揭示短睡眠时间与肥胖发生率之间的纵向关联：宾夕法尼亚州立大学队列研究。
Unveiling the longitudinal association between short sleep duration and the incidence of obesity: the Penn State Cohort.
作者信息
Vgontzas A N, Fernandez-Mendoza J, Miksiewicz T, Kritikou I, Shaffer M L, Liao D, Basta M, Bixler E O
机构信息
Sleep Research & Treatment Center, Department of Psychiatry, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Children's Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA.
出版信息
Int J Obes (Lond). 2014 Jun;38(6):825-32. doi: 10.1038/ijo.2013.172. Epub 2013 Sep 12.
OBJECTIVE
Several epidemiologic, longitudinal studies have reported that short sleep duration is a risk factor for the incidence of obesity. However, the vast majority of these studies used self-reported measures of sleep duration and did not examine the role of objective short sleep duration, subjective sleep disturbances and emotional stress.
DESIGN
Longitudinal, population-based study.
SUBJECTS
We studied a random sample of 815 non-obese adults from the Penn State Cohort in the sleep laboratory for one night using polysomnography (PSG) and followed them up for a mean of 7.5 years. Subjective and objective measures of sleep as well as emotional stress were obtained at baseline. Obesity was defined as a body mass index (BMI) ≥30 kg/ m(-2).
RESULTS
The incidence of obesity was 15% and it was significantly higher in women and in individuals who reported sleep disturbances, shorter sleep duration and higher emotional stress. Significant mediating effects showed that individuals with subjective sleep disturbances who developed obesity reported the shortest sleep duration and the highest emotional stress, and that subjective sleep disturbances and emotional stress were independent predictors of incident obesity. Further analyses revealed that the association between short sleep duration, subjective sleep disturbances and emotional stress with incident obesity was stronger in young and middle-age adults. Objective short sleep duration was not associated with a significantly increased risk of incident obesity.
CONCLUSION
Self-reported short sleep duration in non-obese individuals at risk of developing obesity is a surrogate marker of emotional stress and subjective sleep disturbances. Objective short sleep duration is not associated with a significant increased risk of incident obesity. The detection and treatment of sleep disturbances and emotional stress should become a target of our preventive strategies against obesity.
目的
多项流行病学纵向研究报告称，睡眠时间短是肥胖发生率的一个风险因素。然而，这些研究绝大多数使用的是自我报告的睡眠时间测量方法，并未考察客观的短睡眠时间、主观睡眠障碍和情绪压力的作用。
设计
基于人群的纵向研究。
研究对象
我们从宾夕法尼亚州立队列中随机抽取了815名非肥胖成年人，在睡眠实验室使用多导睡眠图（PSG）对他们进行了一晚的研究，并对他们进行了平均7.5年的随访。在基线时获取了睡眠的主观和客观测量数据以及情绪压力数据。肥胖定义为体重指数（BMI）≥30 kg/m²。
结果
肥胖发生率为15%，在女性以及报告有睡眠障碍、睡眠时间短和情绪压力高的个体中显著更高。显著的中介效应表明，发生肥胖的有主观睡眠障碍的个体报告的睡眠时间最短且情绪压力最高，并且主观睡眠障碍和情绪压力是肥胖发生的独立预测因素。进一步分析显示，短睡眠时间、主观睡眠障碍和情绪压力与肥胖发生之间的关联在年轻人和中年人中更强。客观的短睡眠时间与肥胖发生风险的显著增加无关。
结论
有肥胖风险的非肥胖个体自我报告的短睡眠时间是情绪压力和主观睡眠障碍的替代指标。客观的短睡眠时间与肥胖发生风险的显著增加无关。睡眠障碍和情绪压力的检测与治疗应成为我们预防肥胖策略的目标。
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