体重指数在同煤集团职工打鼾与代谢综合征关系中的中介效应
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摘要
目的研究在山西大同煤矿集团职工中打鼾对代谢综合征(MS)的影响,并探讨体重指数(BMI)在打鼾与MS关联中的中介作用。方法选择3 794名大同煤矿集团职工为研究对象,调查其一般情况并测量身高、体重、腰围、血压以及MS相关生化指标。用Logistic回归模型在井上井下2个亚组中分析打鼾与MS的关联;并用中介效应模型分析BMI在打鼾与MS关系中BMI的中介效应。结果井上和井下职工中,打鼾者患MS的风险均较高。OR值分别为:1.40(1.11,1.76)和1.60(1.29,2.02)。BMI对打鼾与MS的中介效应有统计学意义(中介效应值为9.55,P<0.01)。中介效应百分比为20.53%。结论同煤集团职工中,打鼾是MS的危险因素,BMI在打鼾与MS的关系中起部分中介作用。
Objective The aim of this study was to explore the effect of snoring on metabolic syndrome(MS) among Datong coal mining enterprises and further examine the mediating effect of body mass index(BMI). Methods From July 2013 to December 2013, 3794 employees of coal mining enterprises aged from 18 to 65 were recruited from Shanxi province, China.They were interviewed with self-made general condition questionnaire and international physical activity questionnaire.Height, weight, waist, blood pressure and biochemical variables related to MS were also measured. Logistic regression model was used to assess the relationship between snoring and MS among underground and ground workers. Mediation effect analysis was conducted to investigate the mediating effect of BMI on the association between snoring and MS. Results In Datong coal mining enterprises, snoring was related to the prevalence of MS in both ground(OR: 1.40; 95%CI: 1.11, 1.76)and underground(OR: 1.60; 95%CI: 1.29, 2.02) workers. Furthermore, there was a significant mediating effect of BMI on the association between snoring and MS(ZMediation=9.55; P <0.001). Mediation effect accounted for 20.53% of the total effect.Conclusion Snoring is a risk factor for MS. And BMI had significant mediating effect on snoring and MS.
Objective The aim of this study was to explore the effect of snoring on metabolic syndrome(MS) among Datong coal mining enterprises and further examine the mediating effect of body mass index(BMI). Methods From July 2013 to December 2013, 3794 employees of coal mining enterprises aged from 18 to 65 were recruited from Shanxi province, China.They were interviewed with self-made general condition questionnaire and international physical activity questionnaire.Height, weight, waist, blood pressure and biochemical variables related to MS were also measured. Logistic regression model was used to assess the relationship between snoring and MS among underground and ground workers. Mediation effect analysis was conducted to investigate the mediating effect of BMI on the association between snoring and MS. Results In Datong coal mining enterprises, snoring was related to the prevalence of MS in both ground(OR: 1.40; 95%CI: 1.11, 1.76)and underground(OR: 1.60; 95%CI: 1.29, 2.02) workers. Furthermore, there was a significant mediating effect of BMI on the association between snoring and MS(ZMediation=9.55; P <0.001). Mediation effect accounted for 20.53% of the total effect.Conclusion Snoring is a risk factor for MS. And BMI had significant mediating effect on snoring and MS.
引文
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[3]Zhao SC,Xia M,Tang JC,et al.Associations between metabolic syndrome and clinical benign prostatic hyperplasia in a northern urban Han Chinese population:A prospective cohort study[J].2016,6:33933.
[4]吕霞霞,李福辉.高血压相关危险因素及其与代谢综合征的相关性分析[J].现代预防医学,2016,43(5):857-859,890.
[5]Scuteri A,Laurent S,Cucca F,et al.Metabolic syndrome across Europe:different clusters of risk factors[J].European Journal of Preventive Cardiology,2015,22(4):486-491.
[6]Vidigal FD,Ribeiro AQ,Babio N,et al.Prevalence of metabolic syndrome and pre-metabolic syndrome in health professionals:LAT-INMETS Brazil study[J].Diabetology&Metabolic Syndrome,2015,7(1):1-9.
[7]Leineweber C,Kecklund G,Akerstedt T,et al.Snoring and the metabolic syndrome in women[J].Sleep Medicine,2003,4(6):531-536.
[8]Roopa M,Deepa M,Indulekha K,et al.Prevalence of sleep abnormalities and their association with metabolic syndrome among Asian Indians:Chennai Urban Rural Epidemiology Study(CURES-67)[J].Journal of Diabetes Science&Technology,2010,4(6):1524-1531.
[9]Sabanayagam C,Zhang R,Shankar A.Markers of Sleep-Disordered breathing and metabolic syndrome in a multiethnic sample of USadults:results from the National health and nutrition examination survey 2005-2008[J].International Journal of Endocrinology,2012(2012):69-77.
[10]Shin MH,Kweon SS,Choi BY,et al.Self-reported snoring and metabolic syndrome:the Korean Multi-Rural Communities Cohort Study[J].Sleep and Breathing,2014,18(2):423-430.
[11]Sun L,Pan A,Yu ZJ,et al.Snoring,inflammatory markers,adipokines and metabolic syndrome in apparently healthy Chinese[J].PLOS One,2011,6(11):436-436.
[12]Ben Kazman J,Abraham PA,Zeno SA,et al.Self-reported sleep impairment and the metabolic syndrome among African Americans[J].Ethnicity&Disease,2012,22(4):410-415.
[13]陶然,黄建军,孙晨明,等.男性煤矿工人高体力活动水平与不同定义下血脂异常水平的关联性[J].中华疾病控制杂志,2017,21(2):123-127.
[14]Wolin K,Heil D,Askew S,et al.Guidelines for data processing and analysis of the International Physical Activity Questionnaire(IPAQ)-short and long form;2005[J].J Phys Act Health,2008,,5(5):746-760.
[15]Panoulas VF,Ahmad N,Fazal AA,et al.The inter-operator variability in measuring waist circumference and its potential impact on the diagnosis of the metabolic syndrome[J].Postgraduate Medical Journal,2008,84(993):344-347.
[16]Alberti KGMM,Eckel RH,Grundy SM,et al.Harmonizing the metabolic syndrome[J].Circulation,2009,120(16):1640-1645.
[17]Baron RM,Kenny DA.The moderator-mediator variable distinction in social psychological research:conceptual,strategic,and statistical considerations[J].Journal of Personality and Social Psychology,1986,51(6):1173-1182.
[18]Iacobucci D.Mediation analysis and categorical variables:The final frontier[J].Journal of Consumer Psychology,2012,22(4):582-594.
[19]Goya TT,Silva RF,Guerra RS,et al.Increased muscle sympathetic nerve activity and impaired executive performance capacity in obstructive sleep apnea[J].Sleep,2016,39(1):25-33.
[20]贺群,李明晖.阻塞性睡眠呼吸暂停低通气综合征程度与血压变异性和血清瘦素相关性研究[J].中华全科医学,2017,15(2):258-260.
[21]Bove C,Younes N,Hynes M,et al.0639 Sleepiness in patients with obstructive sleep apnea is associated with unhealthy diet[J].Sleep,2017,40(suppl 1):A236-A236.
[22]Rosen ED,Spiegelman BM.Adipocytes as regulators of energy balance and glucose homeostasis[J].Nature,2006,444(7121):847-853.收稿日期:2017-12-23