中国成年人睡眠状况与肾结石风险的前瞻性队列研究

汪涵; 张艺倩; 余灿清; 郭彧; 裴培; 陈君石; 陈铮鸣; 吕筠; 李立明

Abstract

汪涵,张艺倩,余灿清,郭彧,裴培,陈君石,陈铮鸣,吕筠,李立明.中国成年人睡眠状况与肾结石风险的前瞻性队列研究[J].Chinese journal of Epidemiology,2022,43(7):1002-1009

中国成年人睡眠状况与肾结石风险的前瞻性队列研究

Associations between sleep status and risk for kidney stones in Chinese adults: a prospective cohort study

Received:September 30, 2021

DOI：10.3760/cma.j.cn112338-20210930-00760

KeyWord: 失眠睡眠时间打鼾肾结石队列研究中国人

English Key Word: Insomnia Sleep duration Snoring Kidney stones Cohort studies Chinese

FundProject:国家自然科学基金(81941018);国家重点研发计划(2016YFC0900500,2016YFC0900501,2016YFC0900504);中国香港Kadoorie Charitable基金

Author Name	Affiliation	E-mail
Wang Han	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Zhang Yiqian	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Guo Yu	Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing 100037, China
Pei Pei	Chinese Academy of Medical Sciences, Beijing 100730, China
Chen Junshi	China National Center for Food Safety Risk Assessment, Beijing 100022, China
Chen Zhengming	Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing 100191, China	lvjun@bjmu.edu.cn
Li Liming	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China

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Abstract:

目的分析中国成年人睡眠状况与肾结石风险之间的关联。方法基于中国慢性病前瞻性研究的长期随访数据，剔除基线自报患有慢性肾病、恶性肿瘤、睡眠时间为极端值的研究对象，共纳入501 701人。研究收集的睡眠数据包括失眠症状、白天嗜睡情况、午休习惯、打鼾情况和睡眠时间；并根据失眠症状、白天嗜睡情况和睡眠时间构建睡眠评分（0~3分）。采用Cox比例风险回归模型分析各睡眠因素、睡眠评分与肾结石风险的关联。结果研究对象随访（10.7±2.2）年，随访期间首次记录的肾结石病例共12 381例。调整潜在混杂因素后，与没有对应失眠症状者相比，有入睡困难或过早醒来症状者的肾结石风险比（HR）分别为1.12（95%CI：1.06~1.18）和1.06（95%CI：1.00~1.12）。使用安眠药、白天嗜睡、午休习惯、打鼾与肾结石风险均不存在统计学显著的关联。与每日睡眠时间≥7 h者相比，<7 h者发生肾结石的HR=1.13（95%CI：1.08~1.18）。与睡眠评分为3分（睡眠质量最高）者相比，睡眠评分为2、1、0分者对应的HR值分别为1.08（95%CI：1.03~1.13）、1.16（95%CI：1.10~1.23）、1.19（95%CI：1.03~1.37）。结论中国成年人中有失眠症状或睡眠时间短者的肾结石风险增加。

English Abstract:

Objective To analyze the associations between sleep status and the risk for kidney stone in Chinese adults. Methods This study used baseline and long-term follow-up data of China Kadoorie Biobank. After excluding those with self-reporting of diagnosed chronic kidney disease and cancer and those with extreme values of sleep duration at baseline survey, 501 701 participants were included in this study. The information about their sleep status were collected, including insomnia symptoms, daytime sleepiness, nap habit, snoring and sleep duration. The sleep score was constructed based on insomnia symptoms, daytime sleepiness, and sleep duration, ranging from 0 to 3. Cox proportional hazards regression models were used to evaluate the association of sleep status with the risk for kidney stone, including individual sleep factors and combined sleep score. Results During the follow-up for average (10.7±2.2) years, 12 381 cases of kidney stone were recorded for the first time. Compared with participants without insomnia symptoms, the multivariable-adjusted HR of kidney stone in those with difficulty falling asleep and waking up early were 1.12 (95%CI:1.06-1.18) and 1.06 (95%CI:1.00-1.12), respectively. There was no statistically significant association of kidney stone risk with sleeping pill use, daytime sleepiness, nap habit, or snoring. Compared with participants with sleep duration ≥ 7 hours per day, the HR of kidney stone in those with sleep duration <7 hours per day was 1.13 (95%CI:1.08-1.18). Compared with participants with sleep score of 3 (highest sleep quality), the HR of kidney stone in those with sleep score of 2, 1, and 0 were 1.08 (95%CI:1.03-1.13), 1.16 (95%CI:1.10-1.23), and 1.19 (95%CI:1.03-1.37), respectively.Conclusion In China, adults with insomnia symptoms or short sleep duration have increased risk for kidney stone.

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