Taraz Mohammad, Khatami Mohammad-Reza, Hajiseyedjavadi Maryam, Farrokhian Amir, Amini Mohsen, Khalili Hossein, Abdollahi Alireza, Dashti-Khavidaki Simin
Tehran University of Medical Sciences, Tehran, Iran.
Hemodial Int. 2013 Jul;17(3):382-90. doi: 10.1111/hdi.12035. Epub 2013 Mar 12.
Elevated proinflammatory cytokines have been attributed to poor sleep quality in patients receiving hemodialysis. This is the first investigation about the relationship between sleep quality and circulating levels of antiinflammatory markers in these patients. A total of 72 patients who were receiving maintenance hemodialysis were enrolled in this cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. Patients were divided into two groups: good sleepers (PSQI score < 5) and poor sleepers (PSQI score ≥ 5). Assessments were made for serum biochemical parameters (albumin, parathyroid hormone), inflammatory (interleukin [IL]-6, tumor necrosis factor-alpha [TNF-α], and high-sensitivity c-reactive protein [hs-CRP] ) and antiinflammatory (IL-10) markers. Fifty-four patients (75%) were classified as poor sleepers. Poor sleepers showed significantly lower levels of serum IL-10 and higher serum triglyceride and parathyroid hormone concentrations. These patients were more likely to have more comorbidities. The global PSQI score was significantly correlated with serum IL-10 (p = 0.03) and triglyceride levels (p = 0.01). Multivariate logistic regression analysis showed a direct correlation between PSQI and having comorbidities (p = 0.011, odds ratio [OR] = 3.918; confidence interval 95% [CI] = 2.742-19.031), between PSQI and serum triglyceride (p = 0.027, OR = 1.027 [95% CI = 1.007-1.048] ), and an inverse correlation between PSQI and serum IL-10 level (p = 0.021, OR = 0.424 [95% CI = 0.195-0.922]). Reduced circulating levels of the antiinflammatory cytokine IL-10 were significantly associated with poor sleep quality in hemodialysis patients. Factors including serum IL-10 and triglyceride concentrations and having comorbidities may predict patients prone to poor sleep quality.
炎症细胞因子水平升高被认为与接受血液透析患者的睡眠质量差有关。这是首次对这些患者睡眠质量与抗炎标志物循环水平之间的关系进行的调查。本横断面研究共纳入了72例接受维持性血液透析的患者。采用匹兹堡睡眠质量指数（PSQI）来衡量睡眠质量。患者被分为两组：睡眠良好者（PSQI评分<5）和睡眠不佳者（PSQI评分≥5）。对血清生化参数（白蛋白、甲状旁腺激素）、炎症标志物（白细胞介素[IL]-6、肿瘤坏死因子-α[TNF-α]和高敏C反应蛋白[hs-CRP]）和抗炎标志物（IL-10）进行了评估。54例患者（75%）被归类为睡眠不佳者。睡眠不佳者血清IL-10水平显著较低，血清甘油三酯和甲状旁腺激素浓度较高。这些患者更易合并更多疾病。PSQI总分与血清IL-10（p = 0.03）和甘油三酯水平（p = 0.01）显著相关。多因素逻辑回归分析显示，PSQI与合并症（p = 0.011，比值比[OR]=3.918；95%置信区间[CI]=2.742 - 19.031）、PSQI与血清甘油三酯（p = 0.027，OR = 1.027[95%CI = 1.007 - 1.048]）之间存在直接相关性，PSQI与血清IL-10水平之间存在负相关（p = 0.021，OR = 0.424[95%CI = 0.195 - 0.922]）。血液透析患者中抗炎细胞因子IL-10循环水平降低与睡眠质量差显著相关。包括血清IL-10和甘油三酯浓度以及合并症在内的因素可能预测患者易出现睡眠质量差。
