Cappuccio Francesco P, Taggart Frances M, Kandala Ngianga-Bakwin, Currie Andrew, Peile Ed, Stranges Saverio, Miller Michelle A
Clinical Sciences Research Institute, University of Warwick Medical School, Coventry, UK.
Sleep. 2008 May;31(5):619-26. doi: 10.1093/sleep/31.5.619.
Recent epidemiological studies suggest that short sleep duration may be associated with the development of obesity from childhood to adulthood.
To assess whether the evidence supports the presence of a relationship between short sleep duration and obesity at different ages, and to obtain an estimate of the risk.
We performed a systematic search of publications using MEDLINE (1996-2007 wk 40), EMBASE (from 1988), AMED (from 1985), CINHAL (from 1982) and PsycINFO (from 1985) and manual searches without language restrictions. When necessary, authors were contacted. Criteria for inclusion were: report of duration of sleep as exposure, BMI as continuous outcome and prevalence of obesity as categorical outcome, number of participants, age, and gender. Results were pooled using a random effect model. Sensitivity analysis was performed, heterogeneity and publication bias were also checked. Results are expressed as pooled odds ratios (OR [95% confidence intervals, CIs]) and as pooled regression coefficients (beta; 95% CIs).
Of 696 studies identified, 45 met the inclusion criteria (19 in children and 26 in adults) and 30 (12 and 18, respectively) were pooled in the meta-analysis for a total of 36 population samples. They included 634,511 participants (30,002 children and 604,509 adults) from around the world. Age ranged from 2 to 102 years and included boys, girls, men and women. In children the pooled OR for short duration of sleep and obesity was 1.89 (1.46 to 2.43; P < 0.0001). In adults the pooled OR was 1.55 (1.43 to 1.68; P < 0.0001). There was no evidence of publication bias. In adults, the pooled beta for short sleep duration was -0.35 (-0.57 to -0.12) unit change in BMI per hour of sleep change.
Cross-sectional studies from around the world show a consistent increased risk of obesity amongst short sleepers in children and adults. Causal inference is difficult due to lack of control for important confounders and inconsistent evidence of temporal sequence in prospective studies.
近期的流行病学研究表明，从儿童期到成年期，睡眠时间短可能与肥胖的发生有关。
评估证据是否支持不同年龄段睡眠时间短与肥胖之间存在关联，并估计风险。
我们使用MEDLINE（1996 - 2007年第40周）、EMBASE（自1988年起）、AMED（自1985年起）、CINHAL（自1982年起）和PsycINFO（自1985年起）对出版物进行系统检索，并进行无语言限制的手工检索。必要时与作者联系。纳入标准为：将睡眠时间作为暴露因素、BMI作为连续结局以及肥胖患病率作为分类结局的报告、参与者数量、年龄和性别。结果采用随机效应模型进行汇总。进行敏感性分析，同时检查异质性和发表偏倚。结果以汇总比值比（OR[95%置信区间，CIs]）和汇总回归系数（β；95% CIs）表示。
在检索到的696项研究中，45项符合纳入标准（儿童19项，成人26项），30项（儿童12项，成人18项）被纳入荟萃分析，共涉及36个总体样本。它们包括来自世界各地的634,511名参与者（儿童30,002名，成人604,509名）。年龄范围为2至102岁，包括男孩、女孩、男性和女性。儿童中，睡眠时间短与肥胖的汇总OR为1.89（1.46至2.43；P < 0.0001）。成人中，汇总OR为1.55（1.43至1.68；P < 0.0001）。没有发表偏倚的证据。在成人中，睡眠时间短的汇总β为每睡眠小时变化导致BMI变化 - 0.35（ - 0.57至 - 0.12）单位。
来自世界各地的横断面研究表明，儿童和成人中睡眠不足者肥胖风险持续增加。由于前瞻性研究中缺乏对重要混杂因素的控制以及时间顺序证据不一致，难以进行因果推断。
