睡眠与肥胖对中老年人功能损失的联合作用研究

王云艳; 李莉; 孙东晗; 邬闻文

doi:10.16462/j.cnki.zhjbkz.2023.08.003

睡眠与肥胖对中老年人功能损失的联合作用研究

doi: 10.16462/j.cnki.zhjbkz.2023.08.003

王云艳¹,
李莉²,
孙东晗²,
邬闻文^{2, 3, 4, ,}

1.
湖北医药学院第一临床学院麻醉学系，十堰 442000
2.
湖北医药学院附属人民医院循证护理研究所，十堰 442000
3.
湖北医药学院公共卫生与健康学院预防医学教研室，十堰 442000
4.
湖北医药学院卫生管理与卫生事业发展研究中心，十堰 442000

基金项目:

湖北省教育厅重点项目 D20222105

湖北医药学院人才启动金项目 2020QDJRW003

大学生创新创业训练计划项目 S202210929030

湖北省普通高等学校人文社科重点研究基地开放基金 2022YB001

详细信息

通讯作者:
邬闻文，E-mail: 335631216@qq.com

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2021-11-17
- 修回日期: 2022-04-28
- 网络出版日期: 2023-09-02
- 刊出日期: 2023-08-10

Study on the combined effects of sleep and obesity on functional loss in middle-aged and elderly people

WANG Yunyan¹,
LI Li²,
SUN Donghan²,
WU Wenwen^{2, 3, 4
, ,}

1.
Department of Anesthesia, First Clinical Medicine School, Hubei University of Medicine, Shiyan 442000, China
2.
Institute of Medicine and Nursing, Affiliated People′s Hospital, Hubei University of Medicine, Shiyan 442000, China
3.
Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan 442000, China
4.
Center of Health Administration and development studies, Hubei University of Medicine, Shiyan 442000, China

Funds:

Key Project of Natural Science Foundation of Hubei Provincial Department of Education D20222105

Cultivating Project for Young Scholar at Hubei University of Medicine 2020QDJRW003

Innovation and Entrepreneurship Training Program for University Students S202210929030

Open Fund Project of Key Research Center for Humanities and Socia1 Sciences in Hubei Province 2022YB001

More Information

Corresponding author: WU Wenwen, E-mail: 335631216@qq.com

摘要

摘要: 目的了解中老年人睡眠、肥胖的联合作用对中老年人功能损失的影响。方法数据来源于北京大学2015年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)数据库。采用logistic回归分析模型分析睡眠、肥胖对功能损失的联合作用。结果以腰围(waist circumference, WC)正常+夜间睡眠6~ < 8 h组为参照，腹型肥胖+夜间睡眠0~ < 4 h组功能损失患病风险最高(OR=1.655, P < 0.001)。以WC正常+午睡0~ < 30 min组为参照，腹型肥胖+无午睡组功能损失患病风险最高(OR=3.360, P=0.008)。以非全身性肥胖+夜间睡眠6~ < 8 h组为参照，全身性肥胖+夜间睡眠4~ < 6 h组功能损失患病风险最高(OR=2.359, P < 0.001)。以非全身性肥胖+午睡0~ < 30 min组为参照，全身性肥胖+午睡30~ < 90 min组功能损失患病风险最高(OR=1.905, 95% CI: 1.237~2.933, P=0.003)。结论夜间睡眠时间短、无午睡或午睡时间长分别与腹型肥胖或全身性肥胖共存会增加功能损失的患病风险，提示夜间睡眠时间短、无午睡或午睡时间长的中老年人控制BMI和WC有利于改善日常生活活动能力。
- 睡眠 /
- BMI /
- 腰围 /
- 功能损失
Abstract: Objective The aim of this study was to investigate the combined effect of sleep and obesity on the prevalence of functional disability among middle-aged and older adults. Methods Data were collected from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The logistic regression model was performed to estimate the combined effect of sleep and obesity on the prevalence of functional disability. Results Compared to participants with normal waist circumference (WC) and 6- < 8 hours of nocturnal sleep, those with abdominal obesity and 0- < 4 hours of nocturnal sleep exhibited an increased risk of functional disability (OR=1.655, P < 0.001). Similarly, participants with abdominal obesity and no afternoon nap, compared to those with normal WC and 0- < 30 minutes of afternoon nap, showed an elevated risk of functional disability (OR=3.360, P=0.008). When compared to non-systemically obese individuals with 6- < 8 hours of nocturnal sleep, those with systemic obesity and 4- < 6 hours of nocturnal sleep had an increased risk of functional disability (OR=2.359, P < 0.001). Additionally, systemically obese individuals with 30- < 90 minutes of afternoon nap, compared to non-systemically obese individuals with 0- < 30 minutes of afternoon nap, showed an increased risk of functional disability (OR=1.905, 95% CI: 1.237-2.933, P=0.003). Conclusions The concurrent presence of short nocturnal sleep duration, absence of an afternoon nap or extended afternoon nap duration, and either abdominal or systemic obesity, increases the risk of functional disability. This suggests that controlling body mass index (BMI) and WC among middle-aged and older adults with short nocturnal sleep duration, absence of an afternoon nap, or extended afternoon nap duration could be beneficial in preventing functional disability.
- Sleep /
- Body mass index /
- Waist circumference /
- Functional disability

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图 1 中老年人功能损失影响因素的logistic回归分析模型

校正的变量有性别、年龄、婚姻状态、文化程度、跌倒、抑郁、视力、听力、自评健康、生活满意度。

Figure 1. Logistic regression analysis of the influencing factors on the prevalence of functional disability among middle-aged and older adults

Adjusting variables included sex, age, marital status, education level, falls, depression, vision, hearing, health self-assessment, and life satisfaction.

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表 1 2015年中国不同特征的中老年人功能损失情况的比较

Table 1. Comparison of the prevalence of functional disability among Chinese middle-aged and older adults with different characteristics in 2015

变量 Variable	调查人数[人数(占比/%)] Number of respondents [Number (proportion/%)]	功能损失[人数(占比/%)] Functional disability [Number (proportion/%)]	功能未损失[人数(占比/%)] Non-functional disability [Number (proportion/%)]	χ²值 value	P值 value
性别 Gender				28.271	< 0.001
男 Male	2 952(41.79)	751(25.44)	2 201(74.56)
女 Female	4 112(58.21)	1 285(31.25)	2 827(68.75)
年龄组/岁 Age group/years				67.108	< 0.001
40~ < 60	2 852(40.37)	669(23.46)	2 183(76.54)
≥60	4 212(59.63)	1 367(32.45)	2 845(67.55)
跌倒 Fall				261.335	< 0.001
是 Yes	1 543(21.84)	699(45.30)	844(54.70)
否 No	5 521(78.16)	1 337(24.22)	4 184(75.78)
文化程度 Education				17.359	< 0.001
小学及以下 Primary school and below	5 038(71.32)	1 497(29.71)	3 541(70.29)
初中 Middle school	1 325(18.76)	384(28.98)	941(71.02)
高中及以上 High school and above	701(9.92)	155(22.11)	546(77.89)
婚姻状况 Marital status				36.372	< 0.001
已婚/同居 Married/cohabitated	5 510(78.00)	1 493(27.10)	4 017(72.90)
离婚/分居/丧偶/未婚 Divorced/separated/widowed/unmarried	1 554(22.00)	543(34.94)	1 011(65.06)
夜间睡眠/h Nocturnal sleep time/h				132.090	< 0.001
0~ < 4	866(12.26)	365(42.15)	501(57.85)
4~ < 6	1 888(26.73)	618(32.73)	1 270(67.27)
6~ < 8	2 466(34.91)	626(25.39)	1 840(74.61)
≥8	1 844(26.10)	427(23.16)	1 417(76.84)
吸烟 Smoking				0.017	0.895
是 Yes	410(5.80)	117(28.54)	293(71.46)
否 No	6 654(94.20)	1 919(28.84)	4 735(71.16)
饮酒 Drinking				0.314	0.575
是 Yes	1 330(18.83)	375(28.20)	955(71.80)
否 No	5 734(81.17)	1 661(28.97)	4 073(71.03)
午睡/min Nap/min				12.732	0.005
0	3 370(47.71)	1 020(30.27)	2 350(69.73)
0~ < 30	202(2.86)	45(22.28)	157(77.72)
30~ < 90	2 496(35.33)	672(26.92)	1 824(73.08)
≥90	996(14.10)	299(30.02)	697(69.98)
抑郁 Depression				263.228	< 0.001
是 Yes	3 498(49.52)	1 317(37.65)	2 181(62.35)
否 No	3 566(50.48)	719(20.16)	2 847(79.84)
视力 Eyesight				96.494	< 0.001
好及以上 Good and above	2 545(36.03)	554(21.77)	1 991(78.23)
一般及以下 General and below	4 519(63.97)	1 482(32.79)	3 037(67.21)
听力 Hearing				104.648	< 0.001
好及以上 Good and above	2 000(28.31)	401(20.05)	1 599(79.95)
一般及以下 General and below	5 064(71.69)	1 635(32.29)	3 429(67.71)
BMI/(kg·m^-2)				27.665	< 0.001
< 18.50	380(5.38)	121(31.84)	259(68.16)
18.50~ < 24.00	3 252(46.04)	966(29.70)	2 286(70.30)
24.00~ < 28.00	2 441(34.55)	618(25.32)	1 823(74.68)
≥28.00	991(14.03)	331(33.40)	660(66.60)
WC				9.317	0.002
腹型肥胖 Abdominal obesity	4 794(67.87)	1 436(29.95)	3 358(70.05)
正常 Normal	2 270(32.13)	600(26.43)	1 670(73.57)
自评健康状况 Health self-assessment				389.839	< 0.001
极好 Excellent	51(0.72)	1(1.96)	50(98.04)
很好 Very good	420(5.95)	64(15.24)	356(84.76)
好 Good	613(8.68)	136(22.19)	477(77.81)
一般 General	3 617(51.20)	808(22.34)	2 809(77.66)
不好 Poor	2 363(33.45)	1 027(43.46)	1 336(56.54)
生活满意度 Life satisfaction				155.100	< 0.001
满意 Satisfaction	6 277(88.86)	1 660(26.45)	4 617(73.55)
不满意 Dissatisfaction	787(11.14)	376(47.78)	411(52.22)

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表 2 夜间睡眠与腹型肥胖的联合作用对功能损伤影响的logistic回归分析模型

Table 2. Logistic regression analysis of the combined effect of nocturnal sleep and central obesity on the prevalence of functional disability

夜间睡眠时间/h Nocturnal sleep time/h	非腹型肥胖 Non-abdominal obesity		腹型肥胖 Abdominal obesity
夜间睡眠时间/h Nocturnal sleep time/h	OR值(95% CI) OR value(95% CI)	P值 value	OR值(95% CI) OR value(95% CI)	P值 value
0~ < 4	1.182(0.868~1.608)	0.288	1.655(1.280~2.141)	< 0.001
4~ < 6	1.033(0.798~1.337)	0.805	1.355(1.085~1.692)	0.007
6~ < 8	1.000		1.120(0.903~1.390)	0.303
≥8	0.715(0.542~0.944)	0.018	1.032(0.820~1.298)	0.791
注：调整的变量有性别、年龄、婚姻状态、文化程度、跌倒、抑郁、视力、听力、自评健康、生活满意度。 Note: Adjusted variables include gender, age, marital status, educational level, falls, depression, vision, hearing, health self-assessment, and life satisfaction.

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表 3 午睡与腹型肥胖的联合作用对功能损伤影响的logistic回归分析模型

Table 3. Logistic regression analysis of the combined effect of afternoon nap and central obesity on the prevalence of functional disability

午睡时间/min Afternoon nap time/min	非腹型肥胖 Non-abdominal obesity		腹型肥胖 Abdominal obesity
午睡时间/min Afternoon nap time/min	OR值(95% CI) OR value(95% CI)	P值 value	OR值(95% CI) OR value(95% CI)	P值 value
0	2.482(1.014~6.072)	0.046	3.360(1.379~8.186)	0.008
0~ < 30	1.000		2.926(1.114~7.690)	0.029
30~ < 90	2.303(0.933~5.684)	0.070	2.885(1.183~7.040)	0.020
≥90	2.885(1.141~7.296)	0.025	3.118(1.266~7.679)	0.013
注：调整的变量有性别、年龄、婚姻状态、文化程度、跌倒、抑郁、视力、听力、自评健康、生活满意度。 Note: Adjusted variables included gender, age, marital status, educational level, falls, depression, vision, hearing, health self-assessment, and life satisfaction.

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表 4 夜间睡眠与全身性肥胖的联合作用对功能损伤影响的logistic回归分析模型

Table 4. Logistic regression analysis of the combined effect of nocturnal sleep time and systemic obesity on the prevalence of functional disability

夜间睡眠时间/h Nocturnal sleep time/h	非全身性肥胖 Non-systemic obesity		全身性肥胖 Systemic obesity
夜间睡眠时间/h Nocturnal sleep time/h	OR值(95% CI) OR value(95% CI)	P值 value	OR值(95% CI) OR value(95% CI)	P值 value
0~ < 4	1.519(1.258~1.835)	< 0.001	1.020(0.621~1.675)	0.936
4~ < 6	1.115(0.955~1.302)	0.167	2.359(1.750~3.180)	< 0.001
6~ < 8	1.000		1.551(1.208~1.993)	0.001
≥8	0.878(0.744~1.036)	0.122	1.087(0.811~1.458)	0.576
注：调整的变量有性别、年龄、婚姻状态、文化程度、跌倒、抑郁、视力、听力、自评健康、生活满意度。 Note: Adjusted variables included gender, age, marital status, educational level, falls, depression, vision, hearing, health self-assessment, and life satisfaction.

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表 5 午睡与全身性肥胖的联合作用对功能损伤影响的logistic回归分析模型

Table 5. Logistic regression model of the combined effect of afternoon nap and systemic obesity on the prevalence of functional disability

午睡时间/min Afternoon nap time/min	非全身性肥胖 Non-abdominal obesity		全身性肥胖 Abdominal obesity
午睡时间/min Afternoon nap time/min	OR值(95% CI) OR value(95% CI)	P值 value	OR值(95% CI) OR value(95% CI)	P值 value
0	1.348(0.919~1.975)	0.126	1.606(1.036~2.492)	0.034
0~ < 30	1.000		1.744(0.616~4.936)	0.295
30~ < 90	1.123(0.762~1.655)	0.558	1.905(1.237~2.933)	0.003
≥90	1.304(0.868~1.959)	0.202	1.868(1.138~3.066)	0.014
注：调整的变量有性别、年龄、婚姻状态、文化程度、跌倒、抑郁、视力、听力、自评健康、生活满意度。 Note: Adjusted variables included gender, age, marital status, educational level, falls, depression, vision, hearing, health self-assessment, and life satisfaction.

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