睡眠质量与心脑血管疾病发病中、低危人群颈动脉粥样硬化的相关性分析  

Correlation analysis between sleep quality and carotid atherosclerosis in low and moderate risk individuals for cardiovascular and cerebrovascular diseases

作　　者：赵倩[1] 王颖 谢依热·哈木拉提 古丽洁合热·吐尔逊 李晓梅[1] 杨毅宁[1,2] ZHAO Qian;WANG Ying;HAMULATI Xieyire;TUERXUN Gulijiehere;LI Xiaomei;YANG Yining(Heart Centre,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Cardiology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心,乌鲁木齐830054 [2]新疆维吾尔自治区人民医院心内科,乌鲁木齐830001

出　　处：《上海交通大学学报（医学版）》2023年第11期1366-1373,共8页Journal of Shanghai Jiao tong University:Medical Science

基　　金：新疆维吾尔自治区重点研发计划(2020B03002,2020B03002-2);新疆维吾尔自治区自然科学基金(2020D01C255)。

摘　　要：目的探讨睡眠质量与心脑血管疾病发病中、低危人群颈动脉粥样硬化的相关性。方法基于新疆地区心脑血管自然人群队列,于2019年7月—2021年9月采用两阶段整群随机抽样的方法选取新疆北部(北疆)地区乌鲁木齐市和南疆地区库尔勒市共2个固定社区35~75岁的居民。在既往无冠心病且未发生脑血管事件的人群中,运用中国动脉粥样硬化性心血管疾病风险预测[prediction for atherosclerotic cardiovascular disease(ASCVD)risk in China,China-PAR]模型进行发病风险评估,纳入心脑血管疾病发病中、低危人群。所有纳入的研究对象均完成体格检查、问卷调查[包括新疆地区心脑血管疾病危险因素评测量表、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、国际体力活动问卷(International Physical Activity Questionnaire,IPAQ)、食物频率问卷]、心血管代谢相关的实验室检查和颈动脉超声检查。根据颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)和是否有斑块形成判断研究对象颈动脉粥样硬化情况。采用多因素Logistic回归模型和限制性立方样条(restricted cubic spline,RCS)分析心脑血管疾病发病中、低危人群颈动脉粥样硬化与睡眠质量的相关性。结果共1528名心脑血管疾病发病中、低危人群纳入研究,平均年龄(49.4±8.2)岁,其中男性685人(44.8%)。纳入的人群中颈动脉内膜中层增厚581人(38.0%),颈动脉斑块形成305人(20.0%);其中,内膜中层增厚且斑块形成154人(10.1%)。因此颈动脉粥样硬化患病率为47.9%(732人)。相较于颈动脉无增厚组,颈动脉内膜中层增厚/斑块组的一般心脑血管危险因素水平较高,包括年龄、男性比例、血脂水平和肥胖程度等,同时PSQI睡眠评分较高[(7.06±2.13)分vs(7.43±2.51)分,P=0.001],睡眠质量较差组的比例较高(6.5%vs 12.1%,P=0.001)。多因素Logistic回归分析在校正了与颈动脉粥样硬化相关的影响因素后Objective To explore the relationship between sleep quality and carotid atherosclerosis in the population with low or moderate risk of cardiovascular and cerebrovascular diseases.Methods Based on the population-based cohort study of chronic diseases in Xinjiang,the researchers selected residents aged 35-75 from two fixed communities in Urumqi and Korla,in Northern and Southern Xinjiang,respectively,using a two-stage random cluster sampling method from July 2019 to September 2021.In the population without a history of coronary heart disease and cerebrovascular events,the prediction model for atherosclerotic cardiovascular disease(ASCVD)risk in China(China-PAR)was used to evaluate the risk of cardiovascular and cerebrovascular diseases.Low and moderate risk population of cardiovascular and cerebrovascular diseases were included.Participants completed physical examinations,questionnaires[including the Risk Factors Assessment Scale of Cardiovascular and Cerebrovascular Diseases in Xinjiang,Pittsburgh Sleep Quality Index(PSQI),International Physical Activity Questionnaire(IPAQ),and Food Frequency Questionnaire],cardiovascular and metabolic biochemical examinations,and carotid color doppler.Carotid intima-media thickness(CIMT)and plaque formation were used to determine the carotid atherosclerosis of the study subjects.Multivariate Logistic regression model and restricted cubic spline(RCS)were used to analyze the relationship between sleep quality and carotid intima-media thickening/plaque formation in the population with low and moderate risk of cardiovascular and cerebrovascular diseases.Results A total of 1528 subjects were included in the study,the mean age was(49.4±8.2)years,and 685(44.8%)were male.In the included population,there were 581(38.0%)subjects with carotid intima-media thickening and 305(20.0%)subjects with carotid plaque formation.Among them,intima-media thickening and plaque formation both occurred in 154(10.1%)people.Therefore,the prevalence of carotid atherosclerosis was 47.9%(732 subjects).Compared

关 键 词：心脑血管疾病 睡眠质量 危险分层 动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病] R743.3[医药卫生—内科学]