Lou Peian, Chen Peipei, Zhang Lei, Zhang Pan, Chang Guiqiu, Zhang Ning, Li Ting, Qiao Cheng
Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, School of Public Health, Xuzhou Medical University, Xuzhou, China.
BMJ Open. 2014 Mar 13;4(3):e004436. doi: 10.1136/bmjopen-2013-004436.
To explore the interactions of sleep quality and sleep duration and their effects on impaired fasting glucose (IFG) in Chinese adults.
Cross-sectional survey.
Community-based investigation in Xuzhou, China.
15 145 Chinese men and women aged 18-75 years old who fulfilled the inclusion criteria.
The Pittsburgh Sleep Quality Index was used to produce sleep quality categories of good, common and poor. Fasting blood glucose levels were assessed for IFG. Sleep duration was measured by average hours of sleep per night, with categories of <6, 6-8 and >8 h. The products of sleep and family history of diabetes, obesity and age were added to the logistic regression model to evaluate the addictive interaction and relative excess risk of interaction (RERI) on IFG. The attributable proportion (AP) of the interaction and the synergy index (S) were applied to evaluate the additive interaction of two factors. Bootstrap measures were used to calculate 95% CI of RERI, AP and S.
The prevalence of IFG was greatest in those with poor sleep quality and short sleep duration (OR 6.37, 95% CI 4.66 to 8.67; p<0.001) compared with those who had good sleep quality and 6-8 h sleep duration, after adjusting for confounders. After adjusting for potential confounders RERI, AP and S values (and their 95% CI) were 1.69 (0.31 to 3.76), 0.42 (0.15 to 0.61) and 2.85 (2.14 to 3.92), respectively, for the interaction between poor sleep quality and short sleep duration, and 0.78 (0.12 to 1.43), 0.61 (0.26 to 0.87) and -65 (-0.94 to -0.27) for the interaction between good sleep quality and long sleep duration.
The results suggest that there are additive interactions between poor sleep quality and short sleep duration.
探讨中国成年人睡眠质量与睡眠时间的相互作用及其对空腹血糖受损（IFG）的影响。
横断面调查。
中国徐州的社区调查。
15145名年龄在18 - 75岁之间符合纳入标准的中国男性和女性。
采用匹兹堡睡眠质量指数将睡眠质量分为良好、一般和较差三类。评估空腹血糖水平以检测IFG。睡眠时间通过每晚平均睡眠时间来衡量，分为<6小时、6 - 8小时和>8小时三类。将睡眠与糖尿病家族史、肥胖和年龄的乘积纳入逻辑回归模型，以评估对IFG的相加交互作用和交互作用的相对超额危险度（RERI）。应用交互作用的归因比例（AP）和协同指数（S）来评估两个因素的相加交互作用。采用Bootstrap方法计算RERI、AP和S的95%置信区间。
在调整混杂因素后，与睡眠质量良好且睡眠时间为6 - 8小时的人相比，睡眠质量差且睡眠时间短的人IFG患病率最高（比值比6.37，95%置信区间4.66至8.67；p<0.001）。调整潜在混杂因素后，睡眠质量差与睡眠时间短之间交互作用的RERI、AP和S值（及其95%置信区间）分别为1.69（0.31至3.76）、0.42（0.15至0.61）和2.85（2.14至3.92），而睡眠质量良好与睡眠时间长之间交互作用的RERI、AP和S值分别为0.78（0.12至1.43）、0.61（0.26至0.87）和 - 65（ - 0.94至 - 0.27）。
结果表明睡眠质量差与睡眠时间短之间存在相加交互作用。
