Akbaraly Tasnime N, Jaussent Isabelle, Besset Alain, Bertrand Marion, Barberger-Gateau Pascale, Ritchie Karen, Ferrie Jane E, Kivimaki Mika, Dauvilliers Yves
INSERM U1061, Université Montpellier, Montpellier, France; INSERM U710, Montpellier, France; EPHE, Paris, France; INSERM U1198, Montpellier, France; Department of Epidemiology and Public Health, University College London, United Kingdom; INSERM U710, Montpellier, France; EPHE, Paris, France.
INSERM U1061, Université Montpellier, Montpellier, France.
Am J Geriatr Psychiatry. 2015 Aug;23(8):818-28. doi: 10.1016/j.jagp.2014.10.001. Epub 2014 Oct 15.
To assess whether sleep complaints (rather than clinically defined sleep disturbances) were associated with the metabolic syndrome (MetS) and each of its components in an elderly population.
Cross-sectional analyses of data from the French Three City Study, a large multicenter cohort of elderly community-dwellers.
6,354 participants (56.4% women, median age 73; range: 65-97 years).
Frequency of insomnia complaints (difficulty in initiating sleep, difficulty in maintaining sleep [DMS], and early morning awakening) and excessive daytime sleepiness (EDS) were self-reported. MetS was assessed using National Cholesterol Education program Adult Treatment Panel III criteria.
A total of 977 participants had MetS. After adjustment for a large range of potential confounders, we report an association between the number of insomnia complaints and MetS. Among insomnia complaints only DMS was consistently associated with MetS (OR: 1.23, 95% CI: 1.06 to 1.43). Our results showed that EDS independently increased the risk of MetS (OR: 1.46, 95% CI: 1.18 to 1.81 for "frequently"; OR: 1.99, 95% CI: 1.49 to 1.67 for "often"). The EDS-MetS association was independent of past-history of cardiovascular disease, insomnia complaints, and obesity and loud snoring.
We report significant independent associations between frequent sleep complaints (EDS and to a lesser extent DMS) and MetS in the elderly with potential implications in terms of management and cardiovascular prevention in general geriatric practice. Prospective studies are required to clarify the direction of the association between sleep complaints and MetS.
评估在老年人群中，睡眠主诉（而非临床定义的睡眠障碍）是否与代谢综合征（MetS）及其各组分相关。
对法国三城市研究的数据进行横断面分析，该研究是一个针对老年社区居民的大型多中心队列研究。
6354名参与者（56.4%为女性，中位年龄73岁；范围：65 - 97岁）。
通过自我报告失眠主诉（入睡困难、维持睡眠困难[DMS]和早醒）及日间过度嗜睡（EDS）的频率。采用美国国家胆固醇教育计划成人治疗小组第三次报告标准评估MetS。
共有977名参与者患有MetS。在对一系列潜在混杂因素进行校正后，我们报告了失眠主诉数量与MetS之间的关联。在失眠主诉中，仅DMS始终与MetS相关（比值比：1.23，95%置信区间：1.06至1.43）。我们的结果显示，EDS独立增加MetS风险（“频繁”时比值比：1.46，95%置信区间：1.18至1.81；“经常”时比值比：1.99，95%置信区间：1.49至1.67）。EDS与MetS的关联独立于心血管疾病病史、失眠主诉、肥胖及大声打鼾。
我们报告了在老年人中，频繁的睡眠主诉（EDS以及程度较轻的DMS）与MetS之间存在显著的独立关联，这在一般老年医学实践的管理和心血管预防方面可能具有潜在意义。需要进行前瞻性研究以阐明睡眠主诉与MetS之间关联的方向。
