Impact of sleep characteristics and obesity on diabetes and hypertension across genders and menopausal status: the Nagahama study
Impact of sleep characteristics and obesity on diabetes and hypertension across genders and menopausal status: the Nagahama study
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DOI：
10.1093/sleep/zsy071
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发表时间：
2018-07-01
期刊：
影响因子：
5.6
通讯作者：
Chin, Kazuo
中科院分区：
文献类型：
--
作者：
Matsumoto, Takeshi;Murase, Kimihiko;Chin, Kazuo
研究目的：睡眠呼吸障碍（SDB）、睡眠时间短和肥胖的个体患病率较高且呈上升趋势。本研究旨在探讨性别间SDB、客观睡眠时间、肥胖、糖尿病和高血压之间的潜在关联，以及绝经前后状态的影响。方法：一项横断面研究对7051名社区参与者进行了为期一周的腕关节活动描记和两晚的夜间血氧测定。通过腕部活动记录仪获得的3%氧去饱和指数（ODI）校正睡眠时间来评估SDB。中度至重度SDB定义为ODI3%水平>= 15 /小时。结果：logODI3%和体重指数均与睡眠时间呈独立负相关（分别为β = -0.16, p < 0.001和β = -0.07, p < 0.001）。中度至重度SDB（男性/绝经前女性/绝经后女性；分别为23.7/1.5/9.5%）与绝经前女性（OR 28.1; 95% CI 6.35-124.6; p < 0.001）和绝经后女性（OR 3.25; 95% CI 1.94-5.46; p < 0.001）发生糖尿病的风险较高相关，但与男性无关（OR 1.47; 95% CI 0.90-2.40; p = 0.119）。在男性（OR 3.11; 95% CI 2.23-4.33; p < 0.001）、绝经前女性（OR 3.88; 95% CI 1.42-10.6; p = 0.008）和绝经后女性（OR 1.96; 95% CI 1.46-2.63; p < 0.001）中，中度至重度SDB与高血压的高风险相关。睡眠时间短与糖尿病或高血压无关。肥胖与糖尿病或高血压的关联由SDB间接介导（分别为24.0%和21.5%），并可能出现性别差异（男性/女性，分别为15.3/27.8%和27.0/16.9%）。结论：尽管采用了横断面设计，但SDB和肥胖与糖尿病和高血压独立相关，而睡眠不足与糖尿病和高血压无关，并且在风险上存在性别和绝经状态相关的差异。睡眠呼吸障碍（SDB）、睡眠时间短和肥胖可能与糖尿病和全身性高血压有关。然而，性别和更年期状况的影响实际上尚未得到探索。这项基于社区的大型研究表明，SDB和肥胖与睡眠时间较短有关，但只有SDB和肥胖与糖尿病和全身性高血压独立相关，并且在这些结果中表现出性别和更年期状态相关的差异。此外，约20%的肥胖对糖尿病或全身性高血压的影响是由SDB间接介导的。因此，SDB和肥胖可能与糖尿病和全身性高血压独立相关，而睡眠不足可能与糖尿病和全身性高血压独立相关，并出现与性别和绝经状态相关的风险差异。
Study Objectives: The individual prevalence of sleep-disordered breathing (SDB), short sleep duration, and obesity is high and increasing. The study aimed to investigate potential associations between SDB, objective sleep duration, obesity, diabetes and hypertension across genders, and the effect of pre-or post-menopausal status.Methods: A cross-sectional study evaluated 7051 community participants with wrist actigraphy for a week, and nocturnal oximetry 2 nights. SDB was assessed by 3 per cent oxygen desaturation index (ODI) corrected for sleep duration obtained from wrist actigraphy. Moderate-to-severe SDB was defined as ODI3% levels >= 15 per hour.Results: Both logODI3% and body mass index showed independent negative associations with sleep duration (beta = -0.16, p < 0.001 and beta = -0.07, p < 0.001, respectively). Moderate-to-severe SDB (men/premenopausal women/postmenopausal women; 23.7/1.5/9.5%, respectively) was associated with a higher risk of diabetes in premenopausal women (OR 28.1; 95% CI 6.35-124.6; p < 0.001) and postmenopausal women (OR 3.25; 95% CI 1.94-5.46; p < 0.001), but not in men (OR 1.47; 95% CI 0.90-2.40; p = 0.119). Moderate-to-severe SDB was associated with a higher risk of hypertension in men (OR 3.11; 95% CI 2.23-4.33; p < 0.001), premenopausal women (OR 3.88; 95% CI 1.42-10.6; p = 0.008), and postmenopausal women (OR 1.96; 95% CI 1.46-2.63; p < 0.001). Short sleep duration was not associated with diabetes or hypertension. The associations of obesity with diabetes or hypertension were indirectly mediated by SDB (24.0% and 21.5%, respectively), with possible sex differences emerging (men/women; 15.3/27.8% and 27.0/16.9%, respectively).Conclusions: Notwithstanding the cross-sectional design, SDB and obesity, but not short sleep duration, were independently associated with diabetes and hypertension, with gender and menopausal status-related differences in risk emerging.Statement of SignificanceSleep-disordered breathing (SDB), short sleep duration, and obesity may be associated with diabetes and systemic hypertension. However, the impact of gender and menopausal status remains virtually unexplored. This large community-based study showed that SDB and obesity were associated with shorter sleep duration, but only SDB and obesity were independently associated with diabetes and systemic hypertension and exhibited gender and menopause status-related differences in these outcomes. In addition, about 20 per cent of the effects of obesity on diabetes or systemic hypertension were indirectly mediated by SDB. Therefore, SDB and obesity but not short sleep duration may be independently associated with diabetes and systemic hypertension, with gender and menopausal status-related differences in risk emerging.