Higher systemic inflammation is associated with poorer sleep quality in stable haemodialysis patients
Higher systemic inflammation is associated with poorer sleep quality in stable haemodialysis patients
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DOI：
10.1093/ndt/gfn439
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发表时间：
2009-01-01
影响因子：
6.1
通讯作者：
Tsai, Tun-Jun
中科院分区：
文献类型：
--
作者：
Chiu, Yen-Ling;Chuang, Yi-Fang;Tsai, Tun-Jun
背景在肾功能正常的睡眠障碍患者中已经注意到炎症增加。然而，睡眠质量和循环炎症标志物之间的关系尚未在血液透析（HD）患者中进行过研究。本研究共纳入114例接受维持HD> 3个月的HD终末期肾病患者。匹兹堡睡眠质量指数（PSQI）用于测量个体的睡眠质量。根据PSQI总分将患者分为睡眠良好组（PSQI < 5）和睡眠不良组（PSQI ≥ 5）。23名患者（20.2%）被归类为睡眠良好，91名患者（79.8%）被归类为睡眠不良。睡眠不良组血清hsCRP水平显著高于正常组（P < 0.05），血清磷水平显著低于正常组（P < 0.05）。总体PSQI评分或较差睡眠质量与血清甘油三酯水平、高敏C反应蛋白（hsCRP）水平、IL-1 β水平呈正相关，与血红蛋白和磷酸盐水平呈负相关。多变量线性回归模型中，hsCRP（β = 0.209，P = 0.029）和甘油三酯（β = 0.212，P = 0.025）水平均为PSQI总分的独立预测因子。我们的研究证实了HD患者的睡眠质量严重受损，并证实了炎症在睡眠障碍发病机制中的作用。
Background. Increased inflammation has been noted in sleep disorder patients with normal renal function. However, the relationship between sleep quality and circulating inflammatory markers has not been previously studied in haemodialysis (HD) patients.Methods. A total of 114 HD end-stage renal disease patients receiving maintenance HD for > 3 months were included in this study. Pittsburgh Sleep Quality Index (PSQI) was used to measure individual's sleep quality. Based on the global PSQI score, patients were divided into groups of good sleepers (PSQI < 5) and bad sleepers (PSQI >= 5).Results. Twenty-three patients (20.2%) were classified as good sleepers and 91 patients (79.8%) were bad sleepers. Bad sleepers have significantly higher serum hsCRP level and lower serum phosphate level (all P < 0.05). The global PSQI score, or worse sleep quality are positively correlated with serum triglyceride level, high-sensitivity C-reactive protein (hsCRP) level, IL-1 beta level and negatively correlated with the haemoglobin and phosphate level. In the multi-variable linear regression model, levels of hsCRP (beta = 0.209, P = 0.029) and triglyceride (beta = 0.212, P = 0.025) were both significant independent predictors for the global PSQI score.Conclusion. Our study demonstrated severe impairment of sleep quality in HD patients and corroborated the role of inflammation in the pathogenesis of sleep disturbance.