Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
Am J Kidney Dis. 2012 Mar;59(3):343-55. doi: 10.1053/j.ajkd.2011.08.032. Epub 2011 Oct 22.
Although multiple studies have shown that sleep duration is a predictor of cardiovascular diseases and mortality, few studies have reported an association between sleep duration and chronic kidney disease.
Retrospective cohort study.
SETTING & PARTICIPANTS: 6,834 employees of Osaka University aged 20-65 years who visited Osaka University Healthcare Center for their mandatory annual health examinations between April 2006 and March 2010 and did not have estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2), proteinuria, or treatment for self-reported kidney disease.
Self-reported questionnaires about life style, including sleep duration, and blood and urine testing at the first examinations during the study period. An association between sleep duration and outcome was assessed using multivariate Poisson regression models adjusting for clinically relevant factors.
Time to the development of proteinuria defined as 1+ or higher by dipstick test.
Self-reported baseline sleep duration was 6.0 ± 0.9 hours, which reflected the mean sleep duration during a median of 2.5 (25th-75th percentile, 1.4-3.9) years of the observational period. Development of proteinuria was observed in 550 employees (8.0%). A multivariate Poisson regression model clarified that shorter sleep duration, especially 5 or fewer hours, was associated with the development of proteinuria in a stepwise fashion (vs 7 hours; incidence rate ratios of 1.07 [95% CI, 0.87-1.33; P = 0.5], 1.28 [95% CI, 1.00-1.62; P = 0.05], and 1.72 [95% CI, 1.16-2.53; P = 0.007] for 6, 5, and ≤4 hours, respectively), along with younger age, heavier current smoking, trace urinary protein by dipstick test, higher eGFR, higher serum hemoglobin A(1c) level, and current treatment for heart disease. A stepwise association between shorter sleep duration and the development of proteinuria also was verified in 4,061 employees who did not work the night shift.
Self-reported sleep duration might be biased. Results in a single center should be confirmed in the larger cohort including different occupations.
Short sleep duration, especially 5 or fewer hours, was a predictor of proteinuria.
尽管多项研究表明睡眠时间是心血管疾病和死亡率的预测因素，但很少有研究报告睡眠时间与慢性肾脏病之间存在关联。
回顾性队列研究。
大阪大学 6834 名 20-65 岁的员工，他们在 2006 年 4 月至 2010 年 3 月期间在大阪大学医疗中心进行了强制性年度健康检查，且估算肾小球滤过率（eGFR）≥60 mL/min/1.73 m2、蛋白尿或自我报告的肾脏疾病治疗史。
研究期间首次检查时，通过自我报告的生活方式问卷，包括睡眠时间和血液及尿液检测。使用多变量泊松回归模型，在调整了临床相关因素后，评估了睡眠时间与结局之间的关联。
蛋白尿的发生时间定义为尿试纸检测为 1+或更高。
自我报告的基线睡眠时间为 6.0±0.9 小时，反映了观察期内中位数为 2.5（25 百分位数至 75 百分位数，1.4-3.9）年的平均睡眠时间。在 550 名员工（8.0%）中观察到蛋白尿的发生。多变量泊松回归模型明确表明，较短的睡眠时间，尤其是 5 小时或更短，与蛋白尿的发生呈逐步相关（与 7 小时相比；发生率比为 1.07[95%CI，0.87-1.33；P=0.5]、1.28[95%CI，1.00-1.62；P=0.05]和 1.72[95%CI，1.16-2.53；P=0.007]，分别为 6 小时、5 小时和≤4 小时），同时还与年龄较小、当前吸烟量较大、尿试纸检测微量蛋白尿、较高的 eGFR、较高的血清血红蛋白 A1c 水平以及当前的心脏疾病治疗有关。在未上夜班的 4061 名员工中，也验证了较短睡眠时间与蛋白尿发生之间的逐步关联。
自我报告的睡眠时间可能存在偏差。应在包括不同职业的更大队列中确认单一中心的研究结果。
较短的睡眠时间，尤其是 5 小时或更短，是蛋白尿的预测因素。
