Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
Sleep. 2013 May 1;36(5):769-779E. doi: 10.5665/sleep.2646.
We hypothesize that extremes of sleep duration are associated with elevated C-reactive protein (CRP), a pro-inflammatory marker for cardiovascular disease risk.
Cross-sectional.
Population-based research.
Nationally representative sample of 2007-2008 National Health and Nutrition Examination Survey participants (n = 5,587 adults).
None.
Associations between CRP and self-reported total sleep time (TST) were examined. Explanatory models considered contributions of sex, age, race/ethnicity, body mass index (BMI), and BMI squared (BMI2). Models also explored the role of insomnia symptoms, sleep apnea, active medical illness, and antidiabetic/antihypertensive treatment. Differential patterns among race/ethnicity groups were examined using interactions and stratified analyses. Nonlinear relationships between CRP and TST were assessed using polynomial and multinomial regression models (< 5, 5, 6, 7, 8, 9, and > 9 h). Linear and squared terms were significant in all models in the complete sample, with notable differences by sex and ethnoracial group. Overall, in models adjusted for sociodemographics and BMI, different patterns were observed for non-Hispanic white (elevated CRP for < 5 h and > 9 h), black/African-American (elevated CRP for < 5 h and 8 h), Hispanic/Latino (elevated CRP for > 9 h), and Asian/ Other (higher in 9 and > 9 h and lower in 5 h and 6 h) groups. Ethnoracial groups also demonstrated patterning by sex.
In a representative sample of American adults, elevated CRP was associated with extreme sleep durations. Sex, race/ethnicity, sleep disorders, and medical comorbidity influenced these associations. Differences in CRP along these dimensions should be considered in future research on sleep related disparities influencing cardiometabolic disease risk.
我们假设睡眠时长的极端情况与 C 反应蛋白（CRP）升高有关，CRP 是心血管疾病风险的促炎标志物。
横断面研究。
基于人群的研究。
2007-2008 年全国健康与营养调查参与者的全国代表性样本（n = 5587 名成年人）。
无。
检查 CRP 与自我报告的总睡眠时间（TST）之间的关联。解释模型考虑了性别、年龄、种族/族裔、体重指数（BMI）和 BMI 平方（BMI2）的贡献。模型还探讨了失眠症状、睡眠呼吸暂停、活动性内科疾病和降糖/降压治疗的作用。使用交互作用和分层分析检查了不同种族/族裔群体之间的差异模式。使用多项式和多项回归模型评估 CRP 和 TST 之间的非线性关系（<5、5、6、7、8、9 和>9 h）。在完整样本的所有模型中，线性和平方项均具有统计学意义，性别和种族/族裔群体之间存在显著差异。总体而言，在调整了社会人口统计学和 BMI 的模型中，观察到非西班牙裔白人（<5 h 和>9 h 时 CRP 升高）、黑人/非裔美国人（<5 h 和 8 h 时 CRP 升高）、西班牙裔/拉丁裔（>9 h 时 CRP 升高）和亚洲/其他（9 h 和>9 h 时较高，5 h 和 6 h 时较低）组存在不同的模式。种族/族裔群体也表现出性别模式。
在代表美国成年人的样本中，CRP 升高与极端睡眠持续时间有关。性别、种族/族裔、睡眠障碍和合并症影响了这些关联。在未来研究中，应考虑 CRP 在这些维度上的差异，以了解影响睡眠相关心血管代谢疾病风险的差异因素。
