40~65岁人群睡眠时型与血脂异常的关联性分析  

Association between Chronotype and Dyslipidemia among Population Aged 40-65 Years

作　　者：梁晓仙 杨瑾 金菊珍 周静 胡瑾[1] 盖云 丁晓云 汪俊华[1] 王子云[1] LIANG Xiaoxian;YANG Jin;JIN Juzhen;ZHOU Jing;HU Jin;GAI Yun;DING Xiaoyun;WANG Junhua;WANG Ziyun(School of Public Health/Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guizhou Medical University,Guiyang 550025,China;Physical Examination Center,the First People's Hospital of Fuquan City,Fuquan 550500,China;Department of Science and Education,the First People's Hospital of Fuquan City,Fuquan 550500,China)

机构地区：[1]贵州医科大学公共卫生与健康学院、环境污染与疾病监控教育部重点实验室,贵州省贵阳市550025 [2]贵州省福泉市第一人民医院体检中心,550500 [3]贵州省福泉市第一人民医院科教科,550500

出　　处：《中国全科医学》2023年第34期4277-4282,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81960612);贵州省科技计划项目(黔科合基础-ZK[2022]一般382)。

摘　　要：背景 中老年人的晚睡行为可能影响其血脂代谢,但二者的关联性仍需深入分析。目的 探讨不同性别、中心性肥胖、睡前加餐和吸烟人群睡眠时型与血脂异常的关联性。方法 对2022年3—8月在福泉市第一人民医院体检中心体检的40~65岁人群开展问卷调查(n=697),收集研究对象的一般资料和睡眠情况,采用“清晨型-夜晚型量表”的单项问题来评价睡眠时型。采用非条件二分类Logistic回归模型评估睡眠时型与血脂异常患病风险的关联,在总人群中以性别、中心性肥胖、睡前加餐进行分层分析,在男性人群中以是否吸烟进行分层分析。采用敏感性分析排除夜班工作的影响。结果 纳入体检者中,睡眠时型为清晨型偏好393人(56.4%)、夜晚型偏好304人(43.6%),检出血脂异常334人(47.9%)。剔除夜班人群后的非条件二分类Logistic回归分析结果显示,睡眠时型是血脂异常的影响因素[OR(95%CI)=1.54(1.10,2.16)](P<0.05),夜晚型人群患高TG血症、低HDL-C血症的风险高于清晨型人群[OR(95%CI)分别为1.48(1.04,2.12)、1.79(1.18,2.72)](P<0.05)。在总人群中进行分层分析结果显示:在男性人群和中心性肥胖人群中,夜晚型人群患低HDL-C血症的风险分别是清晨型的1.80倍[95%CI为(1.12,2.91)](P<0.05)和1.73倍[95%CI为(1.02,2.81)](P<0.05);在睡前加餐人群中,夜晚型人群患高TG血症的风险是清晨型的3.43倍[95%CI为(1.30,8.99)](P<0.05),在女性人群、非中心性肥胖人群中睡眠时型对血脂异常及其各指标均无明显影响(P>0.05)。在男性人群中以吸烟分层,结果显示:在吸烟的男性人群中,夜晚型人群患低HDL-C血症的风险是清晨型的1.83倍[95%CI为(1.03,3.26)](P<0.05),在吸烟和不吸烟的男性人群中,睡眠时型对高TC血症、高TG血症、高LDL-C血症和非HDL-C异常均无明显影响(P>0.05)。结论 在40~65岁人群中,夜晚型睡眠偏好可能是血脂异常的危险因素。不同性别、是否�Background Lipid metabolism of middle-aged and older adults may be influenced by their late bedtime behavior,but the association between the above two still needs to be analyzed in-depth.Objective To explore the association between chronotype and dyslipidemia among populations with different gender,central obesity,late evening snacks and smoking.Methods A questionnaire survey was conducted among the population aged 40-65 years who received health examination in physical examination center,the First People's Hospital of Fuquan City from March to August,2022(n=697).General information and sleep conditions of the included patients were collected and chronotype was evaluated by single-item question of the Morning and Evening Questionnaire.Unconditional binary Logistic regression model was used to evaluate the association between chronotype and the risk of dyslipidemia.Stratified analysis was also performed by gender,central obesity and late evening snacks among the whole population,and performed by smoking among male population.Sensitivity analysis was used to exclude the effect of shift work.Results Among the included subjects,morningness preference chronotype accounted for 56.4%(n=393),while eveningness preference chronotype accounted for 43.6%(n=304),with 334 cases(47.9%)detected with dyslipidemia.Unconditional binary Logistic regression analysis showed that chronotype was an influencing factor of dyslipidemia[OR(95%CI)=1.54(1.10,2.16)],the risk of hypertriglyceridemia[OR(95%CI)=1.48(1.04,2.12)]and low high-density lipoprotein cholesterol[OR(95%CI)=1.79(1.18,2.72)]was higher in the adults with eveningness chronotype than those with morningness chronotype(P<0.05).Stratified analysis of the whole population showed that the risk of low high-density lipoprotein cholesterol was 1.80 times(95%CI:1.12,2.91)and 1.73 times(95%CI:1.02,2.81)in adults with eveningness chronotype of that in adults with morningness chronotype among male population and the central obesity population,respectively(P<0.05);the risk of hypertriglyce

关 键 词：睡眠时型 昼夜节律 清晨型-夜晚型 血脂异常 

分 类 号：R749.42[医药卫生—神经病学与精神病学]