Table 1 Overview of the studies reporting the impact of shift work on MASLD

Balakrishnan et al.⁵³

8159 participants from the 2005-2010 NHANES cycles, aged 20–79 years

To investigate the association between shiftwork and the risk of MASLD identified by elevated aminotransferases

MASLD occurred more frequently in shift workers than in non-shift workers, but overall shift work was not associated with the risk of MASLD

Wang et al.⁵⁵

4740 male workers of whom 39.5% were night shift workers

To address the relationship between night shift work and the elevated alanine transaminase level of workers, and analyse the potential mediating effect of MASL by means of liver ultrasound

Night shift workers had a higher risk of elevated alanine transaminase levels, which increased with increasing years of night shifts. It is likely that shift work involving circadian disruption exerts a direct effect on liver dysfunction

Zhang et al.⁵⁴

6881 subjects including night shift workers and those who never worked night shifts

To explore the association between night shift work and MASLD assessed with abdominal ultrasonography in steel workers

Night shift workers had greater odds of MASLD compared to those who never worked night shifts. The duration, cumulative number and cumulative duration of night shifts were positively associated with MASLD

Huang et al.⁵⁶

281,280 UK Biobank participants aged 37–73 years

To explore the association between night shift work and the risk of MASLD diagnosed in the event of hospitalisation or death

Compared to workers who never/rarely worked night shifts, those who worked some or regular/permanent night shifts were more likely to develop MASLD. Longer duration and higher frequency shift work showed a higher risk of incident MASLD, and the association was not modified by genetic predisposition

Maidstone et al.⁵⁷

286,825 UK Biobank participants aged 40–69 years

To study the relationship between shift work and chronotype with liver fat fraction and MASLD defined by Dallas steatosis index, previous hospital admissions and proton density fat fraction (PDFF)

Shift workers were more likely to develop pathological fat content in the liver, predisposing to MASLD, and this effect was mediated by obesity. Extreme late chronotypes had accumulation of liver fat similar to shift workers