National Health And Nutrition Examination Survey (NHANES)

在过去的一年中，我们完成了对NHANES调查中儿童和成人部分数据的广泛分析。我们研究了睡眠时间与心血管疾病（CVD）之间的U形关联。我们纳入了2005年至2008年NHANES调查的成人样本，并根据他们平日的睡眠时间将受访者分为3组，即< 6小时（14.1%），6-8小时（78.8%）和9小时（7.0%）。 我们在单变量分析中发现，睡眠时间与CVD生物标志物（包括收缩压（SBP），C反应蛋白（CRP）和尿白蛋白/肌酐比值）的风险五分位数以及CVD（充血性心力衰竭（CHF），心脏病发作，中风和任何CVD）的U型相关性。然而，除CRP外，长时间睡眠与CVD和生物标志物之间的大多数关联在控制人口统计学和临床因素后消失。相比之下，除了CRP和CHF之外，在充分调整的模型中，在短睡眠时间中发现的大多数显著相关性持续存在。亚组分析显示，睡眠时间短与SBP、中风和任何CVD的高风险五分位数之间的关联仅发生在女性中。这些结果表明，短睡眠和长睡眠与CVD和生物标志物的关联存在不同的机制。CVD与长睡眠持续时间的关联可归因于共病的非CVD条件，而在调整非CVD条件和CVD生物标志物后，大多数CVD结果与短睡眠持续时间之间存在直接关联，特别是在女性中。（Zhang等人，审查中）。 我们还研究了生物学证实的二手烟暴露（血清可替宁）和DSM-IV疾病的症状之间的潜在关联，在8-15岁的青少年使用NHANES 2001-2004年的调查数据。我们发现，在非吸烟者中，血清可替宁与DSM-IV重度抑郁症、广泛性焦虑症、注意力缺陷/多动障碍和品行障碍的症状呈正相关，调整了调查设计、年龄、性别、种族/民族、贫困、偏头痛、哮喘、花粉热、母亲是否在怀孕期间吸烟和非稳态负荷。 与血清可替宁的相关性在非西班牙裔白人和男性中更明显。我们的研究结果与越来越多的研究一致，这些研究记录了二手烟暴露与心理健康结果之间的关联。 未来的研究是必要的，以建立生物和/或心理机制的协会。（Bandiera等人，（2011年） 公共卫生影响： 这些研究结果提供了来自普通人群的证据，拓宽了我们的知识，并提供了关于睡眠时间与美国成年人心血管疾病和生物标志物之间的关联以及二手烟对青少年精神疾病的负面影响的新信息。这些结果是研究了解生物学机制，在临床和遗传研究中确定更同质的亚组，并开发更好的临床管理的重要一步。 未来计划 未来的分析将研究行为障碍的危险因素、社会人口学和生物学相关性，并调查一般人群中头痛与精神病合并症之间的相关性。我们将优先考虑我们的分析，以解决我们自己的研究重点的关键研究问题。

During the past year we have completed extensive analyses of the data from both the child and adult components of the NHANES surveys. We have examined a U-shaped association between sleep duration and cardiovascular diseases (CVD). We included an adult sample of the 2005 to 2008 NHANES surveys and divided respondents into 3 groups according to their usual sleep duration on weekdays, namely < 6 hours (14.1%), 6-8 hours (78.8%), and 9 hours (7.0%). We found U-shaped associations of sleep duration with the risk quintiles of CVD biomarkers (including systolic blood pressure (SBP), C-reactive Protein (CRP), and urinary albumin-to-creatinine ratio) and with CVD (congestive heart failure (CHF), heart attack, stroke and any CVD) in univariate analyses. However, with the exception of CRP, most of the associations between long sleep duration and CVD and biomarkers dissipated after controlling for demographic and clinical factors. By contrast, the majority of significant associations found in short sleep duration persisted in the fully adjusted models, except for CRP and CHF. Subgroup analyses revealed that the associations between short sleep duration and the high risk quintile of SBP, stroke and any CVD occurred in females only. These results demonstrate that there are different mechanisms for the associations of short and long sleep duration with CVD and biomarkers. The association of CVD with long sleep duration is attributable to comorbid non-CVD conditions, whereas there is a direct association between most CVD outcomes and short sleep duration after adjusting for non-CVD conditions and CVD biomarkers, particularly in females. (Zhang et al., under review). We also have investigated a potential association between biologically-confirmed secondhand smoke exposure (serum cotinine) and symptoms of DSM-IV disorders in 8-15 year-old youth using NHANES 2001-2004 survey data. We found among non-smokers, serum cotinine was positively associated with symptoms of DSM-IV major depressive disorder, generalized anxiety disorder, attention-deficit/hyperactive disorder, and conduct disorder, after adjustment for survey design, age, gender, race/ethnicity, poverty, migraine, asthma, hay fever, whether mother smoked during pregnancy, and allostatic load. The association with serum cotinine was more apparent for non-Hispanic Whites and males. Our study findings are consistent with a growing body of research documenting associations between secondhand smoke exposure and mental health outcomes. Future research is warranted to establish the biological and/or psychological mechanisms of association. (Bandiera et al., 2011) Public Health Impact: These findings provided evidence from the general population that broaden our knowledge and provide new information on the association between sleep duration and cardiovascular disorders and biomarkers in U.S. adults and negative effects of secondhand smoking on youth psychiatric disorders. These results are a significant step towards research to understand biologic mechanisms, identify more homogeneous subgroups in clinical and genetic studies, and develop better clinical management. Future Plans Future analyses will examine the risk factors and sociodemographic and biological correlates of conduct disorder and investigate the association between headache and psychiatric comorbidity in the general population. We will prioritize our analyses to address the key study questions that are the focus of our own research.