Paradoxical Effects of Prolonged Insufficient Sleep on Lipid Profile: A Pooled Analysis of 2 Randomized Trials.
Paradoxical Effects of Prolonged Insufficient Sleep on Lipid Profile: A Pooled Analysis of 2 Randomized Trials.
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DOI：
10.1161/jaha.123.032078
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发表时间：
2023-10-17
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
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睡眠不足与心血管疾病风险增加有关，但因果关系尚不清楚。我们研究了长期轻度睡眠限制（SR）对血脂和炎症的影响。78名习惯性睡眠持续时间为7 - 9 h/晚（充足睡眠[AS]）的受试者（56名女性[12名绝经后];年龄34.3±12.5岁;体重指数25.8±3.5 kg/m2）在随机交叉设计中接受了两种为期6周的条件：AS与SR（AS-1.5 h/晚）。评估总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇、甘油三酯和炎症标志物（CRP [C反应蛋白]、白细胞介素6和肿瘤坏死因子-α）。线性模型测试了SR对全样本结局的影响，并按性别+绝经状态（绝经前与绝经后女性+男性）进行了分析。在完整样本中，与AS相比，SR增加了高密度脂蛋白胆固醇（β=1.2±0.5 mg/dL; P=0.03）。性别+绝经状态影响SR对总胆固醇（P-相互作用=0.04）、LDL-C（P-相互作用=0.03）和白细胞介素6（P-相互作用=0.07）变化的影响。绝经前女性SR组的总胆固醇和LDL-C低于AS组（总胆固醇：β=−4.2±1.9 mg/dL; P=0.03; LDL-C：β=−6.3±2.0 mg/dL; P=0.002）。鉴于SR对胆固醇浓度的矛盾作用，我们探讨了每种条件下炎症变化与终点脂质之间的关联。SR期间白细胞介素6和肿瘤坏死因子-α的升高倾向于与绝经前女性的低密度脂蛋白胆固醇（LDL-C）降低相关（白细胞介素6：β=−5.3±2.6 mg/dL; P=0.051;肿瘤坏死因子-α：β=−32.8±14.2 mg/dL; P=0.027）。对于健康成年人来说，长期睡眠不足不会增加致动脉粥样硬化的脂质。然而，SR中炎症的增加倾向于预测绝经前妇女的低密度脂蛋白-C水平较低，类似于“脂质悖论”，其中低胆固醇与促炎性疾病中心血管疾病风险增加相关。URL：https://www.clinicaltrials.gov;唯一标识符：NCT 02835261、NCT 02960776。
Insufficient sleep is associated with increased cardiovascular disease risk, but causality is unclear. We investigated the impact of prolonged mild sleep restriction (SR) on lipid and inflammatory profiles. Seventy‐eight participants (56 women [12 postmenopausal]; age, 34.3±12.5 years; body mass index, 25.8±3.5 kg/m2) with habitual sleep duration 7 to 9 h/night (adequate sleep [AS]) underwent two 6‐week conditions in a randomized crossover design: AS versus SR (AS–1.5 h/night). Total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol, triglycerides, and inflammatory markers (CRP [C‐reactive protein], interleukin 6, and tumor necrosis factor‐α) were assessed. Linear models tested effects of SR on outcomes in the full sample and by sex+menopausal status (premenopausal versus postmenopausal women+men). In the full sample, SR increased high‐density lipoprotein cholesterol compared with AS (β=1.2±0.5 mg/dL; P=0.03). Sex+menopausal status influenced the effects of SR on change in total cholesterol (P‐interaction=0.04), LDL‐C (P‐interaction=0.03), and interleukin 6 (P‐interaction=0.07). Total cholesterol and LDL‐C decreased in SR versus AS in premenopausal women (total cholesterol: β=−4.2±1.9 mg/dL; P=0.03; LDL‐C: β=−6.3±2.0 mg/dL; P=0.002). Given paradoxical effects of SR on cholesterol concentrations, we explored associations between changes in inflammation and end point lipids under each condition. Increases in interleukin 6 and tumor necrosis factor‐α during SR tended to relate to lower LDL‐C in premenopausal women (interleukin 6: β=−5.3±2.6 mg/dL; P=0.051; tumor necrosis factor‐α: β=−32.8±14.2 mg/dL; P=0.027). Among healthy adults, prolonged insufficient sleep does not increase atherogenic lipids. However, increased inflammation in SR tends to predict lower LDL‐C in premenopausal women, resembling the “lipid paradox” in which low cholesterol associates with increased cardiovascular disease risk in proinflammatory conditions. URL: https://www.clinicaltrials.gov; Unique identifiers: NCT02835261, NCT02960776.
急性心肌梗死中胆固醇悖论的谜：在年龄匹配且性匹配的病例对照研究中，全因死亡率进行了8年随访的教训，并从患者招聘区域进行对照。
影响因子：
2.9
作者：
Nilsson G;Leppert J;Ohrvik J
通讯作者：
Ohrvik J
影响因子：
6.9
作者：
Nedeltcheva, Arlet V.;Imperial, Jacqueline G.;Penev, Plamen D.
通讯作者：
Penev, Plamen D.