1_3_7_31_1
e_1_3_7_56_1
Borbély AA (e_1_3_7_8_1) 1982; 1
e_1_3_7_12_1
e_1_3_7_33_1
e_1_3_7_54_1
e_1_3_7_14_1
e_1_3_7_35_1
e_1_3_7_16_1
e_1_3_7_37_1
e_1_3_7_58_1
e_1_3_7_18_1
e_1_3_7_3_1
e_1_3_7_5_1
Horne JA (e_1_3_7_21_1) 1976; 4
e_1_3_7_7_1
Skrzypińska-Gawrysiak M (e_1_3_7_39_1) 2000; 13
e_1_3_7_9_1
References_xml – ident: e_1_3_7_3_1
  doi: 10.1002/(SICI)1096-9136(199807)15:7<539:AID-DIA668>3.0.CO;2-S
– ident: e_1_3_7_14_1
  doi: 10.1016/j.jhep.2020.03.039
– ident: e_1_3_7_37_1
  doi: 10.1111/obr.12308
– volume: 1
  start-page: 195
  year: 1982
  ident: e_1_3_7_8_1
  article-title: A two process model of sleep regulation
  publication-title: Hum Neurobiol
– ident: e_1_3_7_43_1
  doi: 10.1093/jn/nxab391
– ident: e_1_3_7_28_1
  doi: 10.1016/S2468-1253(19)30039-1
– ident: e_1_3_7_46_1
  doi: 10.1111/liv.13896
– ident: e_1_3_7_16_1
  doi: 10.1016/j.jhep.2018.05.036
– ident: e_1_3_7_44_1
  doi: 10.1111/pedi.13003
– ident: e_1_3_7_23_1
  doi: 10.3109/07420528.2013.837478
– ident: e_1_3_7_31_1
  doi: 10.1016/S0140-6736(18)31772-0
– ident: e_1_3_7_20_1
  doi: 10.1016/j.jhep.2021.10.016
– ident: e_1_3_7_17_1
  doi: 10.1016/j.dld.2015.07.154
– ident: e_1_3_7_45_1
  doi: 10.1002/hep.32207
– ident: e_1_3_7_2_1
  doi: 10.3109/07420528.2012.719971
– ident: e_1_3_7_52_1
  doi: 10.1016/j.sleep.2023.11.020
– ident: e_1_3_7_11_1
  doi: 10.3390/ijms21155214
– ident: e_1_3_7_26_1
  doi: 10.1016/j.dsx.2020.09.026
– ident: e_1_3_7_5_1
  doi: 10.1111/jsr.12307
– ident: e_1_3_7_7_1
  doi: 10.1136/oem.51.9.638
– ident: e_1_3_7_58_1
  doi: 10.1111/joim.12924
– ident: e_1_3_7_40_1
  doi: 10.1007/s10620-005-2719-1
– ident: e_1_3_7_6_1
  doi: 10.1126/science.1195027
– ident: e_1_3_7_38_1
  doi: 10.1093/aje/152.12.1192
– ident: e_1_3_7_12_1
  doi: 10.1016/S0016-5085(98)70599-2
– ident: e_1_3_7_15_1
  doi: 10.1007/s12072-020-10094-2
– volume: 4
  start-page: 97
  year: 1976
  ident: e_1_3_7_21_1
  article-title: A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms
  publication-title: Int J Chronobiol
– ident: e_1_3_7_32_1
  doi: 10.1152/ajpgi.1990.258.5.G653
– ident: e_1_3_7_49_1
  doi: 10.1038/nrgastro.2016.160
– ident: e_1_3_7_42_1
  doi: 10.1007/s11010-010-0636-x
– ident: e_1_3_7_29_1
  doi: 10.1016/j.jhep.2018.06.025
– ident: e_1_3_7_57_1
  doi: 10.1177/2042018820947550
– ident: e_1_3_7_56_1
  doi: 10.3390/ijerph18126355
– ident: e_1_3_7_54_1
  doi: 10.2147/NSS.S329894
– ident: e_1_3_7_55_1
  doi: 10.1073/pnas.0506982103
– ident: e_1_3_7_27_1
  doi: 10.3390/ijerph17061818
– ident: e_1_3_7_13_1
  doi: 10.1073/pnas.95.1.282
– ident: e_1_3_7_22_1
  doi: 10.1111/liv.14902
– ident: e_1_3_7_35_1
  doi: 10.1016/j.jad.2022.10.014
– ident: e_1_3_7_33_1
  doi: 10.1037/met0000347
– ident: e_1_3_7_48_1
  doi: 10.2147/NSS.S290465
– ident: e_1_3_7_34_1
  doi: 10.1093/sleep/zsy029
– ident: e_1_3_7_9_1
  doi: 10.1111/jsr.12266
– ident: e_1_3_7_41_1
  doi: 10.14218/JCTH.2021.00173
– ident: e_1_3_7_19_1
  doi: 10.1016/j.jsmc.2016.10.012
– ident: e_1_3_7_18_1
  doi: 10.1177/0748730416657921
– ident: e_1_3_7_4_1
  doi: 10.1093/hmg/ddh261
– ident: e_1_3_7_10_1
  doi: 10.3390/nu15143257
– ident: e_1_3_7_36_1
  doi: 10.1016/j.jhep.2010.04.008
– ident: e_1_3_7_47_1
  doi: 10.1136/oemed-2018-105273
– ident: e_1_3_7_24_1
  doi: 10.1016/j.jml.2007.11.007
– ident: e_1_3_7_30_1
  doi: 10.1080/00273171.2021.1889946
– ident: e_1_3_7_25_1
  doi: 10.1016/j.ccell.2016.10.007
– ident: e_1_3_7_51_1
  doi: 10.21037/hbsn-2022-07
– ident: e_1_3_7_50_1
  doi: 10.1016/j.lanwpc.2021.100252
– volume: 13
  start-page: 165
  year: 2000
  ident: e_1_3_7_39_1
  article-title: Circadian variations in hepatotoxicity of carbon tetrachloride in mice
  publication-title: Int J Occup Med Environ Health
– ident: e_1_3_7_53_1
  doi: 10.1210/jc.2014-3754
SSID ssj0008063
Score 2.382965
Snippet The circadian system is an essential physiological regulator of mammals, and sleep chronotype may be associated with the risk of metabolic disorders. However,...
SourceID proquest
pubmed
crossref
SourceType Aggregation Database
Index Database
Enrichment Source
StartPage 1557
SubjectTerms Adult
Animals
China
Chronotype
Circadian Rhythm
Humans
Longitudinal Studies
Mammals
Non-alcoholic Fatty Liver Disease
Title Association between chronotype and metabolic-associated fatty liver disease in employed adults: A longitudinal study in Southwestern China
URI https://www.ncbi.nlm.nih.gov/pubmed/38012067
https://www.proquest.com/docview/2894725874
Volume 40
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Jb9QwFLaGVlS9ICjbsMlIXDPK2M7GbcqiUSUQh1YULpG3SJGmSUWTA1y58at5XiegqVgu0cixMyN_3zw_vzx_D6EXeaEYLdUyaTJTwoyoNCmlThPwXSnNldTSZfm-z9dn7OQ8O5_Nvk-ylsZBLOS3nedK_gdVaANczSnZf0A2PhQa4DPgC1dAGK5_hfFkbmPClTRqt72NrJqY-IUeAOZNKxPuO4OH2fDBFIwwKRnhDY2VDnHVf5UT5bhyh9Y3valoNCpbPcuK0ZqutvKeV1nY1uCOkgf2NwR9p3YadIx8Ga3x5300O7bhuI1k_eQj2cexywcXrD1p-TRWQajN-3DGVnv7SrIkT131kmCAnV5TIBqZmFNwdoqddt4nRsK-Ps2IydAjdEEIuB7u4OYE-8sLCz41K3HqKn_8JrAdbt1A-wT2GmAs91fr158_xgW9BDcuHP4ysuy7vvUQHYTn_OrhXLNtse7L6W10y-878MqR6A6a6e4I3XSVSL8eoYN3PsfiLvoxYRX2rMJbVmFgFd7FKmxZhS2rsGcVbjscWIUdq17iFZ5yCltOmY5TTmHLqXvo7O2b01frxFfsSCS4gkMiNeVLQVPZUC1IwUtYP5QgUjVEVlTxvGFGH7FqtK4kSZWkFReUaWG20SUr6X201_WdfohwyVhVKCFZtRQwSPKKsEJUGUww1wDIHLEwy7X0cvamqsqmXgbVW49TbXCqPU5ztIjDLp2ey58GPA8Q1mB5zes03ul-vKpJWbGCZGXB5uiBwzY-MnDh0bV3HqPD7T_kCdobvoz6Kfi3g3jm-fcTOeykJQ
linkProvider Library Specific Holdings
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Association+between+chronotype+and+metabolic-associated+fatty+liver+disease+in+employed+adults%3A+A+longitudinal+study+in+Southwestern+China&rft.jtitle=Chronobiology+international&rft.au=Fu%2C+Yao&rft.au=Yu%2C+Bin&rft.au=Yang%2C+Bo&rft.au=Pan%2C+Jia&rft.date=2023-12-02&rft.eissn=1525-6073&rft.volume=40&rft.issue=12&rft.spage=1557&rft_id=info:doi/10.1080%2F07420528.2023.2285316&rft_id=info%3Apmid%2F38012067&rft.externalDocID=38012067
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0742-0528&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0742-0528&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0742-0528&client=summon