Autonomic, Endothelial, and Inflammatory Correlates of Sleep Duration

睡眠持续时间的自主神经、内皮细胞和炎症相关性

• 批准号: 8150634
• 负责人: Mercedes Renee Carnethon
• 金额: $ 45.43万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8150634
• 关键词: 35-64 years old; Acute; Adipocytes; Adult; African American; Age; Apnea; Area; Asian Americans; Asians; Autonomic nervous system; Berlin; Biological Markers; Blood; Blood Pressure; Blood Vessels; C-reactive protein; Cardiovascular Diseases; Cardiovascular system; Categories; Caucasians; Caucasoid Race; Characteristics; Chicago; Child; Chinese People; Chronic; Clinical; Coronary heart disease; Cross-Sectional Studies; Data; Development; Diabetes Mellitus; Diagnosis; Diastolic blood pressure; Disease; E-Selectin; Education; Educational Status; Endothelial Cells; Epidemiologic Studies; Epidemiology; Equilibrium; Ethnic Origin; Ethnic group; Evaluation; Fasting; Female; Functional disorder; Future; Gender; Glucose; Health; Health behavior; Heart Diseases; High Prevalence; Home environment; Hormones; Hour; Hypertension; Impairment; Incidence; Inflammation; Inflammatory; Injury; Insulin; Insulin Resistance; Interleukin-6; Intervention; Latino; Leptin; Life; Link; Lipids; Longitudinal Studies; Maintenance; Marital Status; Measurement; Measures; Mechanics; Mediating; Medical History; Mental Depression; Metabolic; Metabolic Diseases; Metabolic syndrome; Methods; Monitor; Mood Disorders; Nervous System Physiology; Obesity; Observational Study; Outcome; Overweight; Parasympathetic Nervous System; Participant; Patient Self-Report; Pattern; Persons; Physical activity; Plasminogen Activator Inhibitor 1; Platelet aggregation; Polysomnography; Population; Population Heterogeneity; Prevalence; Procedures; Process; Public Health; Questionnaires; Race; Recruitment Activity; Reporting; Research; Research Personnel; Rest; Risk; Risk Factors; Sampling; Screening procedure; Sleep; Sleep Apnea Syndromes; Sleep Disorders; System; Testing; Time; Tumor Necrosis Factor-alpha; Variant; Vasodilation; Withdrawal; Woman; Wrist; actigraphy; adiponectin; aged; base; biological adaptation to stress; cardiovascular disorder risk; cohort; cytokine; depressive symptoms; disorder risk; fasting glucose; heart rate variability; indexing; inflammatory marker; innovation; insulin secretion; interest; population based; research study; resistin; response; sex; tool; vasoconstriction; von Willebrand Factor; waist circumference

DESCRIPTION (provided by applicant): Short sleep duration (<6 hours/night) is associated with a higher prevalence and incidence of hypertension, diabetes, and overweight/obesity, all of which can contribute to coronary heart disease. Pathophysiologic mechanisms that could explain these associations such as autonomic nervous system dysfunction, endothelial dysfunction, inflammation, and insulin resistance have been identified in the setting of sleep disordered breathing (SDB), namely sleep apnea, or in experimental studies of sleep restriction. However, over 90% of adults do not suffer from SDB, and complete sleep restriction is rare. Rather, an important public health concern is whether these pathophysiologic mechanisms are apparent in association with short sleep duration in persons without SDB. The present epidemiologic study will recruit a sample of 500 adults aged 35-64 from the Chicago, IL area who do not have SDB as determined by validated screening questionnaires and in-home overnight polysomnography. Half of the population will be female and 25% each will be of Caucasian, African- American, Asian, and Latino race/ethnicity. Participants free from SDB will undergo wrist actigraphy to measure sleep duration for 7-days in their regular home environment. They will undergo a 2.5-hour clinical examination to have resting parasympathetic function measured, and biomarkers of endothelial function (von Willebrand factor and E-selectin) and adipocytokines that represent insulin resistance (adiponectin, leptin, resistin, tumor necrosis factor-1, plasminogen activator inhibitor-1) and inflammation (C-reactive protein) measured in fasting blood. Metabolic syndrome components (blood pressure, lipids, glucose, anthropometrics), the prevalence of mood disorders, medical history, and health behaviors will be determined using standard clinical procedures and questionnaires. Using this information, the investigators will test the hypothesis that shortened sleep duration, in the absence of SDB, is associated with lower resting parasympathetic function, endothelial dysfunction insulin resistance, and inflammation. Using the wealth of assembled data, investigators will explore the confounding and modifying effects of demographic characteristics, physical activity and depressive symptoms on any observed associations. The primary innovation of this cross-sectional epidemiologic study is the ability to study the association of objectively- measured sleep duration within the normal population range on pathophysiologic mechanisms associated with metabolic syndrome components. Our population-based sampling method permits generalizability of our findings to the race/ethnically diverse population with known variations in sleep duration and metabolic disease. Findings from this cross-sectional study will suggest mechanisms to explain the prior observed associations between sleep duration and cardiovascular disease risk factors. PUBLIC HEALTH RELEVANCE: Persons who sleep for less time each night have worse health profiles characterized by higher rates of hypertension, diabetes, and heart disease (i.e., cardiovascular diseases [CVD]). Studies in persons with sleep disordered breathing (SDB) conditions such as sleep apnea and experimental studies that restrict sleep have identified a number of mechanisms that could explain this association. No studies have tested whether these mechanisms are present in relation to measured (i.e., not self-reported) sleep duration in an observational setting of persons who do not have SDB. The present study will recruit a sample of 500 adults (50% women and 25% each Caucasian, African-American/Black, Asian, and Latino) ages 35-64 years from Chicago, IL and screen them for SDB using in-home polysomnography. Adults without SDB will wear portable wrist monitors for 7 days to measure sleep duration. Participants will attend a brief clinical examination to measure the mechanisms above and traditional CVD risk factors. The investigators hypothesize that shorter sleep duration is associated with autonomic nervous system dysfunction, endothelial dysfunction, inflammation, and insulin resistance. Findings from this study will suggest mechanisms to explain the prior observed associations between sleep duration and CVD risk factors.

描述（由申请人提供）：睡眠时间短（<6小时/晚）与高血压、糖尿病和超重/肥胖的患病率和发病率较高相关，所有这些都可能导致冠心病。可以解释这些关联的病理生理机制，如自主神经系统功能障碍、内皮功能障碍、炎症和胰岛素抵抗，已在睡眠呼吸障碍（SDB）即睡眠呼吸暂停的背景下或在睡眠限制的实验研究中被确定。然而，超过90%的成年人并没有患上SDB，完全的睡眠限制是罕见的。相反，一个重要的公共卫生问题是，这些病理生理机制是否明显与睡眠时间短的人没有SDB。本流行病学研究将从伊利诺伊州芝加哥地区招募500名年龄在35-64岁的成年人，这些人通过有效的筛选问卷和家庭过夜多导睡眠图确定没有SDB。一半人群为女性，高加索人、非裔美国人、亚洲人和拉丁美洲人各占25%。无SDB的受试者将在其常规家庭环境中接受腕动计，以测量7天的睡眠持续时间。他们将接受2.5小时的临床检查，以测量静息副交感神经功能，并在空腹血液中测量内皮功能的生物标志物（血管性血友病因子和E-选择素）和代表胰岛素抵抗的脂肪细胞因子（脂联素、瘦素、β-内酰胺酶、肿瘤坏死因子-1、纤溶酶原激活物抑制剂-1）和炎症（C-反应蛋白）。将使用标准临床程序和问卷确定代谢综合征组分（血压、血脂、血糖、人体测量学）、情绪障碍的患病率、病史和健康行为。利用这些信息，研究人员将检验以下假设：在没有SDB的情况下，睡眠时间缩短与静息副交感神经功能降低、内皮功能障碍、胰岛素抵抗和炎症相关。利用丰富的汇总数据，研究人员将探索人口统计学特征、体力活动和抑郁症状对任何观察到的关联的混杂和修正效应。这项横断面流行病学研究的主要创新是能够研究正常人群范围内客观测量的睡眠时间与代谢综合征组分相关的病理生理机制之间的关联。我们基于人群的抽样方法允许我们的研究结果的普遍性，以种族/种族多样化的人口与已知的变化，睡眠时间和代谢疾病。这项横断面研究的结果将提出机制来解释先前观察到的睡眠时间和心血管疾病风险因素之间的关联。公共卫生关系：每晚睡眠时间较短的人健康状况较差，其特征是高血压、糖尿病和心脏病的发病率较高（即，心血管疾病[CVD]）。对睡眠呼吸障碍（SDB）患者的研究，如睡眠呼吸暂停和限制睡眠的实验研究，已经确定了一些可以解释这种关联的机制。没有研究测试这些机制是否存在于测量的（即，非自我报告的）睡眠持续时间。本研究将从伊利诺伊州芝加哥招募500名年龄在35-64岁的成年人（50%为女性，白人、非裔美国人/黑人、亚洲人和拉丁裔各25%），并使用家庭多导睡眠图对他们进行SDB筛查。没有SDB的成年人将佩戴便携式手腕监测器7天，以测量睡眠时间。参与者将参加一个简短的临床检查，以测量上述机制和传统的CVD危险因素。研究人员假设睡眠时间短与自主神经系统功能障碍、内皮功能障碍、炎症和胰岛素抵抗有关。这项研究的结果将提出机制来解释先前观察到的睡眠时间和CVD风险因素之间的关联。