睡眠总时长与代谢综合征的相关性研究
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摘要
目的探讨自我报告睡眠总时长与代谢综合征(MS)发生风险的关系,为MS的早期预防提供依据。方法使用2015年于深圳市南山区开展的"慢性病与营养监测"和"慢性病及危险因素监测"调查数据,采用多阶段随机抽样方法,选取深圳市南山区1 820名18岁及以上人群为研究对象。问卷均由通过统一培训的调查员面对面询问填写,包括人口学基本特征、吸烟状况、饮酒频率、业余时间体育锻炼情况、睡眠总时长以及既往疾病史等信息,进行身高、体重、腰围等体格检查和血脂、血糖等生化指标测定。依据国际糖尿病联合会流行病学和预防专委会联合声明(JIS)和国际糖尿病联盟(IDF)定义分别对研究对象进行MS诊断。根据自报睡眠总时长将研究对象分成3组,其中≤6.0 h/d组266名、6.1～8.0 h/d组1 288名和>8.0 h/d组167名。采用易侕软件version 2.14.9和R软件version 3.2.0软件进行χ~2检验,自我报告睡眠总时长与罹患MS风险之间的关系采用多因素logistic回归分析。结果本次研究纳入1 721名信息完善者,调查对象平均每天睡眠总时长为(7.36±1.00)h。24 h睡眠总时长为≤6.0、6.1～8.0和>8.0 h的人群分别占总人群的15.46%、74.84%和9.70%。按照JIS和IDF诊断标准,MS患病率分别为31.49%和21.38%。多因素logistic回归结果显示,45岁以下人群24 h睡眠总时长≤6.0 h是MS(JIS)、MS(IDF)和中心性肥胖的危险因素,其OR值分别为1.81(95%CI:1.14～2.87),2.52(95%CI:1.52～4.20)和2.35(95%CI:1.42～3.87),45岁以上人群未发现这种相关性;未发现18岁及以上人群睡眠总时长>8.0 h/d与罹患MS风险之间的关联。结论 45岁以下人群24 h睡眠总时长≤6.0 h与MS相关,睡眠总时长≤6.0 h可能是其发生MS的危险因素。
Objective To explore the correlation between self-report total sleep duration and the morbidity of metabolic syndrome(MS),and to provide the reference for early prevention of MS. Methods Date were from the China Health and Nutrition Survey and the Influencing Factors of Chronic Diseases Survey conducted among residents of the Nanshan District in Shenzhen in 2015 of China. The multi-stage random sampling method was used to selected the 1 820 residents(≥18 years old) as the subjects. The investigation was performed by questionnaire,physical examination and biochemical indexes. The questionnaire included the demographic characteristic,smoking,drinking,exercises,total sleep duration,disease history. The physical examination included the height,weight,waistline. The biochemical indexes included the blood lipid and blood glucose. MS was diagnosed according to the criteria from the Joint Interim Statement(JIS) criteria and the International Diabetes Federation(IDF) criteria,respectively.According to total sleep duration,the subjects were divided into three groups:≤6.0 h/d group(266 cases),6.1～8.0 h/d group(1 288 cases) and >8.0 h/d group(167 cases). The R 3.2.0 software and Empower 2.14.9 software were used to analyze the data,the χ2 test was used to compare the difference between groups. Multivariate logistic regression analysis method was used to analyze the correlation between self-report total sleep duration and the MS morbidity. Results This study include 1 721 subjects. The mean total sleep duration of the subjects was(7.36±1.00) h,according to of total sleep duration for 24 h,the proportions of ≤6.0 h/d group,6.1～8.0 h/d group and >8.0 h/d group were15.46%,74.84% and 9.70%,respectively. The MS morbidities based on the definitions from the JIS and IDF were 31.49% and 21.38%,respectively. The multiple logistic regression showed that the sleep duration for 24 h ≤6 h was the risk factor of MS(JIS)(OR=1.81,95%CI:1.14-2.87),MS(IDF)(OR=2.52,95%CI:1.52-4.20)and central obesity(OR=2.35,95%CI:1.42-3.87) in the subjects(≤45 years old),but in the subjects(>45 years old) this correlation was not found. The correlation between long sleep duration(>8.0 h) and MS was not found in the subjects(≥18 years old). Conclusion In subjects(<45 years old),the sleep duration for 24 h ≤6.0 h was associated with MS,the total sleep duration≤6.0 h may be a risk factor for MS.
Objective To explore the correlation between self-report total sleep duration and the morbidity of metabolic syndrome(MS),and to provide the reference for early prevention of MS. Methods Date were from the China Health and Nutrition Survey and the Influencing Factors of Chronic Diseases Survey conducted among residents of the Nanshan District in Shenzhen in 2015 of China. The multi-stage random sampling method was used to selected the 1 820 residents(≥18 years old) as the subjects. The investigation was performed by questionnaire,physical examination and biochemical indexes. The questionnaire included the demographic characteristic,smoking,drinking,exercises,total sleep duration,disease history. The physical examination included the height,weight,waistline. The biochemical indexes included the blood lipid and blood glucose. MS was diagnosed according to the criteria from the Joint Interim Statement(JIS) criteria and the International Diabetes Federation(IDF) criteria,respectively.According to total sleep duration,the subjects were divided into three groups:≤6.0 h/d group(266 cases),6.1～8.0 h/d group(1 288 cases) and >8.0 h/d group(167 cases). The R 3.2.0 software and Empower 2.14.9 software were used to analyze the data,the χ2 test was used to compare the difference between groups. Multivariate logistic regression analysis method was used to analyze the correlation between self-report total sleep duration and the MS morbidity. Results This study include 1 721 subjects. The mean total sleep duration of the subjects was(7.36±1.00) h,according to of total sleep duration for 24 h,the proportions of ≤6.0 h/d group,6.1～8.0 h/d group and >8.0 h/d group were15.46%,74.84% and 9.70%,respectively. The MS morbidities based on the definitions from the JIS and IDF were 31.49% and 21.38%,respectively. The multiple logistic regression showed that the sleep duration for 24 h ≤6 h was the risk factor of MS(JIS)(OR=1.81,95%CI:1.14-2.87),MS(IDF)(OR=2.52,95%CI:1.52-4.20)and central obesity(OR=2.35,95%CI:1.42-3.87) in the subjects(≤45 years old),but in the subjects(>45 years old) this correlation was not found. The correlation between long sleep duration(>8.0 h) and MS was not found in the subjects(≥18 years old). Conclusion In subjects(<45 years old),the sleep duration for 24 h ≤6.0 h was associated with MS,the total sleep duration≤6.0 h may be a risk factor for MS.
引文
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[14]王靖.大学生睡眠状况与影响因素分析研究[J].公共卫生与预防医学,2012,23(1):56-58.
[15] Haseli-Mashhadi N,Pan A,Ye X,et al. Self-rated health in middleaged and elderly Chinese:distribution,determinants and associations with cardio-metabolic risk factors[J]. BMC Public Health,2009,9:368-378.DOI:10.1186/1471-2458-9-368.
[16]马冠生,崔朝辉,胡小琪,等.中国居民的睡眠时间分析[J].中国慢性病预防与控制,2006,14(2):68-71.
[17]殷鹏,张梅,李镒冲,等.中国15-69岁居民睡眠状况分析[J].中国慢性病预防与控制,2011,19(2):152-153.
[18] Chaput JP,McNeil J,Despres JP,et al. Short sleep duration as a risk factor for the development of the metabolic syndrome in adults[J].Prev med,2013,57(6):872-877.
[19] Choi KM,Lee JS,Park HS,et al. Relationship between sleep duration and the metabolic syndrome:Korean National Health and Nutrition Survey 2001[J]. Int J Obes,2008,32(7):1091-1097.
[20] Arora T,Jiang CQ,Thomas GN,et al. Self-reported long total sleep duration is associated with metabolic syndrome:the Guangzhou Biobank Cohort Study[J]. Diabetes Care,2011,34(10):2317-2319.
[21] Wu J,Xu G,Shen L,et al. Daily sleep duration and risk of metabolic syndrome among middle-aged and older Chinese adults:crosssectional evidence from the Dongfeng-Tongji cohort study[J]. BMC Public Health,2015,15:178. DOI:10.1186/s12889-015-1521-z.
[22] Hirshkowitz M,Whiton K,Albert SM,et al. National Sleep Foundation’s sleep time duration recommendations:methodology and results summary[J]. Hypertens Res,2013,36(11):985-995.
[23] Chaput JP,Despres JP,Bouchard C,et al. The association between sleep duration and weight gain in adults:a 6-year prospective study from the Quebec Family Study[J]. Sleep,2008,31(4):517-523.
[24]洪忻,李解权,梁亚琼,等.睡眠时间与肥胖关系的3年随访研究[J].中国慢性病预防与控制,2011,19(3):226-230.
[25] Van Cauter E,Knutson KL. Sleep and the epidemic of obesity in children and adults[J]. Eur J Endocrinol,2008,159(Suppl 1):S59-66.
[2] Xi B,He D,Hu Y,et al. Prevalence of metabolic syndrome and its influencing factors among the Chinese adults:the China Health and Nutrition Survey in 2009[J]. Prev Med,2013,57(6):867-871.
[3] Mottillo S,Filion KB,Genest J,et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis[J]. J Am Coll Cardiol,2010,56(14):1113-1132.
[4] Ford ES. Risks for all-cause mortality,cardiovascular disease,and diabetes associated with the metabolic syndrome:a summary of the evidence[J]. Diabetes Care,2005,28(7):1769-1778.
[5] Noda H,Iso H,Saito I,et al. The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke:the Japan public health center-based study[J]. Hypertens Res,2009,32(4):289-298.
[6] Esposito K,Chiodini P,Colao A,et al. Metabolic syndrome and risk of cancer:a systematic review and meta-analysis[J]. Diabetes Care,2012,35(11):2402-2411.
[7] Wu Y,Zhai L,Zhang D. Sleep duration and obesity among adults:a meta-analysis of prospective studies[J]. Sleep Med,2014,15(12):1456-1462.
[8] Gangwisch JE. A review of evidence for the link between sleep duration and hypertension[J]. Am J Hypertens,2014,27(10):1235-1242.
[9]吴宪明,孙跃民,姚薇,等.睡眠时间与高血压发生的相关性队列研究[J].中国慢性病预防与控制,2016,24(4):255-258.
[10] Shan Z,Ma H,Xie M,et al. Sleep duration and risk of type 2diabetes:a meta-analysis of prospective studies[J]. Diabetes Care,2015,38(3):529-537.
[11] Cappuccio FP,Cooper D,D'elia L,et al. Sleep duration predicts cardiovascular outcomes:a systematic review and meta-analysis of prospective studies[J]. Eur Heart J,2011,32(12):1484-1492.
[12] Alberti KG,Zimmet P,Shaw J,et al. The metabolic syndrome--a new worldwide definition[J]. Lancet,2005,366(9491):1059-1062.
[13]国家卫生计生委疾病预防控制局编著.中国居民营养与慢性病状况报告(2015年)[R].北京:人民卫生出版社,2015.
[14]王靖.大学生睡眠状况与影响因素分析研究[J].公共卫生与预防医学,2012,23(1):56-58.
[15] Haseli-Mashhadi N,Pan A,Ye X,et al. Self-rated health in middleaged and elderly Chinese:distribution,determinants and associations with cardio-metabolic risk factors[J]. BMC Public Health,2009,9:368-378.DOI:10.1186/1471-2458-9-368.
[16]马冠生,崔朝辉,胡小琪,等.中国居民的睡眠时间分析[J].中国慢性病预防与控制,2006,14(2):68-71.
[17]殷鹏,张梅,李镒冲,等.中国15-69岁居民睡眠状况分析[J].中国慢性病预防与控制,2011,19(2):152-153.
[18] Chaput JP,McNeil J,Despres JP,et al. Short sleep duration as a risk factor for the development of the metabolic syndrome in adults[J].Prev med,2013,57(6):872-877.
[19] Choi KM,Lee JS,Park HS,et al. Relationship between sleep duration and the metabolic syndrome:Korean National Health and Nutrition Survey 2001[J]. Int J Obes,2008,32(7):1091-1097.
[20] Arora T,Jiang CQ,Thomas GN,et al. Self-reported long total sleep duration is associated with metabolic syndrome:the Guangzhou Biobank Cohort Study[J]. Diabetes Care,2011,34(10):2317-2319.
[21] Wu J,Xu G,Shen L,et al. Daily sleep duration and risk of metabolic syndrome among middle-aged and older Chinese adults:crosssectional evidence from the Dongfeng-Tongji cohort study[J]. BMC Public Health,2015,15:178. DOI:10.1186/s12889-015-1521-z.
[22] Hirshkowitz M,Whiton K,Albert SM,et al. National Sleep Foundation’s sleep time duration recommendations:methodology and results summary[J]. Hypertens Res,2013,36(11):985-995.
[23] Chaput JP,Despres JP,Bouchard C,et al. The association between sleep duration and weight gain in adults:a 6-year prospective study from the Quebec Family Study[J]. Sleep,2008,31(4):517-523.
[24]洪忻,李解权,梁亚琼,等.睡眠时间与肥胖关系的3年随访研究[J].中国慢性病预防与控制,2011,19(3):226-230.
[25] Van Cauter E,Knutson KL. Sleep and the epidemic of obesity in children and adults[J]. Eur J Endocrinol,2008,159(Suppl 1):S59-66.