Abstract
陈一佳,苏健,覃玉,李莹,潘恩春,高艳,张宁,周金意,余小金,武鸣,沈冲.睡眠时间和2型糖尿病患者死亡风险的前瞻性队列研究[J].Chinese journal of Epidemiology,2019,40(4):394-399
睡眠时间和2型糖尿病患者死亡风险的前瞻性队列研究
A prospective cohort study on the duration of sleep and risk of all-cause mortality among patients with type 2 diabetes
Received:October 11, 2018  
DOI:10.3760/cma.j.issn.0254-6450.2019.04.005
KeyWord: 糖尿病,2型  睡眠时间  死亡风险  前瞻性研究
English Key Word: Diabetes mellitus, type 2  Sleep duration  Mortality  Prospective study
FundProject:江苏省医学领军人才和创新团队项目(K201105);国家自然科学基金青年基金(81602919);江苏省第四期"333工程"科研项目(BRA2013107);国家自然科学基金(81673274);科教强业工程青年人才(JKRC2016007);江苏省研究生科研与实践创新计划(SJCX17-0066)
Author NameAffiliationE-mail
Chen Yijia School of Public Health, Southeast University, Nanjing 210009, China  
Su Jian Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Qin Yu Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Li Ying School of Public Health, Southeast University, Nanjing 210009, China  
Pan Enchun Huai'an City Center for Disease Control and Prevention of Jiangsu Province, Huai'an 223001, China  
Gao Yan Suzhou City Center for Disease Control and Prevention, Suzhou 215004, China  
Zhang Ning Changshu City Center for Disease Control and Prevention of Jiangsu Province, Changshu 215500, China  
Zhou Jinyi Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Yu Xiaojin School of Public Health, Southeast University, Nanjing 210009, China  
Wu Ming School of Public Health, Southeast University, Nanjing 210009, China
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China 
jswuming@vip.sina.com 
Shen Chong School of Public Health, Nanjing Medical University, Nanjing 211166, China sc100@126.com 
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Abstract:
      目的 探讨2型糖尿病人群中睡眠时间和全死因死亡风险的关联。方法 以江苏省常熟市、淮安市清河区和淮安区纳入国家基本公共卫生服务管理的17 452名2型糖尿病患者作为观察队列。利用Cox比例风险模型计算不同睡眠时间人群随访期间的全死因死亡风险比(HR)值及其95% CI,并按照性别、年龄、生活方式因素进行分层分析。结果 研究人群累计随访67 912人年,平均随访4年,随访期间糖尿病患者死亡1 057人。以睡眠时间7 h/d为参照,调整混杂因素后,睡眠时间≤ 6、8、9和≥ 10 h/d发生死亡的HR值(95% CI)分别为1.14(0.94~1.37)、1.10(0.91~1.32)、1.33(1.05~1.70)和1.52(1.24~1.87)。分层分析显示结果和全人群结果相似,睡眠时间过长与糖尿病患者死亡风险有统计学关联,但未见睡眠时间不足与糖尿病患者死亡风险有统计学关联。结论 睡眠时间过长可增加2型糖尿病患者死亡风险。
English Abstract:
      Objective To investigate the relationship between duration of sleep and all-cause mortality in patients with type 2 diabetes. Methods A total of 17 452 type 2 diabetic patients who were under the National Basic Public Health Service Project, in Changshu county, Qinghe district and Huai'an district in Huai'an city of Jiangsu province, were recruited as participants. Cox proportional hazards regression models were used to estimate the associations between different levels on the duration of sleep and all-cause mortality. Stratified analysis was performed according to factors as gender, age, and lifestyle. Results Among the 67 912 person-years of observation, from the fo1low-up program, the median time of follow-up was 4 years, with 1 057 deaths occurred during the follow-up period. Taking patients with duration of sleep as 7 h/d for reference, the multivariate adjusted hazard ratios (95% CI) of all-cause mortality appeared as ≤ 6, 8, 9 and ≥ 10 h/d were 1.14 (0.94-1.37), 1.10 (0.91-1.32), 1.33 (1.05-1.70), and 1.52 (1.24-1.87), respectively which were associated with the duration of sleep. Data from the subgroup analysis showed that this was consistent with the whole population. Longer duration of sleep was associated with the all-cause mortality but no significant association was found between shorter duration of sleep and the all-cause mortality. Conclusion Longer duration of sleep seemed to have increased the risk of all-cause mortality in type 2 diabetic patients.
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