围绝经期女性睡眠模式与骨密度的关系
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摘要
目的探讨围绝经期女性睡眠模式与骨密度的关系。方法对南京6510例40岁以上女性进行问卷调查和跟骨定量超声测量骨密度,分析睡眠模式与骨密度的关系。结果 6510例受试对象中,50.01%诊断为骨量正常;36.51%诊断为骨量减少;12.47%诊断为骨质疏松。与未绝经女性相比,已绝经女性更容易发生骨量减少和骨质疏松(P<0.01)。在校正了相关影响因素后,入睡时间在24点以后女性的骨量减少和骨质疏松发生风险是22~23点入睡女性的2.183倍和1.687倍(P<0.05)。日睡眠总时间>10h和夜间睡眠时间<7h的女性发生骨量减少和骨质疏松的风险更高(P<0.05)。相比白天不睡和不午睡的女性,白天睡眠时间>120min和午睡时间>30min的女性发生骨量减少和骨质疏松的风险升高(P<0.05)。结论睡眠的生理节律打乱可能促进绝经女性的骨量流失。
Objective To explore the relationship between sleep patterns and bone mineral density in perimenopausal women.Methods A total of 6510 females aged over 40 year old living in Nanjing was surveyed,in whom the bone mineral density was measured by quantitative ultrasound.The relationship between sleep patterns and bone mineral density was analyzed.Results Of 6510 subjects,the percentage of women diagnosed as normal bone mass was 50.01%,that of those with bone loss was 36.51%,and that of those with osteoporosis was 12.47%.Compared with nonmenopausal women,menopausal women were more likely to develop bone loss and osteoporosis(P<0.01).After adjusting for relevant factors,the risks for bone loss and osteoporosis in women sleeping at 22∶00 to 23∶00pm were 2.183 times and 1.687 times as in those sleeping at 24∶00pm(P<0.05).The risks for bone loss and osteoporosis were higher in women with a total sleep time>10 hours per day and nocturnal sleep time<7 hours(P<0.05).The risks for bone loss and osteoporosis were increased in women having daytime sleep time>120 minutes and nap time>30minutes than those without sleep and afternoon nap in daytime(P<0.05).Conclusion The disturbance of physiological rhythm may promote bone mass loss in postmenopausal women.
Objective To explore the relationship between sleep patterns and bone mineral density in perimenopausal women.Methods A total of 6510 females aged over 40 year old living in Nanjing was surveyed,in whom the bone mineral density was measured by quantitative ultrasound.The relationship between sleep patterns and bone mineral density was analyzed.Results Of 6510 subjects,the percentage of women diagnosed as normal bone mass was 50.01%,that of those with bone loss was 36.51%,and that of those with osteoporosis was 12.47%.Compared with nonmenopausal women,menopausal women were more likely to develop bone loss and osteoporosis(P<0.01).After adjusting for relevant factors,the risks for bone loss and osteoporosis in women sleeping at 22∶00 to 23∶00pm were 2.183 times and 1.687 times as in those sleeping at 24∶00pm(P<0.05).The risks for bone loss and osteoporosis were higher in women with a total sleep time>10 hours per day and nocturnal sleep time<7 hours(P<0.05).The risks for bone loss and osteoporosis were increased in women having daytime sleep time>120 minutes and nap time>30minutes than those without sleep and afternoon nap in daytime(P<0.05).Conclusion The disturbance of physiological rhythm may promote bone mass loss in postmenopausal women.
引文
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[3]Kobayashi D,Takahashi O,Deshpande GA,et al.Association between osteoporosis and sleep duration in healthy middleaged and elderly adults:a large-scale,cross-sectional study in Japan[J].Sleep Breath,2012,16(2):579-583.
[4]Fu X,Zhao X,Lu H,et al.Association between sleep duration and bone mineral density in Chinese women[J].Bone,2011,49(5),1062-1066.
[5]Sun X,Dai X,Yang T,et al.Effects of mental resilience on neuroendocrine hormones level changes induced by sleep deprivation in servicemen[J].Endocrine,2014,47(3):884-888.
[6]Everson CA,Folley AE,Toth JM.Chronically inadequate sleep results in abnormal bone formation and abnormal bone marrow in rats[J].Exp Biol Med(Maywood),2012,237(9):1101-1109.
[7]Ning G,Reaction study group.Risk evaluation of cAncers in Chinese diabeTic Individuals:a lONgitudial(REACTION)study[J].J Diabetes,2012,4(2):172-173.
[8]Wang K,Yang Y,Wu Y,et al.The association of menstrual and reproductive factors with thyroid nodules in Chinese women older than 40years of age[J].Endocrine,2015,48(2):603-614.
[9]Hahm BJ,Jo B,Dhabhar FS,et al.Bedtime misalignment and progression of breast cancer[J].Chronobiol Int,2014,31(2):214-221.
[10]宁魏青,杨玲,吴洁,等.苏州地区绝经后妇女骨质疏松症及相关影响因素分析[J].江苏医药,2011,37(18):2157-2159.
[11]Xu F,Dong Y,Huang X,et al.Decreased osteoclastogenesis,osteoblastogenesis and low bone mass in a mouse model of type 2diabetes[J].Mol Med Rep,2014,10(4),1935-1941.
[12]Burgard SA,Ailshire JA.Gender and time for sleep among U.S.adults[J].Am Sociol Rev,2013,78(1),51-69.
[13]Bi Y,Lu J,Wang W,et al.Cohort profile:risk evaluation of cancers in Chinese diabetic individuals:a longitudinal(REACTION)study[J].J Diabetes,2014,6(2),147-157.
[14]Burgess HJ,Eastman CI.Early versus late bedtimes phase shift the human dim light melatonin rhythm despite a fixed morning lights on time[J].Neurosci Lett,2004,356(2):115-118.
[15]Nagata C,Nagao Y,Yamamoto S,et al.Light exposure at night,urinary 6-sulfatoxymelatonin,and serum estrogens and androgens in postmenopausal Japanese women[J].Cancer Epidemiol Biomarkers Prev,2008,17(16):1418-1423.
[16]Feskanich D,Hankinson SE,Schernhammer ES.Nightshift work and fracture risk:the Nurses'Health Study[J].Osteoporos Int,2009,20(4):537-542.
[17]Heshmati HM,Riggs BL,Burritt MF,et al.Effects of the circadian variation in serum cortisol on markers of bone turnover and calcium homeostasis in normal postmenopausal women[J].J Clin Endocrinol Metab,1998,83(3):751-756.