Wang Kun, Wu Yang, Yang Yu, Chen Jie, Zhang Danyu, Hu Yongxin, Liu Zhoujun, Xu Juan, Shen Qiaoxuan, Zhang Niya, Mao Xiaodong, Liu Chao
Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100, Hongshan Road, Nanjing, 210028, China.
Endocrine. 2015 Jun;49(2):538-48. doi: 10.1007/s12020-014-0493-6. Epub 2014 Dec 2.
To explore the association of sleep patterns with bone mineral density (BMD) in pre- and post-menopausal women, we used a questionnaire to evaluate the sleep patterns and performed calcaneal quantitative ultrasound to estimate BMD, in 6,510 women aged 40 years or older, from June to November 2011 in Nanjing City. We found a 1.7-fold risk of osteoporosis in post-menopausalwomen with bedtime of ≥0:00 am (OR = 1.69, 95 % CI 1.39-2.13), compared to those whose bedtime of <0:00 am. post-menopausalwomen with excessive total sleep (>10 h vs. 8-9 h, OR = 1.54, 95 % CI 1.05-2.02) were shown to have a higher risk of osteoporosis, however, this high risk was not detected in those with excessive nocturnal sleep (>10 h vs. 8-9 h, OR = 0.85, 95 % CI 0.62-1.30). By contrast, post-menopausalwomen with inadequate nocturnal sleep (≤7 h vs. 8-9 h, OR = 1.68, 95 % CI 1.32-2.75), excessive daytime sleep (≥180 min vs. 0 min, OR = 1.52, 95 % CI 1.08-2.13), and noontime nap (>60 min vs. 0 min: OR = 1.37, 95 % CI 1.06-1.76) were demonstrated to have higher risk of bone loss. Nevertheless, these associations were not found in premenopausal women. We conclude that delayed bedtime, nocturnal sleep deprivation, excessive daytime sleep, and noontime nap, but not reduced total sleep duration, could promote bone loss in post-menopausalwomen, which might be related to circadian rhythm disturbances. However, they have limited influences to BMD in women who were still in menstruating. Mechanism responsible for the phenomena warrants further investigation.
为探讨绝经前后女性睡眠模式与骨密度（BMD）之间的关联，我们于2011年6月至11月在南京市对6510名40岁及以上女性进行了研究。通过问卷调查评估睡眠模式，并采用跟骨定量超声检测来估算骨密度。我们发现，与就寝时间在凌晨0点之前的绝经后女性相比，就寝时间在凌晨0点及以后的绝经后女性患骨质疏松症的风险高1.7倍（OR = 1.69，95% CI 1.39 - 2.13）。绝经后女性总睡眠时间过长（>10小时与8 - 9小时相比，OR = 1.54，95% CI 1.05 - 2.02）时，患骨质疏松症的风险较高；然而，夜间睡眠时间过长（>10小时与8 - 9小时相比，OR = 0.85，95% CI 0.62 - 1.30）时未发现此高风险。相比之下，夜间睡眠不足（≤7小时与8 - 9小时相比，OR = 1.68，95% CI 1.32 - 2.75）、白天睡眠时间过长（≥180分钟与0分钟相比，OR = 1.52，95% CI 1.08 - 2.13）以及午睡时间过长（>60分钟与0分钟相比：OR = 1.37，95% CI 1.06 - 1.76）的绝经后女性，骨量流失风险较高。然而，这些关联在绝经前女性中未发现。我们得出结论，就寝时间延迟、夜间睡眠剥夺、白天睡眠时间过长和午睡，但不是总睡眠时间减少，可能会促进绝经后女性的骨质流失，这可能与昼夜节律紊乱有关。然而，它们对仍在月经的女性的骨密度影响有限。导致这些现象的机制值得进一步研究。
