Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence
Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence
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DOI：
10.1111/j.1467-789x.2010.00724.x
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发表时间：
2011-02-01
期刊：
影响因子：
8.9
通讯作者：
Sorensen, T. I. A.
中科院分区：
文献类型：
--
作者：
Nielsen, L. S.;Danielsen, K. V.;Sorensen, T. I. A.
系统性文献检索提供了71项原始研究和7项对这些研究的不同子集的综述，以寻找睡眠不足与体重增加和最终肥胖发展之间关系的流行病学证据。我们总结了这种关联的证据，特别强调前瞻性研究。研究表明，睡眠时间短始终与儿童和年轻人的肥胖发展有关，但在老年人中并不总是如此。我们已经确定了证据的关键方面，并评估了因果关系方面解释证据的可能性。我们已经讨论了假定的暴露和结果之间的时间序列的要求和它们之间的时滞的影响，暴露和影响的充分测量的问题，可能的双向因果关系，混淆因素和介质之间的必要区分，可能的混淆体重史，和共同的或上游的潜在原因的可能性。总之，因果关系的解释协会是阻碍了基本的概念和方法问题。实验研究可能会阐明机制，但充分覆盖从睡眠减少到肥胖发展的整个途径是不可行的。需要进行随机试验来评估有针对性的干预措施的价值。
Systematic literature search for epidemiological evidence for an association of short sleep with weight gain and eventual development of obesity provided 71 original studies and seven reviews of various subsets of these studies. We have summarized the evidence for such an association with particular emphasis on prospective studies. The studies showed that short sleep duration is consistently associated with development of obesity in children and young adults, but not consistently so in older adults. We have identified critical aspects of the evidence, and assessed the possibility for interpretation of the evidence in terms of causality. We have discussed the requirement of temporal sequence between putative exposure and outcome and the implications of the time lag between them, the problems in adequate measurements of exposure and effects, the possible bidirectional causal effects, the necessary distinction between confounders and mediators, the possible confounding by weight history, and the possibility of common or upstream underlying causes. In conclusion, causal interpretation of the association is hampered by fundamental conceptual and methodological problems. Experimental studies may elucidate mechanisms, but adequate coverage of the entire pathway from sleep curtailment through obesity development is not feasible. Randomized trials are needed to assess the value of targeted interventions.