北京市18~79岁非糖尿病患者睡眠状况与糖化血红蛋白水平的关联研究  

Association between sleep and serum hemoglobin A1c in nondiabetic population in Beijing

作　　者：隗瑛琦 马爱娟[1] 方凯[1] 董晶[1] 谢晨[1] 谢瑾[1] 姜博 赵越[1] 祁琨[1] 董忠[1] Wei Yingqi;Ma Aijuan;Fang Kai;Dong Jing;Xie Chen;Xie Jin;Jiang Bo;Zhao Yue;Qi Kun;Dong Zhong(Beijing Center for Disease Prevention and Control,Beijing Research Center for Preventive Medicine,Beijing 100013,China)

机构地区：[1]北京市疾病预防控制中心,北京市预防医学研究中心,100013

出　　处：《中华流行病学杂志》2020年第8期1256-1260,共5页Chinese Journal of Epidemiology

摘　　要：目的了解2017年北京市18~79岁非糖尿病患者睡眠状况,及其与糖化血红蛋白(HbA1c)的关联。方法数据来源于2017年北京市成年人慢性病与危险因素监测,在北京市16个区采用多阶段分层整群抽样方法抽取18~79岁常住居民,收集人口学信息、慢性病及危险因素、睡眠时长及问题、血清学指标,构建复杂抽样多因素logistic回归模型,分析非糖尿病患者睡眠状况与血清HbA1c的关联。结果纳入11608名非糖尿病患者,年龄(43.36±15.27)岁,睡眠时长为(7.49±1.29)h/d,30 d内存在睡眠问题(每周≥3 d存在打鼾/窒息、入睡困难、觉醒≥2次、早醒或服用安眠药)比例为47.38%,血清HbA1c中位数为5.30%。血清HbA1c水平随着睡眠时长出现显著波动(F=413.06,P<0.01);不同年龄组间是否存在睡眠问题,血清HbA1c水平差异有统计学意义(t=358.3,P<0.01)。单因素分析发现,存在≥1种睡眠问题的人群血清HbA1c水平高于无睡眠问题者(U=15.11,P<0.01)。控制人口学变量、慢性病及危险因素后,无论性别,存在≥1种睡眠问题(OR=1.21,95%CI:1.03~1.41)和打鼾/窒息与HbA1c≥5.7%有关(OR=1.37,95%CI:1.16~1.61),<60岁人群睡眠问题与HbA1c水平较高有关。结论成年人睡眠过长、过短及打鼾/窒息影响血清HbA1c水平,<60岁对象作为高危人群应采取改善睡眠的措施以降低糖尿病发生风险。Objective To understand the status quo of sleep and its associations with serum hemoglobin A1c(HbA1c)among nondiabetic people of 18-79 years old in Beijing.Methods Data was gathered from the 2017 Beijing Non-communicable and Chronic Disease Surveillance Program.Multiple classified clusters sampling method was used while the 18-79 years old were sampled from the 16 districts of Beijing.Questionnaires would include information on demographic characteristics,chronic diseases and related risk factors,sleep duration and related problems(snore/asphyxia,difficult to get to sleep,waking often during the night,waking up early or taking sleeping pills)within the last 30 days.Complex sampling logistic regression models were established to analyze the association between sleep-related problems and serum HbA1c.Results A total of 11608 non-diabetic participants were involved in this study,with average age,reported sleep duration and median of serum HbA1c level as(43.36±15.27)years old,(7.49±1.29)h/d and 5.30%,respectively.47.38%of them reported having sleep problems within the last 30 days.With the increasing time of sleep,serum HbA1c level was fluctuating significantly(F=413.06,P<0.01).Significant differences appeared in serum HbA1c levels among different age groups(t=358.3,P<0.01).Among participants with several kinds of sleep problems,the serum HbA1c levels were significantly higher than those without,through the single factor analysis(U=15.11,P<0.01).After adjusting for potential confounding factors,the combination of one sleep-related problem(OR=1.21,95%CI:1.03-1.41)and snore/asphyxia were associated with higher serum HbA1c levels(HbA1c≥5.7%)(OR=1.37,95%CI:1.16-1.61).People under 60 years of age were with higher risk of having higher serum HbA1c levels.Conclusion Duration and sleep-related problems might affect the serum HbA1c levels,especially among those younger than 60 years of age.

关 键 词：睡眠状况 睡眠时间 睡眠问题 打鼾/窒息 糖化血红蛋白 

分 类 号：R195.4[医药卫生—卫生统计学]