中国城乡地区睡眠模式和心血管疾病风险的关联研究  

Association between Sleep Patterns and Cardiovascular Disease Risk in Chinese Urban and Rural Areas

作　　者：张飞云 陈飞龙 郎欣月 韩国亮 何国敏 张鹏 刘国钦 刘之光 ZHANG Feiyun;CHEN Feilong;LANG Xinyue;HAN Guoliang;HE Guomin;ZHANG Peng;LIU Guoqin;LIU Zhiguang(Bayannaoer City Centre for Disease Control and Prevention,Bayannaoer 015000,Inner Mongolia,China;Medical Research&Biometrics Center,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing 100037,China;Mengla District Center for Disease Control and Prevention,Xishuangbanna 666300,Yunnan,China;Health Center of Guanshan Town,Yanliang District,Xi′an 710089,Shaanxi,China;Jingle People′s Hospital,Xinzhou 035100,Shanxi,China;Drug Clinical Trail Institution,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]巴彦淖尔市疾病预防控制中心,内蒙古巴彦淖尔015000 [2]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院医学研究统计中心,北京100037 [3]勐腊县疾病预防控制中心,云南西双版纳666300 [4]西安市阎良区关山镇卫生院,陕西西安710089 [5]静乐县人民医院,山西忻州035100 [6]首都医科大学附属北京安贞医院药物临床试验机构,北京100029

出　　处：《中国分子心脏病学杂志》2024年第6期6484-6491,共8页Molecular Cardiology of China

基　　金：国家心血管疾病中心(NCRC2020002和2023-GSP-GG-36);国家心血管疾病临床医学研究中心·深圳自主课题(NCRCSZ-2023-012);北京协和医院中央高水平医院临床科研专项(2022-PUMCH-C-026);2022年度中央高水平医院临床科研业务费项目(2022-GSP-PT-10);国家重点研发计划(2020YFC1107900)

摘　　要：目的探索中国城乡社区居民不同睡眠模式和心血管疾病风险的关联。方法本研究依托于前瞻性城乡流行病学研究中国地区(PURE-China)的数据。所有接受基线入组信息收集的受试者被纳入本研究,排除主要研究指标睡眠时长和心血管疾病史信息缺失以及协变量数据缺失的个体。采用问卷调查和体格检查收集数据。睡眠信息和心血管疾病由受试者自我报告。使用以社区为随机效应的广义线性混合效应模型来探索睡眠时长和睡眠模式与心血管疾病的关联,校正年龄、性别、婚姻状况、受教育水平、体力活动强度、体重指数(BMI)、吸烟饮酒习惯、高血压病史、糖尿病病史。校正比值比(AOR)和95%置信区间(CI)用以评估关联的强度和精度。结果本研究最终纳入22297名城镇社区和22006名农村社区受试者。城镇受试者心血管疾病的患病率为8.14%(1816/22297),农村受试者心血管疾病的患病率为5.36%(1180/22006)。对于城镇受试者,与其他睡眠模式相比,夜间睡眠7~8 h的心血管疾病风险最低(AOR:0.641,95%CI:0.530~0.777),任何时长的午睡均会增加受试者的心血管疾病风险;而对于农村居民,睡眠与心血管疾病存在U形关联,睡眠时间过短(<6 h,AOR:2.031,95%CI:1.163~3.546)或过长(≥9 h,AOR:1.493,95%CI:1.056~2.112)均会显著增加受试者的心血管疾病风险。结论城镇居民和农村居民的睡眠模式与心血管疾病之间的关联存在较大差异。应针对不同地区居民的实际状况采取有针对性的健康干预措施。Objective To explore the association between different sleep patterns and cardiovascular disease(CVD)risk among residents in urban and rural communities in China.Methods The study utilized data from the Prospective Urban Rural Epidemiology⁃China(PURE⁃China)study.All subjects who received baseline enrollment were included in this study,while those with missing data on these main research indicators and covariates were excluded.Data were collected by questionnaire and physical examination.Sleep information and history of cardiovascular disease were self⁃reported by the subjects.Generalized linear mixed⁃effect model with random effect in community was used to explore the association between sleep duration,sleep pattern and cardiovascular disease,adjusting for age,sex,marital status,education level,physical activity intensity,body mass index(BMI),smoking and drinking habits,hypertension,diabetes history,community and research center.The adjusted odds ratio(AOR)and 95%confidence interval(CI)were used to evaluate the strength and accuracy of the correlation.Results 22297 urban communities and 22006 rural community subjects were included in the study.The prevalence of cardiovascular disease in urban subjects was 8.14%(1816/22297)and 5.36%in rural subjects(1180/22006).For urban subjects,compared with other sleep patterns,sleep 7⁃8 hours at night had the lowest risk of cardiovascular disease(AOR:0.641,95%CI:0.530⁃0.777).Taking a nap of any length would increase the risk of cardiovascular disease.For rural residents,there is a U⁃shaped correlation between sleep and cardiovascular disease.Too short sleep time(<6 hours,AOR:2.031,95%CI:1.163⁃3.546)or too long sleep time(≥9 hours,AOR:1.493,95%CI:1.056⁃2.112)will significantly increase the risk of cardiovascular disease.Conclusion There are significant differences in the association between sleep patterns and cardiovascular diseases between urban and rural residents.Targeted health intervention measures should be taken according to the actual situation of re

关 键 词：睡眠模式 心血管病 城市 农村 中国 

分 类 号：R54[医药卫生—心血管疾病]