天津市成人夜间睡眠时长与血脂水平的关系

贺江珊; 张莉; 李春君; 郭佩; 张勉之; 王建雄; 汪玉雪; 范雅琪; 张敏英

doi:10.16462/j.cnki.zhjbkz.2022.02.005

天津市成人夜间睡眠时长与血脂水平的关系

doi: 10.16462/j.cnki.zhjbkz.2022.02.005

1.
300071 天津，南开大学医学院
2.
300192 天津，天津市第一中心医院健康管理中心
3.
300121 天津，天津市人民医院健康管理中心
4.
300120 天津，天津中医药研究院附属医院肾病科
5.
300070 天津，天津医科大学研究生院

基金项目:

国家重点研发计划 2016YFC0900600

国家重点研发计划 2016YFC0900604

详细信息

通讯作者:
张敏英，E-mail: zhangminying@nankai.edu.cn

中图分类号: R589.2
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- 被引次数: 0
出版历程
- 收稿日期: 2021-04-06
- 修回日期: 2021-07-31
- 网络出版日期: 2022-02-10
- 刊出日期: 2022-02-10

Associations of night sleep duration with blood lipid levels of adults in Tianjin

1.
School of Medicine, Nankai University, Tianjin 300071, China
2.
Health Management Center, Tianjin First Central Hospital, Tianjin 300192, China
3.
Health Management Center, Tianjin Union Medical Center, Tianjin 300121, China
4.
Department of Nephropathy, Tianjin Academy of Traditional Medicine Affiliated Hospital, Tianjin 300120, China
5.
Graduate School to Tianjin Medical University, Tianjin 300070, China

Funds:

The National Key Research and Development Program of China 2016YFC0900600

The National Key Research and Development Program of China 2016YFC0900604

More Information

Corresponding author: ZHANG Min-ying, E-mail: zhangminying@nankai.edu.cn

摘要

摘要: 目的探索天津市成年人夜间睡眠时长与TC、TG、HDL-C和LDL-C水平之间的关系。方法本研究分析了“十三五”国家重点研发计划“京津冀地区自然人群队列研究”的部分基线数据。采用多阶段分层整群抽样的方法，选取2018年1月8日―2020年1月9日在天津市两家医院体检中心进行体检的498个单位的员工作为研究对象。采用问卷调查收集人口学特征、现病史、生活方式等信息。用简化的匹兹堡睡眠量表(pittsburgh sleep quality index, PSQI))评估研究对象的睡眠状况；并测量调查对象的身高、体重和空腹静脉血中TC、TG、HDL-C和LDL-C浓度。进行多重线性相关和曲线性(U型)相关分析研究睡眠时长与血脂水平的关系。结果共17 807例成人纳入分析，男性占比51.74%，年龄为44(35, 57)岁。在完全调整混杂因素后，睡眠时长与TC(β=-0.027, P＜0.001)、LDL-C(β=-0.039, P＜0.001)和BMI(β=-0.167, P＜0.001)呈线性负相关；与LDL-C呈U型相关(β_一次项=-0.202, P＜0.001；β_二次项=0.011, P=0.004)；未发现睡眠时长与TG和HDL-C水平之间存在相关性。结论短睡眠与TC和BMI升高的风险相关，而过短和过长的睡眠时间都与LDL-C升高的风险相关，提示合理的睡眠时长对于维持正常的血脂水平具有重要意义。
- 睡眠时长 /
- TC /
- TG /
- HDL-C /
- LDL-C /
- BMI
Abstract: Objective We aim to assess the associations between night sleep duration and TC, TG, HDL-C and LDL-C among adults who have not been diagnosed with hyperlipidemia. Methods Using a multi-stage stratified cluster sampling method, employees from 498 units who underwent physical examinations at one of two hospitals in Tianjin from January 8, 2018 to January 9, 2020 were selected as the study population. Demographic characteristics, disease history, lifestyle and other information were collected by questionnaire. The simplified Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration. Fasting TC, TG, HDL-C, LDL-C, and height and weight were measured. Independent associations of night sleep duration with TC, TG, HDL-C, LDL-C, and BMI were evaluated with multiple U-shaped or linear regression models. Results A total of 17 807 participants with a median of 44 years completed the investigation. Sleep duration negatively associated with TC (β=-0.027, P < 0.001), LDL-C (β=-0.039, P < 0.001) and BMI (β=-0.167, P < 0.001) and U-shaped associated with LDL-C (β_{linear term}=-0.202, P < 0.001; β_{quadratic term}=0.011, P=0.004). No associations were found between sleep duration and TG or HDL-C. Conclusion Night sleep duration was associated with TC, HDL-C and BMI, suggesting optimal sleep duration plays an important role in maintaining lipid homeostasis.
- Sleep duration /
- TC /
- TG /
- HDL-C /
- LDL-C /
- BMI

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图 1 不同夜间睡眠时长的TC、ln (TG)、HDL-C和LDL-C的平均值及95%置信区间(a: TC; b: ln (TG); c: HDL-C; d: LDL-C)

Figure 1. Mean values and 95% confidence intervals of TC, ln(TG), HDL-C and LDL-C at different night sleep durations(a: TC; b: ln (TG); c: HDL-C; d: LDL-C)

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表 1 不同夜间睡眠时长分组中调查对象的人口学特征[n (%)]

Table 1. Demographic characteristics of subjects by night sleep durations [n (%)]

特征	睡眠时长(h)				χ²值	P值
特征	< 7(n=2 511)	7~ < 8(n=6 869)	8~ < 9(n=6 710)	≥9(n=1 717)	χ²值	P值
年龄(岁)					394.68	＜0.001
18~ < 31	167(6.65)	695(10.12)	789(11.76)	252(14.68)
31~ < 41	637(25.37)	2 008(29.23)	2 260(33.68)	477(27.78)
41~ < 51	664(26.44)	1 591(23.16)	1 238(18.45)	219(12.75)
51~ < 61	537(21.39)	1 317(19.17)	1 113(16.59)	292(17.01)
61~ < 71	348(13.86)	813(11.84)	807(12.03)	241(14.04)
71~ < 97	158(6.29)	445(6.48)	503(7.49)	236(13.74)
性别					199.46	＜0.001
男	1 526(60.77)	3 762(54.77)	3 156(47.03)	770(44.85)
女	985(39.23)	3 107(45.23)	3 554(52.97)	947(55.15)
民族					8.75	0.188
汉族	2 389(95.14)	6 573(95.69)	6 457(96.23)	1 649(96.04)
其他	122(4.86)	296(4.31)	253(3.77)	68(3.96)
婚姻状况					44.21	＜0.001
未婚	206(8.20)	833(12.13)	823(12.27)	221(12.87)
已婚	2 258(89.92)	5 927(86.29)	5 790(86.29)	1 463(85.21)
离异	25(1.00)	60(0.87)	45(0.67)	11(0.64)
丧偶	22(0.88)	49(0.71)	52(0.77)	22(1.28)
文化程度					162.08	＜0.001
小学	11(0.44)	35(0.51)	37(0.55)	18(1.05)
初中/技校	235(9.36)	490(7.13)	311(4.64)	120(6.99)
高中/中专	379(15.09)	899(13.09)	734(10.94)	230(13.39)
大专/本科	1 420(56.55)	3 797(55.28)	3 865(57.60)	974(56.73)
研究生及以上	466(18.56)	1 648(23.99)	1 763(26.27)	375(21.84)
职业					198.00	＜0.001
工人	122(4.86)	347(5.05)	331(4.93)	82(4.77)
机关工作人员	639(25.45)	1 885(27.44)	1 865(27.80)	461(26.85)
服务员、售货员	508(20.23)	965(14.05)	715(10.66)	154(8.97)
专业技术人员	1 093(43.53)	3 208(46.70)	3 260(48.58)	854(49.74)
其他	149(5.93)	464(6.76)	539(8.03)	166(9.67)
锻炼频率					54.72	＜0.001
从不	1 117(44.48)	2 581(37.58)	2 490(37.11)	692(40.30)
偶尔	754(30.03)	2 379(34.63)	2 428(36.18)	585(43.07)
经常	640(25.49)	1 909(27.79)	1 792(26.71)	440(25.63)
主观睡眠质量					108.11	＜0.001
很好	922(0.37)	2 784(0.41)	2 768(0.41)	737(0.43)
较好	1 190(0.47)	3 383(0.49)	3 356(0.50)	807(0.47)
较差	363(0.15)	644(0.09)	533(0.08)	161(0.09)
很差	36(0.01)	58(0.01)	53(0.01)	12(0.01)
睡眠药物使用					34.91	＜0.001
从不	2 381(0.95)	6 621(0.96)	6 506(0.97)	1 638(0.95)
1次/周	35(0.01)	71(0.01)	60(0.01)	22(0.01)
2~ < 3次/周	39(0.02)	62(0.01)	54(0.01)	13(0.01)
≥3次/周	56(0.02)	115(0.02)	90(0.01)	44(0.03)

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表 2 不同夜间睡眠时长分组的血脂水平及BMI值

Table 2. Blood lipid levels and BMI by sleep durations

变量	睡眠时长(h)				P值
变量	< 7	7~ < 8	8~ < 9	≥9	P值
BMI(kg/m²)	25.25±3.89	24.68±3.84	24.33±3.69	24.18±3.66	＜0.001
TC(mmol/L)	4.94±0.98	4.86±0.93	4.83±0.95	4.85±1.00	＜0.001
TG ^a(mmol/L)	1.32(0.75, 2.34)	1.26(0.71, 2.23)	1.22(0.71, 2.10)	1.23(0.71, 2.14)	＜0.001
HDL-C(mmol/L)	1.35±0.33	1.36±0.31	1.37±0.31	1.38±0.31	0.017
LDL-C(mmol/L)	3.11±0.78	3.03±0.76	2.97±0.77	3.02±0.80	＜0.001
注：^a为几何均值(-1标准差，+1标准差)。

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表 3 夜间睡眠时长与血脂、BMI的多重线性回归结果

Table 3. The results of multiple linear regression between night sleep duration and blood lipid and BMI

变量	β(95% CI)值	t值	s_x	P值
模型1
TC(mmol/L)	-0.031(-0.046~-0.017)	-4.230	0.007	＜0.001
ln (TG)(mmol/L)	-0.012(-0.020~-0.004)	-2.776	0.004	0.006
HDL-C(mmol/L)	-0.001(-0.005~0.004)	-0.231	0.002	0.817
LDL-C(mmol/L)	-0.044(-0.056~-0.032)	-7.267	0.006	＜0.001
BMI(kg/m²)	-0.187(-0.242~-0.132)	-6.694	0.028	＜0.001
模型2
TC(mmol/L)	-0.027(-0.042~-0.013)	-3.667	0.007	＜0.001
ln (TG)(mmol/L)	-0.004(-0.012~0.004)	-1.053	0.004	0.292
HDL-C(mmol/L)	-0.004(-0.008~0.001)	-1.507	0.002	0.132
LDL-C(mmol/L)	-0.041(-0.053~-0.029)	-6.768	0.006	＜0.001
模型3
TC(mmol/L)	-0.027(-0.041~-0.012)	-3.599	0.007	＜0.001
ln (TG)(mmol/L)	-0.002(-0.011~0.006)	-0.575	0.004	0.565
HDL-C(mmol/L)	-0.004(-0.009~0.001)	-1.676	0.002	0.094
LDL-C(mmol/L)	-0.039(-0.051~-0.027)	-6.500	0.006	＜0.001
模型4
BMI(kg/m²)	-0.167(-0.221~-0.113)	-6.040	0.028	＜0.001

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表 4 夜间睡眠时长与血脂的U型检验

Table 4. U-shaped test of night sleep duration and blood lipids

变量	睡眠时长	β(95% CI)值	t值	P值
TC(mmol/L)
模型2	一次项	-0.045(-0.181~0.092)	-0.642	0.521
	二次项	0.001(-0.008~0.010)	0.254	0.799
模型3	一次项	-0.053(-0.190~0.084)	-0.758	0.448
	二次项	0.002(-0.007~0.011)	0.378	0.705
ln(TG)(mmol/L)
模型2	一次项	-0.067(-0.144~0.009)	-1.722	0.085
	二次项	0.004(-0.001~0.009)	1.619	0.105
模型3	一次项	-0.040(-0.117~0.037)	-1.025	0.306
	二次项	0.003(-0.003~0.008)	0.969	0.333
LDL-C(mmol/L)
模型2	一次项	-0.202(-0.313~-0.091)	-3.560	＜0.001
	二次项	0.011(0.003~0.018)	2.858	0.004
模型3	一次项	-0.173(-0.284~-0.061)	-3.042	0.002
	二次项	0.009(0.002~0.017)	2.366	0.018

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