Association between weekend catch-up sleep and Metabolic dysfunction-associated steatotic liver disease in US adults

The present study aims to investigate the relationship between weekend catch-up sleep (WCS) and Metabolic dysfunction-associated steatotic liver disease (MASLD) in US adults aged 20 years and above. Data were obtained from the National Health and Nutrition Examination Survey (2017–2020), a total of 4803 eligible participants were included in this study. Weighted logistic regression modeling, stratified subgroup analysis, and restricted cubic splines (RCS) were employed to examine the association between WCS and MASLD. In weighted logistic regression analyses, a significant positive association was observed between WCS and MASLD risk. When modeled as a continuous variable, each 1-hour increase in WCS was associated with a 9% higher odds of MASLD (OR = 1.09, 95% CI: 1.02–1.16, P = 0.02). Similarly, binary analysis (WCS > 1 h vs. ≤1 h) showed a robust and significant association, with a 38% increase in MASLD odds in the fully adjusted model (OR = 1.38, 95% CI: 1.14–1.67, P = 0.006). The subgroup analyses revealed statistically significant positive associations were specifically observed among older adults (≥ 60 years), individuals with hypertension, and current smokers(P < 0.05), while no statistically significant interactions (all P for interaction > 0.05). A linear dose-response relationship between WCS and MASLD risk was observed in the RCS analysis(P for non-linearity = 0.222; P for overall = 0.003). Prolonged WCS was significantly associated with an elevated risk of metabolic MASLD.