Association between sleep status and diabetes mellitus among adults in Shaanxi Province
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摘要:
目的 探讨陕西省成年人睡眠时间和睡眠质量与糖尿病之间的关联，为糖尿病预防与控制提供依据。 方法 通过多阶段分层整群随机抽样方法，选取2018年陕西省成人慢性病及危险因素监测项目中18岁及以上常住居民6 202人为研究对象，进行问卷调查、体格检查和实验室检测。通过多因素logistic回归分析模型分析睡眠时间和睡眠质量与糖尿病患病的独立和联合关联。 结果 共纳入6 062名研究对象，糖尿病患病率为8.17%。多因素logistic回归分析模型分析结果显示，调整相关混杂因素后，与睡眠时间6~<8 h/d组相比，睡眠时间<6 h/d组(OR=1.38, 95% CI: 1.07~1.78, P=0.014)和>8 h/d组(OR=1.26, 95% CI: 1.05~1.52, P=0.015)患糖尿病的风险增大。与睡眠质量好组相比，睡眠质量差组(OR=1.32, 95% CI: 1.09~1.61, P=0.005)患糖尿病的风险增大。将睡眠时间和质量组合后进一步分析结果显示，与睡眠时间6~<8 h/d且睡眠质量好组相比，睡眠时间<6 h/d且睡眠质量差组(OR=1.55, 95% CI: 1.14~2.10, P=0.005)和睡眠时间>8 h/d且睡眠质量差组(OR=1.53, 95% CI: 1.18~1.99, P=0.002)患糖尿病的风险增大。 结论 睡眠时间异常和睡眠质量差均与糖尿病患病相关，且二者存在联合效应。 Abstract:Objective To explore the associations of sleep duration and sleep quality with diabetes mellitus among adults in Shaanxi Province, thus providing evidence for diabetes prevention and control. Methods Through multi-stage stratified cluster random sampling method, 6 202 permanent residents aged 18 years and older were selected as research subjects from Shaanxi Adult Chronic Disease and Risk Factor Surveillance Program in 2018. Questionnaire survey, physical examination and laboratory test were conducted. Multivariate logistic regression analysis model analysis was used to analyze the independent and combined associations between sleep duration, sleep quality and diabetes mellitus. Results A total of 6 062 subjects were enrolled in this analysis, and the prevalence of diabetes was 8.17%. The results of multivariate logistic regression analysis model analysis showed that after adjusting for relevant confounding factors, compared with the sleep duration of 6 to<8 h/d group, the risk of diabetes increased in the sleep duration<6 h/d group (OR=1.38, 95% CI: 1.07-1.78, P=0.014) and the >8 h/d group (OR=1.26, 95% CI: 1.05-1.52, P=0.015). Compared with the group with good sleep quality, the group with poor sleep quality (OR=1.32, 95% CI: 1.09-1.61, P=0.005). had an increased risk of diabetes. Further analysis of the combination of sleep duration and quality showed that compared with the group with sleep duration of 6-<8 h/d and good sleep quality, those with sleep duration<6 h/d and poor sleep quality (OR=1.55, 95% CI: 1.14-2.10, P=0.005) and those with sleep duration >8 h/d and poor sleep quality (OR=1.53, 95% CI: 1.18-1.99, P=0.002) had an increased risk of diabetes. Conclusions Both abnormal sleep duration and poor sleep quality are associated with diabetes mellitus, and a joint effect exists between them. -
Key words:
- Sleep duration /
- Sleep quality /
- Diabetes mellitus
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表 1 糖尿病组与非糖尿病组基本特征构成比较
Table 1. Comparison of basic characteristics between diabetic group and non-diabetic group
特征 Feature 糖尿病① Diabetes ①
(n=679)非糖尿病① Non-diabetic ①
(n=5 383)χ2值 value P值 value 性别 Gender 0.64 0.423 男 Male 313(46.10) 2 394(44.47) 女 Female 366(53.90) 2 989(55.53) 年龄组/岁 Age group/years 142.63 < 0.001 <45 57(8.39) 1 350(25.08) 45~≤60 258(38.00) 2 232(41.46) ≥60 364(53.61) 1 801(33.46) 城乡 Urban and rural 5.53 0.019 城市 Urban 265(39.03) 1 855(34.46) 农村 Rural 414(60.97) 3 528(65.54) 文化程度 Education 3.56 0.168 小学及以下 Primary school and below 356(52.43) 2 629(48.84) 中学 Middle school 294(43.30) 2 473(45.94) 大专及以上 Junior college and above 29(4.27) 281(5.22) 就业情况 Employment situation 93.84 < 0.001 就业 Employment 459(67.60) 3 995(74.21) 未就业 Unemployment 135(19.88) 1 174(21.81) 离退休 Retirement 85(12.52) 214(3.98) BMI/(kg·m-2) 70.48 < 0.001 消瘦 Low weight 13(1.91) 140(2.60) 正常 Normal 229(33.73) 2 591(48.13) 超重 Over weight 287(42.27) 1 959(36.40) 肥胖 Obesity 150(22.09) 693(12.87) 吸烟 Smoking 4.67 0.031 否 Yes 528(77.76) 3 979(73.92) 是 No 151(22.24) 1 404(26.08) 饮酒 Drinking 1.25 0.264 否 No 511(75.26) 3 943(73.25) 是 Yes 168(24.74) 1 440(26.75) 经常锻炼 Regular exercise 4.08 0.043 否 No 580(85.42) 4 743(88.11) 是 Yes 99(14.58) 640(11.89) 睡眠时间/(h·d-1) Sleep duration/(h·d-1) 17.17 < 0.001 <6 93(13.70) 523(9.71) 6~≤8 382(56.26) 3 425(63.63) >8 204(30.04) 1 435(26.66) 睡眠质量 Sleep quality 34.20 < 0.001 好 Good 162(23.86) 1 891(35.13) 差 Poor 517(76.14) 3 492(64.87) 注：①采用[n(%)]表示。
Note: ①[Number of people (proportion/%)].
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表 2 不同睡眠状况人群糖尿病患病情况
Table 2. Prevalence of diabetes mellitus in people with different sleep status
总人群 Total population 患病率/% Prevalence/% 95% CI χ2值 value P值 value 睡眠时间/(h·d-1) Sleep duration/(h·d-1) 15.652 < 0.001 <6 14.68 11.88~17.48 6~≤8 7.52 6.68~8.35 >8 8.24 6.91~9.58 睡眠质量 Sleep quality 48.868 < 0.001 好 Good 4.64 3.73~5.56 差 Poor 10.78 9.82~11.74
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表 3 睡眠时间、睡眠质量与糖尿病患病的关联
Table 3. Relationship between sleep duration, sleep quality and diabetes mellitus
睡眠状况 Sleep status 单因素分析 Univariate analysis 多因素分析 Multivariate analysis OR值(95% CI)
OR value(95% CI)P值
valueOR值(95% CI)
OR value(95% CI)P值
value睡眠时间/(h·d-1) Sleep duration/(h·d-1) <6 1.59(1.25~2.04) < 0.001 1.38(1.07~1.78) 0.014 6~≤8 1.00 1.00 >8 1.28(1.06~1.53) 0.009 1.26(1.05~1.52) 0.015 睡眠质量 Sleep quality 好 Good 1.00 1.00 差 Poor 1.73(1.44~2.08) < 0.001 1.32(1.09~1.61) 0.005 注：多因素分析调整性别、年龄、城乡、文化程度、就业情况、BMI、吸烟、饮酒、经常锻炼情况。
Note: Multivariate analysis adjusted for gender, age, urban and rural, educational level, employment situation, BMI, smoking, drinking, and regular exercise.
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表 4 睡眠时间和睡眠质量的组合与糖尿病患病的关联
Table 4. Association between the combination of sleep duration and sleep quality and diabetes mellitus
睡眠时间/(h·d-1)
Sleep duration/(h·d-1)睡眠质量
Sleep qualityβ值 value sx OR值(95% CI)
OR value(95% CI)P值 value < 6 好 Good -1.45 1.02 0.23(0.03~1.72) 0.153 差 Poor 0.44 0.16 1.55(1.14~2.10) 0.005 6~≤8 好 Good 1.00 差 Poor 0.07 0.12 1.07(0.85~1.36) 0.564 >8 好 Good -0.12 0.19 0.89(0.61~1.29) 0.533 差 Poor 0.42 0.13 1.53(1.18~1.99) 0.002 注：调整性别、年龄、居住地、文化程度、就业情况、BMI、吸烟、饮酒、经常锻炼情况。
Note: Adjusted variables included gender, age, urban and rural, educational level, employment situation, BMI, smoking, drinking, and regular exercise.
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