A cross-section study of the correlations between BMI and sleep duration or sleep quality based on Hainan cohort study
-
摘要:
目的 本研究旨在探索海南省中老年人群BMI与睡眠时长和睡眠质量的关系，为超重肥胖防控提供参考依据。 方法 对2018年海南省18个市县的体检队列人群中5 169名调查对象进行体格检查和问卷调查。调查对象为本地居住时间≥5年，年龄35~75岁，无严重肢体残疾或精神疾病的常住人口。对BMI的影响因素进行描述性分析和单因素分析，应用有序Logistic回归分析模型分析BMI与睡眠时长和睡眠质量的关系。 结果 不同BMI调查对象在性别、教育程度、家庭年收入、年龄、吸烟、饮茶、午睡、睡眠质量、睡眠时长方面差异均有统计学意义(均有P < 0.05)。有序Logistic回归分析模型进一步分析结果显示，长枕组、睡眠质量较差和很差均为BMI水平增加的危险因素(均有P < 0.05);长枕组“BMI高”的OR值为规范枕组的1.336倍(95% CI：1.094~1.632);睡眠质量较差者与很差者“BMI高”的OR值分别为睡眠质量很好者的1.294倍(95% CI：1.082~1.548)和1.948倍(95% CI：1.131~3.357)。 结论 海南省中老年人睡眠时间延长、睡眠质量差都会增加超重肥胖的风险。 Abstract:Objective To explore the correlation of BMI and sleep duration or sleep quality in middle-aged and elderly population in Hainan, and to provide reference for prevention and control of overweight and obesity. Methods Physical examination and questionnaire survey were conducted on 5 169 physical examination cohort population in 18 Cities and Counties of Hainan Province in 2018. All participants were permanent residents who had been living in Hainan for more than 5 years, aged 35-75 years, and without severe physical disability or mental illness. The influencing factors of BMI were analyzed by descriptive and univariate analysis. The correlations of BMI and sleep duration or sleep quality were analyzed by ordered Logistic regression model. Results There were significant differences in gender, education, income level, age, smoking, tea drinking, noon-nap, sleep quality and sleep duration among different BMI groups (all P < 0.05).The further ordered Logistic regression analysis results showed that longer sleep duration, poor and very poor sleep quality were risk factors of higher BMI level (all P < 0.05). The risk of higher BMI in longer sleep duration was 1.336 times higher than normal sleep duration(95% CI: 1.094-1.632), and the risks of poor and very poor sleep quality groups were respectively 1.294 times higher(95% CI: 1.082-1.548)and 1.948 times higher (95% CI: 1.131-3.357)than good sleep quality group. Conclusion Longer sleep hours and poor sleep quality can increase the risk of overweight and obesity in middle-aged and elderly population in Hainan. -
Key words:
- Sleep duration /
- Sleep quality /
- BMI /
- Cross-sectional study
-
表 1 2018年海南省不同BMI组的调查情况比较[n(%)]
Table 1. Comparison among different BMI groups in Hainan in 2018 [n(%)]
项目 偏瘦 正常 超重 肥胖 合计 χ2值 P值 性别 78.290 < 0.001 男 85(43.6) 1 160(45.6) 1 066(56.0) 325(61.8) 2 636(51.0) 女 110(56.4) 1 386(54.4) 836(44.0) 201(38.2) 2 533(49.0) 教育程度 59.291 < 0.001 高中及以上 88(45.1) 1 321(51.9) 1 099(57.8) 317(60.3) 2 825(54.7) 初中 65(33.3) 880(34.6) 627(33.0) 165(31.4) 1 737(33.6) 小学 25(12.8) 231(9.1) 125(6.6) 30(5.7) 411(8.0) 未上过学 17(8.7) 114(4.5) 51(2.7) 14(2.7) 196(3.8) 婚姻状态 6.680 0.083 已婚 182(93.8) 2 379(95.3) 1 807(96.5) 4 94(96.5) 4 862(95.8) 未婚 12(6.2) 118(4.7) 65(3.5) 18(3.5) 213(4.2) 家庭年收入(万元) 22.467 0.001 >10 25(12.8) 360(14.1) 246(12.9) 72(13.7) 703(13.6) 3~10 90(46.2) 1 307(51.3) 1 089(57.3) 289(54.9) 2 775(53.7) < 3 80(41.0) 879(34.5) 567(29.8) 165(31.4) 1 691(32.7) 年龄(岁) 43.201 < 0.001 35~ < 50 132(67.7) 1 680(66.0) 1 224(64.4) 349(66.3) 3 385(65.5) 50~ < 60 35(17.9) 706(27.7) 588(30.9) 153(29.1) 1 482(28.7) 60~75 28(14.4) 160(6.3) 90(4.7) 24(4.6) 302(5.8) 吸烟情况 19.501 0.003 不吸烟 142(72.8) 1 833(72.0) 1 338(70.3) 339(64.4) 3 652(70.7) 已戒烟 1(0.5) 75(2.9) 75(3.9) 21(4.0) 172(3.3) 吸烟 52(26.7) 638(25.1) 489(25.7) 166(31.6) 1 345(26.0) 饮酒情况 1 085.453 < 0.001 不饮酒 154(79.0) 2 108(82.8) 715(37.6) 206(39.2) 3 183(61.6) 戒酒 2(1.0) 18(0.7) 71(3.7) 17(3.2) 108(2.1) 饮酒 39(20.0) 420(16.5) 1 116(58.7) 303(57.6) 1 878(36.3) 饮茶 121.299 < 0.001 无 160(82.1) 1 843(72.4) 1 182(62.1) 278(52.9) 3 463(67.0) 有 35(17.9) 703(27.6) 720(37.9) 248(47.1) 1 706(33.0) 喝汤 1.838 0.607 无 113(57.9) 1 371(53.8) 1 034(54.4) 276(52.5) 2 794(54.1) 有 82(42.1) 1 175(46.2) 868(45.6) 250(47.5) 2 375(45.9) 吃夜宵 0.084 0.994 无 168(86.2) 2 203(86.5) 1 648(86.6) 457(86.9) 4 476(86.6) 有 27(13.8) 343(13.5) 254(13.4) 69(13.1) 693(13.4) 午睡 10.556 0.014 无 91(46.9) 992(39.1) 690(36.5) 213(41.0) 1 986(38.6) 有 103(53.1) 1 546(60.9) 1 198(63.5) 306(59.0) 3 153(61.4) 睡眠质量 41.089 < 0.001 很好 66(33.8) 980(38.5) 815(42.8) 229(43.5) 2 090(40.4) 较好 94(48.2) 1 169(45.9) 842(44.3) 242(46.0) 2 347(45.4) 较差 26(13.3) 368(14.5) 225(11.8) 52(9.9) 671(13.0) 很差 9(4.6) 29(1.1) 20(1.1) 3(0.6) 61(1.2) 睡眠时长 14.102 0.029 规范枕组 111(56.9) 1 430(56.2) 1 077(56.6) 301(57.2) 2 919(56.5) 长枕组 25(12.8) 263(10.3) 153(8.0) 37(7.0) 478(9.2) 短枕组 59(30.3) 853(33.5) 672(35.3) 188(35.7) 1 772(34.3) 
下载: 导出CSV
表 2 变量赋值情况
Table 2. Assignment of variables
变量 赋值 自变量 性别 女性=0，男性=1 教育程度 未上过学=0，小学=1，初中=2，高中及以上=3 婚姻状态 丧偶=0，离婚=1，未婚=2，已婚=3 家庭年收入(万元) < 3=0，3~10=1， > 10=2 年龄(岁) 60~75=0，50~ < 60=1，35~ < 50=2 吸烟情况 吸烟=0，戒烟=1，不吸烟=2， 饮酒情况 饮酒=0，戒酒=1，不饮酒=2 饮茶 有=0，无=1 喝汤 有=0，无=1 吃夜宵 有=0，无=1 午睡 无=0，有=1 睡眠质量 很差=0，较差=1，较好=2，很好=3 睡眠时长 短枕组=0，长枕组=1，规范枕组=2 因变量 BMI 偏瘦=0，标准=1，超重=2，肥胖=3
下载: 导出CSV
表 3 BMI与睡眠时长的关系
Table 3. Correlation of BMI and sleep duration
变量 β值 ${s_{\bar x}}$值 Wald值 P值 OR(95% CI)值 原始模型 规范枕组 1.000 长枕组 0.311 0.0955 10.526 0.001 1.363(1.131~1.644) 短枕组 -0.055 0.0572 0.926 0.336 0.946(0.846~1.059) 模型1 规范枕组 1.000 长枕组 0.272 0.1024 7.060 0.008 1.313(1.074~1.605) 短枕组 -0.046 0.0616 0.570 0.450 0.955(0.846~1.077) 模型2 规范枕组 1.000 长枕组 0.290 0.1019 8.098 0.004 1.336(1.094~1.632) 短枕组 -0.023 0.0608 0.148 0.700 0.977(0.867~1.100) 注：原始模型，未校正混杂因素; 模型1校正性别、年龄、教育程度、婚姻状态、吸烟、饮酒、饮茶; 模型2在模型1的基础上校正睡眠质量和午睡。
下载: 导出CSV
表 4 BMI与睡眠质量的关系
Table 4. Correlation of BMI and sleep quality
变量 β值 ${s_{\bar x}}$值 Wald值 P值 OR(95% CI)值 原始模型 很好 1.000 较好 0.144 0.0571 6.325 0.012 1.154(1.032~1.891) 较差 0.338 0.0853 15.706 0.000 1.402(1.186~1.657) 很差 0.777 0.2599 8.935 0.003 2.174(1.307~3.619) 模型1 很好 1.000 较好 0.052 0.0608 0.726 0.394 1.053(0.935~1.187) 较差 0.247 0.909 7.368 0.007 1.280(1.071~1.529) 很差 0.647 0.2765 5.467 0.019 1.909(1.110~3.283) 模型2 很好 1.000 较好 0.042 0.0612 0.472 0.492 1.043(0.925~1.176) 较差 0.258 0.0914 7.957 0.005 1.294(1.082~1.548) 很差 0.667 0.2776 5.771 0.016 1.948(1.131~3.357) 注：原始模型，未校正混杂因素; 模型1校正性别、年龄、教育程度、婚姻状态、吸烟、饮酒、饮茶; 模型2在模型1的基础上校正睡眠质量和午睡。
下载: 导出CSV
-
[1] Ruland S, Hung E, Richardson D, et al. Impact of obesity andthe metabolic syndrome on risk factors in African American stroke survivors: a report from the AAASPS[J]. Arch Neurol, 2005, 62(3): 386-390. DOI: 10.1001/archneur.62.3.386. [2] Fruh, Sharon M. Obesity: risk factors, complications, and strategies for sustainable long-term weight management[J]. J Am Assoc Nurse Pract, 2017, 29(S1): S3-S14. DOI: 10.1002/2327-6924.12510. [3] 李舍予, 袁祥, 李双庆, 等. 关注肥胖防控中的睡眠健康[J]. 中国全科医学, 2017, 20(11): 1282-1287. DOI: 10.3969/j.issn.1007-9572.2017.11.002.Li SY, Yuan X, Li SQ, et al. Pay attention to sleep health in obesity prevention and control[J]. Chin Gen Pract, 2017, 20(11): 1282-1287. DOI: 10.3969/j.issn.1007-9572.2017.11.002. [4] Benaich S, Mehdad S, Andaloussi Z, et al. Weight status, dietary habits, physical activity, screen time and sleep duration among university students[J]. Nutr Health, 2021, 27(1): 69-78. DOI: 10.1177/0260106020960863. [5] 陈梦雪, 李丹婷, 张啸, 等. 夜晚睡眠时间和午睡习惯对成都市成年人超重/肥胖的影响[J]. 卫生研究, 2018, 47(6): 918-923. DOI: 10.19813/j.cnki.weishengyanjiu.2018.06.010.Chen MX, Li DT, Zhang X, et al. Effects of night sleep time and nap habit on overweight/obesity of adults in Chengdu[J] J Hygiene Res, 2018, 47(6): 918-923. DOI: 10.19813/j.cnki.weishengyanjiu.2018.06.010. [6] St-Onge MPGM, Brown D, Conroy MB, et al. Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the American Heart Association[J]. Circulation, 2016, 134(18): e367-e386. DOI: 10.1161/CIR.0000000000000444. [7] 李晓飞, 陈芳芳, 陈旭. 老年住院病人衰弱的影响因素[J]. 中国老年学杂志, 2019, 39(4): 970-974. DOI: 10.3969/j.issn.1005-9202.2019.04.068.Li XF, Chen FF, Chen X. Influencing factors of infirmity of elderly inpatients[J]. Chin J Gerontol, 2019, 39(4): 970-974. DOI: 10.3969/j.issn.1005-9202.2019.04.068. [8] 中华人民共和国国家卫生和计划生育委员会. WST 428—2013成人体重判定[S]. 北京: 中国标准出版社, 2013.State Health and Family Planning Commission of the People's Republic of China. Adult weight determination WST 428-2013[S]. Beijing: Standards Press of China, 2013 [9] 贾延昆, 陈利平, 杨瑶, 等. 原发性高血压患者睡眠质量与脂质代谢的相关性研究[J]. 中日友好医院学报, 2019, 33(5): 274-276, 280. DOI: 10.3969/j.issn.1001-0025.2019.05.003.Jia YK, Chen LP, Yang Y, et al. Orrelation between sleep quality and lipid metabolism in patients with essential hypertension[J]. J China-Japan Friendship Hosp, 2019, 33(5): 274-276, 280. DOI: 10.3969/j.issn.1001-0025.2019.05.003. [10] Wang P, Song L, Wang K, et al. Prevalence and associated fac-tors of poor sleep quality among Chinese older adults living in a ruralarea: a population-based study[J]. Aging Clin Exp Res, 2020, 32(1): 125-131. DOI: 10.1007/s40520-019-01171-0. [11] O'Brien E, Hart C, Wing RR. Discrepancies between self-repor ted usual sleep duration and objective measures of total sleep time in treatment seeking overweight and obese individuals[J]. Behav Sleep Med, 2016, 14(5): 539-549. DOI: 10.1080/15402002.2015.1048447. [12] Cespedes EM, Hu FB, Redline S, et al. Comparison of self-reported sleep duration with actigraphy: results from Hispanic Community Health Study/Study of Latinos Sueno Ancillary Study[J]. Am J Epidemiol, 2016, 183(6): 561-573. DOI: 10.1093/aje/kwv251. [13] Fu L, Yu X, Zhang W, et al. The relationship between sleep duration, falls, and muscle mass: a cohort study in an elderly Chinese population[J]. Rejuvenation Res, 2019, 22(5): 390-398. DOI: 10.1089/rej.2018.2102. [14] 周丽, 阮春燕, 周晓丽, 等. 老年人群睡眠时长及睡眠质量与心血管疾病危险因素的关系研究[J]. 中华全科医学, 2020, 18(6): 1035-1039. DOI: 10.16766/j.cnki.issn.1674-4152.001421.Zhou L, Ruan CY, Zhou XL, et al. Study on the relationship between sleep duration, sleep quality and cardiovascular disease risk factors in the elderly[J] Chin J Gen Prac, 2020, 18(6): 1035-1039. DOI: 10.16766/j.cnki.issn.1674-4152.001421. [15] Wang SWY, Ungvari GS, Ng CH, et al. Sleep duration and its association with demographics, lifestyle factors, poor mental health and chronic diseases in older Chinese adults[J]. Psychiatry Res, 2017, 257: 212-218. DOI: 10.1016/j.psychres.2017.07.036. [16] Sun WJ, Yuang Y, Wang ZZ, et al. Sleep duration associated with body mass index among Chinese adults[J]. Sleep Med, 2015, 16(5): 612-616. DOI: 10.1016/j.sleep.2014.12.011. [17] Smagula SF, Koh WP, Wang R, et al. Chronic disease and lifestyle factors associated with change in sleep duration among older adults in the Singapore Chinese health study[J]. J Sleep Res, 2016, 25(1): 57-61. DOI: 10.1111/jsr.12342. [18] Stamatakis KA, Kaplan GA, Roberts RE. Short sleep duration across income, education, and race/ethnic groups: population prevalence and growing disparities during 34 years of follow-up[J]. Ann Epidemiol, 2007, 17(12): 948-955. DOI: 10.1016/j.annepidem.2007.07.096. [19] Whinnery J, Jackson N, Rattanaumpawan P, et al. Short and long sleep duration associated with race/ethnicity, sociodemographics, and socioeconomic position[J]. Sleep, 2014, 37(3): 601-611. DOI: 10.5665/sleep.3508. [20] Kwok CS, Kontopantelis E, Kuligowski G, et al. Self-reported sleep duration and quality and cardiovascular disease and mortality: a dose-response meta-analysis[J]. J Am Heart Assoc, 2018, 7(15): e008552. DOI: 10.1161/JAHA.118.008552. [21] 罗会强, 曹裴娅, 左宗力, 等. 我国老年人腹型肥胖和睡眠时长关系研究[J]. 四川大学学报(医学版), 2017, 48(4): 584-588. DOI: 10.13464/j.scuxbyxb.2017.04.016.Luo HQ, Cao PY, Zuo ZL, et al. Study on the relationship between abdominal obesity and sleep duration in the elderly in China[J]. J Sichuan Univ (Med Sci), 2017, 48(4): 584-588. DOI: 10.13464/j.scuxbyxb.2017.04.016. [22] Stranges S, Dorn JM, Shipley MJ, et al. Correlates of shortand long sleep duration: a cross-cultural comparison between UnitedKingdom and the United States: the Whitehall Ⅱ Study and the Western New York Health Study[J]. Am J Epidemiol, 2008, 168(12): 1353-1364. DOI: 10.1093/aje/kwn337. -
