中国成年人睡眠状况与肾结石风险的前瞻性队列研究  

Associations between sleep status and risk for kidney stones in Chinese adults:a prospective cohort study

作　　者：汪涵 张艺倩 余灿清[1,2] 郭彧 裴培[4] 陈君石 陈铮鸣[6] 吕筠[1,2,7] 李立明 Wang Han;Zhang Yiqian;Yu Canqing;Guo Yu;Pei Pei;Chen Junshi;Chen Zhengming;Lyu Jun;Li Liming(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Peking University Center for Public Health and Epidemic Preparedness&Response,Beijing 100191,China;Fuwai Hospital,Chinese Academy of Medical Sciences,National Center for Cardiovascular Diseases,Beijing 100037,China;Chinese Academy of Medical Sciences,Beijing 100730,China;China National Center for Food Safety Risk Assessment,Beijing 100022,China;Clinical Trial Service Unit and Epidemiological Studies Unit,Nuffield Department of Population Health,University of Oxford,Oxford OX37LF,UK;Key Laboratory of Molecular Cardiovascular Sciences(Peking University),Ministry of Education,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]北京大学公众健康与重大疫情防控战略研究中心,北京100191 [3]中国医学科学院阜外医院,国家心血管病中心,北京100037 [4]中国医学科学院,北京100730 [5]国家食品安全风险评估中心,北京100022 [6]英国牛津大学临床与流行病学研究中心纳菲尔德人群健康系,英国OX37LF [7]北京大学分子心血管学教育部重点实验室,北京100191

出　　处：《中华流行病学杂志》2022年第7期1002-1009,共8页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(81941018);国家重点研发计划(2016YFC0900500,2016YFC0900501,2016YFC0900504);中国香港Kadoorie Charitable基金。

摘　　要：目的:分析中国成年人睡眠状况与肾结石风险之间的关联。方法:基于中国慢性病前瞻性研究的长期随访数据,剔除基线自报患有慢性肾病、恶性肿瘤、睡眠时间为极端值的研究对象,共纳入501701人。研究收集的睡眠数据包括失眠症状、白天嗜睡情况、午休习惯、打鼾情况和睡眠时间;并根据失眠症状、白天嗜睡情况和睡眠时间构建睡眠评分(0~3分)。采用Cox比例风险回归模型分析各睡眠因素、睡眠评分与肾结石风险的关联。结果:研究对象随访(10.7±2.2)年,随访期间首次记录的肾结石病例共12381例。调整潜在混杂因素后,与没有对应失眠症状者相比,有入睡困难或过早醒来症状者的肾结石风险比(HR)分别为1.12(95%CI:1.06~1.18)和1.06(95%CI:1.00~1.12)。使用安眠药、白天嗜睡、午休习惯、打鼾与肾结石风险均不存在统计学显著的关联。与每日睡眠时间≥7 h者相比,<7 h者发生肾结石的HR=1.13(95%CI:1.08~1.18)。与睡眠评分为3分(睡眠质量最高)者相比,睡眠评分为2、1、0分者对应的HR值分别为1.08(95%CI:1.03~1.13)、1.16(95%CI:1.10~1.23)、1.19(95%CI:1.03~1.37)。结论:中国成年人中有失眠症状或睡眠时间短者的肾结石风险增加。Objective To analyze the associations between sleep status and the risk for kidney stone in Chinese adults.Methods This study used baseline and long-term follow-up data of China Kadoorie Biobank.After excluding those with self-reporting of diagnosed chronic kidney disease and cancer and those with extreme values of sleep duration at baseline survey,501701 participants were included in this study.The information about their sleep status were collected,including insomnia symptoms,daytime sleepiness,nap habit,snoring and sleep duration.The sleep score was constructed based on insomnia symptoms,daytime sleepiness,and sleep duration,ranging from 0 to 3.Cox proportional hazards regression models were used to evaluate the association of sleep status with the risk for kidney stone,including individual sleep factors and combined sleep score.Results During the follow-up for average(10.7±2.2)years,12381 cases of kidney stone were recorded for the first time.Compared with participants without insomnia symptoms,the multivariable-adjusted HR of kidney stone in those with difficulty falling asleep and waking up early were 1.12(95%CI:1.06-1.18)and 1.06(95%CI:1.00-1.12),respectively.There was no statistically significant association of kidney stone risk with sleeping pill use,daytime sleepiness,nap habit,or snoring.Compared with participants with sleep duration≥7 hours per day,the HR of kidney stone in those with sleep duration<7 hours per day was 1.13(95%CI:1.08-1.18).Compared with participants with sleep score of 3(highest sleep quality),the HR of kidney stone in those with sleep score of 2,1,and 0 were 1.08(95%CI:1.03-1.13),1.16(95%CI:1.10-1.23),and 1.19(95%CI:1.03-1.37),respectively.Conclusion In China,adults with insomnia symptoms or short sleep duration have increased risk for kidney stone.

关 键 词：失眠 睡眠时间 打鼾 肾结石 队列研究 中国人 

分 类 号：R692.4[医药卫生—泌尿科学]