苏州市成年人睡眠时长与慢性阻塞性肺疾病发病风险关联的前瞻性研究

杨梦诗; 范习康; 苏健; 宛星霖; 俞浩; 陆艳; 华钰洁; 金建荣; 裴培; 余灿清; 孙点剑一; 吕筠; 陶然; 周金意

Abstract

杨梦诗,范习康,苏健,宛星霖,俞浩,陆艳,华钰洁,金建荣,裴培,余灿清,孙点剑一,吕筠,陶然,周金意.苏州市成年人睡眠时长与慢性阻塞性肺疾病发病风险关联的前瞻性研究[J].Chinese journal of Epidemiology,2024,45(3):331-338

苏州市成年人睡眠时长与慢性阻塞性肺疾病发病风险关联的前瞻性研究

A prospective study on association between sleep duration and the risk of chronic obstructive pulmonary disease in adults in Suzhou

Received:September 18, 2023

DOI：10.3760/cma.j.cn112338-20230918-00164

KeyWord: 慢性阻塞性肺疾病睡眠时长前瞻性研究

English Key Word: Chronic obstructive pulmonary disease Sleep duration Prospective study

FundProject:国家自然科学基金（82192900，82192901，82192904，81390540，91846303）；国家重点研发计划“精准医学研究”重点专项（2016YFC0900500）；中国香港Kadoorie Charitable基金；英国Wellcome Trust（202922/Z/16/Z，088158/Z/09/Z，104085/Z/14/Z）；江苏省科技厅社会发展重点项目（BE2019674）；苏州市姑苏卫生人才计划培养项目（GSWS2020098）

Author Name	Affiliation	E-mail
Yang Mengshi	Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
Fan Xikang	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Su Jian	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China School of Public Health, Nanjing Medical University, Nanjing 211166, China
Wan Xinglin	School of Public Health, Nanjing Medical University, Nanjing 211166, China
Yu Hao	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Lu Yan	Suzhou Prefectural Center for Disease Control and Prevention, Suzhou 215003, China
Hua Yujie	Suzhou Prefectural Center for Disease Control and Prevention, Suzhou 215003, China
Jin Jianrong	Wuzhong District Center for Disease Control and Prevention of Suzhou, Suzhou 215128, China
Pei Pei	Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Yu Canqing	Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China
Sun Dianjianyi	Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China
Lyu Jun	Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases(Peking University), Ministry of Education, Beijing 100191, China
Tao Ran	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China School of Public Health, Nanjing Medical University, Nanjing 211166, China
Zhou Jinyi	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China School of Public Health, Nanjing Medical University, Nanjing 211166, China	zhoujinyi74@sina.com

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Abstract:

目的探讨苏州市成年人睡眠时长与慢性阻塞性肺疾病（COPD）发病的前瞻性关联。方法利用中国慢性病前瞻性研究苏州市吴中区项目点53 269名30~79岁调查对象的基线和随访信息，基线调查开展于2004-2008年，本研究使用的数据随访截至2017年12月31日。剔除基线气流阻塞者、基线调查时自报患有慢性支气管炎/肺气肿/肺心病、数据异常或缺失的研究对象后，最终纳入分析45 336名。利用Cox比例风险回归模型分析睡眠时长与COPD发病风险的关联，并计算发病风险比（HR）值及其95%CI。按照年龄、性别、生活方式等因素进行分层分析，根据吸烟状况和每日睡眠时长交叉分组进行联合分析。结果研究对象中位随访时间为11.12年，随访期间共诊断COPD 515名。调整潜在混杂因素后，多因素Cox比例风险回归分析显示，每日睡眠时长≥10 h增加COPD发病风险（HR=1.42，95%CI：1.03~1.97）。联合分析结果显示，睡眠时长过长（≥10 h）可显著增加吸烟者COPD发病风险（HR=2.49，95%CI：1.35~4.59，交互作用P<0.001）。结论每日睡眠时长过长（≥10 h）可以增加苏州市成年人中COPD发病风险，在吸烟者中更加明显。

English Abstract:

Objective To investigate the prospective association of sleep duration with the development of chronic obstructive pulmonary disease (COPD) in adults in Suzhou. Methods The study used the data of 53 269 participants aged 30-79 years recruited in the baseline survey from 2004 to 2008 and the follow-up until December 31, 2017 of China Kadoorie Biobank (CKB) conducted in Wuzhong District, Suzhou. After excluding participants with airflow limitation, self-reported chronic bronchitis/emphysema/coronary heart disease history at the baseline survey and abnormal or incomplete data, a total of 45 336 participants were included in the final analysis. The association between daily sleep duration and the risk for developing COPD was analyzed by using a Cox proportional hazard regression model, and the hazard ratio (HR) values and their 95%CI were calculated. The analysis was stratified by age, gender and lifestyle factors, and cross-analysis was conducted according to smoking status and daily sleep duration.Results The median follow-up time was 11.12 years, with a total of 515 COPD diagnoses in the follow-up. After adjusting for potential confounders, multifactorial Cox proportional hazard regression analysis showed that daily sleep duration ≥10 hours was associated with higher risk for developing COPD (HR=1.42, 95%CI: 1.03-1.97). The cross analysis showed that excessive daily sleep duration increased the risk for COPD in smokers (HR=2.49, 95%CI: 1.35-4.59, interaction P<0.001).Conclusion Longer daily sleep duration (≥10 hours) might increase the risk for COPD in adults in Suzhou, especially in smokers.

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