睡眠时间短与冠状动脉钙化的发生

Short sleep duration and incident coronary artery calcification.

作者信息

King Christopher Ryan, Knutson Kristen L, Rathouz Paul J, Sidney Steve, Liu Kiang, Lauderdale Diane S

机构信息

Department of Health Studies, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA.

出版信息

JAMA. 2008 Dec 24;300(24):2859-66. doi: 10.1001/jama.2008.867.

DOI:10.1001/jama.2008.867

PMID:19109114

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2661105/

Abstract

CONTEXT

Coronary artery calcification is a subclinical predictor of coronary heart disease. Recent studies have found that sleep duration is correlated with established risk factors for calcification including glucose regulation, blood pressure, sex, age, education, and body mass index.

OBJECTIVE

To determine whether objective and subjective measures of sleep duration and quality are associated with incidence of calcification over 5 years and whether calcification risk factors mediate the association.

DESIGN, SETTING, AND PARTICIPANTS: Observational cohort of home monitoring in a healthy middle-aged population of 495 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort Chicago site (black and white men and women aged 35-47 years at year 15 of the study in 2000-2001 with follow-up data at year 20 in 2005-2006). Potential confounders (age, sex, race, education, apnea risk, smoking status) and mediators (lipids, blood pressure, body mass index, diabetes, inflammatory markers, alcohol consumption, depression, hostility, self-reported medical conditions) were measured at both baseline and follow-up. Sleep metrics (wrist actigraphy measured duration and fragmentation, daytime sleepiness, overall quality, self-reported duration) were examined for association with incident calcification. Participants had no detectable calcification at baseline.

MAIN OUTCOME MEASURE

Coronary artery calcification was measured by computed tomography in 2000-2001 and 2005-2006 and incidence of new calcification over that time was the primary outcome.

RESULTS

Five-year calcification incidence was 12.3% (n = 61). Longer measured sleep duration was significantly associated with reduced calcification incidence (adjusted odds ratio, 0.67 per hour [95% confidence interval, 0.49-0.91 per hour]; P = .01). No potential mediators appreciably altered the magnitude or significance of sleep (adjusted odds ratio estimates ranged from 0.64 to 0.68 per sleep hour; maximum P = .02). Alternative sleep metrics were not significantly associated with calcification.

CONCLUSION

Longer measured sleep is associated with lower calcification incidence independent of examined potential mediators and confounders.

摘要

背景

冠状动脉钙化是冠心病的一种亚临床预测指标。最近的研究发现，睡眠时间与钙化的既定风险因素相关，这些因素包括血糖调节、血压、性别、年龄、教育程度和体重指数。

目的

确定睡眠时间和质量的客观及主观测量指标是否与5年内的钙化发生率相关，以及钙化风险因素是否介导了这种关联。

设计、地点和参与者：对来自芝加哥地区年轻成年人冠状动脉风险发展研究（CARDIA）队列的495名健康中年参与者进行家庭监测的观察性队列研究（2000 - 2001年研究第15年时年龄在35 - 47岁的黑人和白人男性及女性，在2005 - 2006年第20年时有随访数据）。在基线和随访时测量潜在混杂因素（年龄、性别、种族、教育程度、呼吸暂停风险、吸烟状况）和中介因素（血脂、血压、体重指数、糖尿病、炎症标志物、饮酒、抑郁、敌意、自我报告的健康状况）。检查睡眠指标（腕部活动记录仪测量的睡眠时间和片段化、日间嗜睡、总体质量、自我报告的睡眠时间）与新发钙化的关联。参与者在基线时未检测到钙化。

主要结局指标

在2000 - 2001年和2005 - 2006年通过计算机断层扫描测量冠状动脉钙化，这段时间内新钙化的发生率是主要结局。

结果

5年钙化发生率为12.3%（n = 61）。测量的睡眠时间越长，钙化发生率显著降低（调整后的优势比为每小时0.67 [95%置信区间为每小时0.49 - 0.91]；P = 0.01）。没有潜在的中介因素能明显改变睡眠的效应大小或显著性（调整后的优势比估计值在每睡眠小时0.64至0.68之间；最大P = 0.02）。其他睡眠指标与钙化无显著关联。