Cross-sectional and Prospective Associations of Actigraphy-Assessed Sleep Regularity With Metabolic Abnormalities: The Multi-Ethnic Study of Atherosclerosis
Cross-sectional and Prospective Associations of Actigraphy-Assessed Sleep Regularity With Metabolic Abnormalities: The Multi-Ethnic Study of Atherosclerosis
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DOI：
10.2337/dc19-0596
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发表时间：
2019-08-01
期刊：
影响因子：
16.2
通讯作者：
Redline, Susan
中科院分区：
文献类型：
--
作者：
Huang, Tianyi;Redline, Susan
目的 横断面和前瞻性地研究不规则睡眠模式（昼夜节律紊乱的潜在标志）与代谢异常之间的关联。研究设计和方法 在动脉粥样硬化的多种族研究中，参与者在考试 5（2010-2013 年）时完成了为期 7 天的体动记录仪，并在整个考试 6（2016 年至 2017 年）期间进行了前瞻性随访。睡眠规律通过体动记录仪评估的睡眠持续时间和睡眠开始时间的 7 天 SD 进行量化。代谢异常的定义为 1) 国家胆固醇教育计划成人治疗小组 III 标准和 2) 数据驱动的代谢因素聚类。结果 在针对社会人口统计学和生活方式因素进行调整的考试 5 横断面分析中 (n = 2,003)，睡眠持续时间 SD 每增加 1 小时，代谢综合征的发病率就会增加 27% (95% CI 1.10, 1.47)，而睡眠时间 SD 每增加 1 小时，代谢综合征的发病率就会增加 23% (95% CI 1.06, 1.42)。通过对睡眠相关因素（包括睡眠持续时间）进行额外调整，这种关联仍然显着。在前瞻性分析 (n = 970) 中，睡眠持续时间相应的完全调整比值比 (OR) 为 1.27 (95% CI 0.97, 1.65)，睡眠时间为 1.36 (1.03, 1.80)。与代谢变化很少的簇相比，睡眠变异性每增加 1 小时，以多种代谢异常发生率为特征的簇的几率几乎增加一倍（睡眠时间的 OR 1.97 [95% CI 1.18, 3.30]，睡眠时间的 OR 2.10 [95% CI 1.25, 3.53]）。结论 即使考虑了睡眠持续时间和其他生活方式因素，睡眠持续时间和时间变化的增加与代谢异常的患病率和发生率较高相关。
OBJECTIVE To cross-sectionally and prospectively investigate the association between irregular sleep patterns, a potential marker for circadian disruption, and metabolic abnormalities. RESEARCH DESIGN AND METHODS In the Multi-Ethnic Study of Atherosclerosis, participants completed 7-day actigraphy at exam 5 (2010-2013) and were prospectively followed throughout exam 6 (2016 to 2017). Sleep regularity was quantified by the 7-day SD of actigraphy-assessed sleep duration and sleep onset timing. Metabolic abnormalities were defined by 1) the National Cholesterol Education Program Adult Treatment Panel III criteria and 2) a data-driven clustering of metabolic factors. RESULTS In the exam 5 cross-sectional analysis adjusted for sociodemographic and lifestyle factors (n = 2,003), every 1-h increase in the sleep duration SD was associated with 27% (95% CI 1.10, 1.47) higher odds of metabolic syndrome, and every 1-h increase in the sleep timing SD was associated with 23% (95% CI 1.06, 1.42) higher odds. The associations remained significant with additional adjustment for sleep-related factors including sleep duration. In the prospective analysis (n = 970), the corresponding fully adjusted odds ratio (OR) was 1.27 (95% CI 0.97, 1.65) for sleep duration and 1.36 (1.03, 1.80) for sleep timing. Compared with the cluster of few metabolic changes, every 1-h increase in sleep variability was associated with almost doubled odds for the cluster characterized by incidence of multiple metabolic abnormalities (OR 1.97 [95% CI 1.18, 3.30] for sleep duration and OR 2.10 [95% CI 1.25, 3.53] for sleep timing). CONCLUSIONS Increased variability in sleep duration and timing was associated with higher prevalence and incidence of metabolic abnormalities even after consideration of sleep duration and other lifestyle factors.