Section on Neuroendocrinology of Obesity, Diabetes, Endocrinology, and Obesity Branch/National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892-2560, USA.
J Clin Endocrinol Metab. 2012 Aug;97(8):2881-9. doi: 10.1210/jc.2011-2858. Epub 2012 Jun 11.
Epidemiological studies reported an inverse or U-shaped relationship between sleep duration and weight. The relationship between sleep and resting energy expenditure (REE) has not been well characterized.
The aim of the study was to determine the relationship between sleep, REE, and stress hormones.
We conducted a cross-sectional evaluation of a prospective cohort study at a tertiary referral research clinical center.
Subjects included 126 obese individuals (30 males, 96 females; age, 40.5 ± 6.9 yr; body mass index, 38.6 ± 6.5 kg/m(2); sleep duration, 360 ± 50 min/night; and sleep efficiency, 79.5 ± 7.5%).
MAIN OUTCOME MEASURE(S): REE and respiratory quotient (RQ) were assessed by indirect calorimetry. Sleep duration and sleep efficiency were assessed by actigraphy. Sleep quality was estimated by questionnaires, and sleep apnea was evaluated by respiratory disturbance index (RDI). Morning plasma ACTH, serum cortisol, and 24-h urinary free cortisol and catecholamines were also measured.
RDI was positively correlated with REE adjusted by fat-free mass (r = 0.307; P = 0.003) and RQ (r = 0.377; P < 0.001). Sleep efficiency was inversely correlated with RQ (r = -0.200; P = 0.033). The relationship of RDI score and REE was stronger in men than women (P = 0.03). In women, serum cortisol was positively correlated (r = 0.407; P < 0.001), and Epworth sleepiness score tended to be inversely (r = -0.190; P = 0.086) correlated with adjusted REE. The RQ was positively related to RDI in women, whereas subjective sleep time was related to RQ in men. In a multiple regression model, RDI, serum cortisol, and urinary norepinephrine were directly related to REE, whereas serum cortisol also directly related to adjusted REE.
Poor sleep quality was associated with increased REE, a higher RQ indicating a shift from fat toward carbohydrate oxidation, and activation of the stress system.
流行病学研究报告称，睡眠时间与体重之间存在负相关或 U 型关系。然而，睡眠与静息能量消耗（REE）之间的关系尚未得到充分描述。
本研究旨在确定睡眠、REE 和应激激素之间的关系。
我们在一家三级转诊研究临床中心进行了一项前瞻性队列研究的横断面评估。
受试者包括 126 名肥胖个体（30 名男性，96 名女性；年龄 40.5 ± 6.9 岁；体重指数 38.6 ± 6.5 kg/m²；睡眠时间 360 ± 50 min/夜；睡眠效率 79.5 ± 7.5%）。
通过间接测热法评估 REE 和呼吸商（RQ）。通过活动记录仪评估睡眠时间和睡眠效率。通过问卷评估睡眠质量，通过呼吸紊乱指数（RDI）评估睡眠呼吸暂停。还测量了早晨血浆 ACTH、血清皮质醇、24 小时尿游离皮质醇和儿茶酚胺。
RDI 与去脂体重校正后的 REE 呈正相关（r = 0.307；P = 0.003）和 RQ（r = 0.377；P < 0.001）。睡眠效率与 RQ 呈负相关（r = -0.200；P = 0.033）。RDI 评分与 REE 的关系在男性中强于女性（P = 0.03）。在女性中，血清皮质醇呈正相关（r = 0.407；P < 0.001），而 Epworth 嗜睡评分则与校正后的 REE 呈负相关趋势（r = -0.190；P = 0.086）。RQ 与女性的 RDI 呈正相关，而主观睡眠时间与男性的 RQ 呈正相关。在多元回归模型中，RDI、血清皮质醇和尿去甲肾上腺素与 REE 直接相关，而血清皮质醇也与校正后的 REE 直接相关。
睡眠质量差与 REE 增加、RQ 升高（表明脂肪向碳水化合物氧化的转变）和应激系统激活有关。
