睡眠质量及时间与2型糖尿病风险交互作用的研究

张盼; 娄培安; 常桂秋; 张雷; 陈培培; 李婷; 乔程; 董宗美

Abstract

张盼,娄培安,常桂秋,张雷,陈培培,李婷,乔程,董宗美.睡眠质量及时间与2型糖尿病风险交互作用的研究[J].Chinese journal of Epidemiology,2014,35(9):990-993

睡眠质量及时间与2型糖尿病风险交互作用的研究

Interaction between quality and duration of sleep on the prevalence of type 2 diabetes

Received:March 31, 2014

DOI：10.3760/cma.j.issn.0254-6450.2014.09.004

KeyWord: 2型糖尿病睡眠质量睡眠时间交互作用

English Key Word: Type 2 diabetes Sleep quality Sleep duration Interaction

FundProject:2012年度江苏省卫生厅预防医学科研课题（Y2012025）； 2011年度徐州市科技计划项目（XF11C090）； 2012年徐州市双百人才培养工程项目（BRA201224）

Author Name	Affiliation	E-mail
Zhang Pan	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China Xuzhou Medical College
Lou Peian	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China Xuzhou Medical College	lpa82835415@126.com
Chang Guiqiu	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
Zhang Lei	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
Chen Peipei	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
Li Ting	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
Qiao Cheng	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
Dong Zongmei	Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China

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Abstract:

目的探讨睡眠质量和睡眠时间与2型糖尿病（T2DM）的关系，并分析两者间对T2DM交互作用的强度。方法采用横断面研究方法于2013年3－5月调查9 622名徐州市社区常住居民，利用非条件logistic回归模型分析睡眠时间和睡眠质量与T2DM的关系，通过Bootstrap法计算相对超额危险度比（RERI）、归因比（AP）和交互作用指数（S）以评价睡眠时间和睡眠质量之间的相加交互作用。结果 T2DM患者和非T2DM患者的匹兹堡睡眠质量量表各组分及总分比较，除入睡时间和催眠药物外，其他差异均有统计学意义（P<0.01）。睡眠质量好者与睡眠质量差者相比、睡眠时间6～8 h与睡眠时间<6 h者相比，T2DM患病率差异均有统计学意义（P<0.01）。调整性别、年龄、文化程度、职业、糖尿病家族史、吸烟、饮酒、非职业性体育活动、BMI等混杂因素后，睡眠质量差且睡眠时间<6 h者与睡眠质量好且睡眠时间在6～8 h者相比，罹患糖尿病的风险高 3.78倍（OR=4.78，95%CI：3.32～6.99）；睡眠质量差且睡眠时间>8 h者，罹患T2DM的风险增加0.92倍（OR=1.92， 95%CI：1.18～3.31）；睡眠质量差合并每天睡眠时间<6 h对发生T2DM的交互作用分别为RERI=2.33（95%CI：1.23～8.79），AP=0.67（95%CI：0.21～0.83），S=6.87（95%CI：2.33～10.75）；睡眠质量差合并每天睡眠时间>8 h对发生T2DM的交互作用分别为RERI=0.33（95%CI：-0.12～1.13），AP=0.17（95%CI：-0.03～0.51），S=1.56（95%CI：0.76～2.74）。结论睡眠质量差和睡眠时间短对罹患T2DM有正相加交互作用。

English Abstract:

Objective To explore the effects related to quality and duration of sleep and their interactions on the prevalence of type-2 diabetes (T2DM). Methods 9 622 people aged 18 years and over were recruited for our cross-sectional study during March 2013 to May 2013. Unconditional logistic regression was used to analyze the relationship between quality and duration of sleep on T2DM. Bootstrap was used to calculate the relative excess risk of interaction (RERI),the attributable proportion (AP) of interaction and the synergy index (SI). 95% confidence intervals (CI) of RERI,AP and SI were estimated. Results Concerning the comparison between cases and controls on both individual and total scores,other scores were all significantly different (P<0.01),except for two items (time for falling asleep and drugs for hypnosis). The prevalence of T2DM in volunteers with poor sleeping quality was higher than that in volunteers with good sleeping quality (P<0.01). Individuals with sleep duration <6 hours had a higher prevalence of T2DM,when compared with individuals with sleep duration of 6-8 hours (P<0.01). After adjusting for age,gender,level of education, occupation,family history of diabetes,status on cigarette smoking,alcohol intake,physical activities and body mass index (BMI),the prevalence of T2DM appeared the highest in those with poor sleeping quality and short duration (OR=4.78,95%CI:3.32-6.99;P<0.01),when compared with those who had good sleep quality and 6-8 h sleep duration. The risk of T2DM still increased in people who had poor sleep or long duration (OR=1.92,95%CI:1.18-3.31;P<0.01). Values of RERI,AP and SI(with 95%CI) were 2.33(1.23-8.79), 0.67(0.21-0.83) and 6.87(2.33-10.75),respectively,for the interaction between poor sleep quality and short sleep duration,while 0.33(-0.12-1.13),0.17(-0.03-0.51),1.56(0.76-2.74) for the interaction between good sleep quality and long sleep duration. Conclusion Our results suggested that there were additive interactions between poor quality and shorter duration of sleep.

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