Lin Miao, Su Qing, Wen Junping, Wei Shichao, Yao Jin, Huang Huibin, Liang Jixing, Li Liantao, Lin Wei, Lin Lixiang, Lu Jieli, Bi Yufang, Wang Weiqing, Ning Guang, Chen Gang
Department of Nephrology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China.
Department of Endocrinology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, 200092, China.
Sleep Breath. 2018 Mar;22(1):223-232. doi: 10.1007/s11325-017-1470-0. Epub 2017 Feb 26.
Renal hyperfiltration (RHF) has emerged as a novel marker of early renal damage in various conditions such as diabetes and metabolic syndrome. Aberrant sleep duration and excessive daytime napping may affect the development of chronic kidney disease (CKD). In this study, the association between sleep duration, daytime napping, and renal hyperfiltration was assessed.
This study was conducted in three communities in China.
A total of 16,119 community volunteers (5735 males and 10,384 females) aged 40-65 years without CKD were included for the study.
Participants with short sleep duration (<6 h/day) or long sleep duration (≥10 h/day) were at a significantly increased risk of renal hyperfiltration. The fully adjusted ORs (95% CI) were 2.112 (1.107, 4.031) and 2.071 (1.504, 2.853), respectively (P < 0.05). In addition, those who took naps longer than 1.5 h per day had a higher risk of renal hyperfiltration compared with those without napping (OR 1.400, 95% CI 1.018-1.924). Further joint analysis indicated that participants with long sleep duration (≥10 h/day) had a more than twofold increased risk of RHF regardless of nap status compared with those who slept 8-9 h per day without daytime napping. The association between sleep duration or daytime napping and RHF could not be explained by the influence of sleep quality. Additional subgroup analysis showed long sleep duration (≥9 h/day) and long daytime napping (≥1.5 h) were associated with an increased risk of RHF among individuals with good sleep quality.
Sleep duration less than 6 h/day or more than 10 h/day and long daytime napping tend to be associated with an increased risk of renal hyperfiltration in middle-aged general population, and this relationship was independent of diabetes, hypertension, obesity, or poor sleep quality.
肾高滤过(RHF)已成为糖尿病和代谢综合征等多种疾病早期肾损伤的一种新标志物。睡眠时间异常和白天过度小睡可能会影响慢性肾脏病(CKD)的发展。在本研究中,评估了睡眠时间、白天小睡与肾高滤过之间的关联。
本研究在中国的三个社区进行。
共有16119名年龄在40 - 65岁、无CKD的社区志愿者(5735名男性和10384名女性)纳入本研究。
睡眠时间短(<6小时/天)或长(≥10小时/天)的参与者发生肾高滤过的风险显著增加。完全调整后的比值比(95%可信区间)分别为2.112(1.107,4.031)和2.071(1.504,2.853)(P < 0.05)。此外,与不午睡者相比,每天午睡超过1.5小时的人发生肾高滤过的风险更高(比值比1.400,95%可信区间1.018 - 1.924)。进一步的联合分析表明,与每天睡眠8 - 9小时且无白天小睡的人相比,睡眠时间长(≥10小时/天)的参与者无论午睡情况如何,发生RHF的风险增加两倍以上。睡眠时间或白天小睡与RHF之间的关联无法用睡眠质量的影响来解释。额外的亚组分析显示,在睡眠质量良好的个体中,睡眠时间长(≥9小时/天)和白天小睡时间长(≥1.5小时)与RHF风险增加有关。
在中年普通人群中,每天睡眠时间少于6小时或多于10小时以及白天长时间小睡往往与肾高滤过风险增加有关,且这种关系独立于糖尿病、高血压、肥胖或睡眠质量差。