苏州市成年人睡眠状况与冠心病发病风险的前瞻性关联研究

华姜; 范习康; 苏健; 陈路路; 陆艳; 华钰洁; 任洪福; 裴培; 孙点剑一; 余灿清; 吕筠; 周金意; 陶然

Abstract

华姜,范习康,苏健,陈路路,陆艳,华钰洁,任洪福,裴培,孙点剑一,余灿清,吕筠,周金意,陶然.苏州市成年人睡眠状况与冠心病发病风险的前瞻性关联研究[J].Chinese journal of Epidemiology,2024,45(7):914-922

苏州市成年人睡眠状况与冠心病发病风险的前瞻性关联研究

Prospective association study of sleep status and risk of coronary heart disease in adults in Suzhou

Received:December 15, 2023

DOI：10.3760/cma.j.cn112338-20231215-00356

KeyWord: 睡眠状况冠心病前瞻性研究

English Key Word: Sleep status Coronary heart disease 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）;江苏省卫生健康委员会医学科研项目（M2020085，H2023022）

Author Name	Affiliation	E-mail
Hua Jiang	School of Public Health, Nanjing Medical University, Nanjing 211166, China
Fan Xikang	Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Su Jian	Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Chen Lulu	Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Lu Yan	Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Prefectural Center for Disease Control and Prevention, Suzhou 215004, China
Hua Yujie	Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Prefectural Center for Disease Control and Prevention, Suzhou 215004, China
Ren Hongfu	Wuzhong District Center for Disease Control and Prevention, Suzhou 215128, China
Pei Pei	Peking University Center for Public Health and Epidemic Preparedness & Response, 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
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
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 State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing 100191, China
Zhou Jinyi	Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Tao Ran	School of Public Health, Nanjing Medical University, Nanjing 211166, China Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China	trltjy@163.com

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Abstract:

目的探讨苏州市成年人睡眠状况与冠心病发病的关联。方法使用中国慢性病前瞻性研究苏州市吴中区项目点53 269例30~79岁调查对象的基线和随访信息，剔除基线调查时自报患有冠心病、脑卒中、癌症的研究对象后，最终纳入分析51 929例研究对象。采用Cox比例风险回归模型分析各睡眠因素（打鼾症状、失眠症状、每日睡眠时长、午睡情况）、健康睡眠评分（0~3分）与冠心病发病风险的关联。结果研究对象中位随访时间为11.12年，随访期间共诊断冠心病1 304例。调整潜在混杂因素后，与没有相应睡眠症状者相比，有时打鼾（HR=1.20，95%CI：1.04~1.38）、经常打鼾（HR=1.17，95%CI：1.02~1.33）、有失眠障碍（HR=1.41，95%CI：1.12~1.78）、日间功能障碍（HR=1.56，95%CI：1.20~2.03）、常年午睡（HR=1.37，95%CI：1.19~1.59）均与冠心病发病风险增加相关。与健康睡眠评分为0~1分（睡眠最不健康）者相比，健康睡眠评分3分（睡眠最健康）者冠心病发病风险降低26%（HR=0.74，95%CI：0.63~0.87）。分层分析结果显示，健康睡眠评分3分与冠心病发病风险的关联在低体力活动水平亚组中更明显（交互作用P<0.05）。结论打鼾、失眠障碍、日间功能障碍、常年午睡均与冠心病发病风险增加相关，遵循健康的睡眠模式也许可以降低成年人冠心病发病风险。

English Abstract:

Objective To investigate the association between sleep status and the risk for coronary heart disease in adults in Suzhou. Methods Using the baseline and follow up information of 53 269 local residents aged 30-79 years in China Kadoorie Biobank conducted in Wuzhong District, Suzhou, 51 929 subjects were included in this study after excluding those reporting coronary heart disease, stroke and cancer at the baseline survey. A Cox proportional hazards regression model was used to analyze the association of healthy sleep score (0-3 points) and sleep factors (snoring, insomnia, long sleep duration and nap) with the risk for coronary heart disease. Results The median follow-up time was 11.12 years, and 1 304 individuals were diagnosed with coronary heart disease during the follow-up. After adjusting for potential confounders, occasional snoring (HR=1.20, 95%CI: 1.04-1.38), usual snoring (HR=1.17, 95%CI: 1.02-1.33), insomnia disorder (HR=1.41, 95%CI: 1.12-1.78), daytime dysfunction (HR=1.56, 95%CI: 1.20-2.03) and perennial nap (HR=1.37, 95%CI: 1.19-1.59) were associated with increased risk of coronary heart disease. Compared with those with sleep score of 0 - 1 (low sleep quality), the people with sleep score of 3 had reduced risk of coronary heart disease by 26% (HR=0.74, 95%CI: 0.63-0.87). Stratified analysis showed that the association of healthy sleep score 3 with risk of coronary heart disease was stronger in low physically active individuals (interaction P<0.05). Conclusions Snoring, insomnia disorders, daytime dysfunction, and perennial napping were all associated with increased risk for coronary heart disease, and keep healthy sleep mode might reduce the risk for coronary heart disease in adults.

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