Li Lujiao, Fu Junling, Yu Xin Ting, Li Ge, Xu Lu, Yin Jinghua, Cheng Hong, Hou Dongqing, Zhao Xiaoyuan, Gao Shan, Li Wenhui, Li Changhong, Grant Struan F A, Li Mingyao, Xiao Yi, Mi Jie, Li Ming
Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Department of Epidemiology, Capital Institute of Paediatrics, Beijing, People's Republic of China.
Sleep. 2017 May 1;40(5). doi: 10.1093/sleep/zsx042.
To assess the associations between sleep duration and cardiometabolic risk factors in Chinese school-aged children and to explore the possible mediating role of adipokines.
Sleep duration was collected in 3166 children from the Beijing Child and Adolescent Metabolic Syndrome study. Glucose homeostasis and other cardiometabolic risk factors were assessed. Serum adipokines including leptin, total and high-molecular-weight (HMW) adiponectin, resistin, fibroblast growth factor 21 (FGF21), and retinol binding protein 4 (RBP4) were determined.
Among the 6- to 12-year-old children, after adjusting for covariates including puberty, short sleep duration was associated with increased body mass index (BMI), waist circumference, fasting glucose, insulin and homeostasis model assessment of insulin resistance (all p < .0001), higher triglyceride and lower high-density lipoprotein cholesterol (p < .05), along with increased leptin (p < .0001), FGF21 (p < .05) and decreased HMW-adiponectin (p ≤ .01); the association with leptin remained significant after further adjustment for BMI. However, these associations, except for glucose (p < .0001), disappeared after further adjusted for leptin. For the 13-18 years old group, short sleep duration was associated with higher BMI, waist circumference, and RBP4 (all p < .05), but the association with RBP4 was attenuated after adjusting for BMI (p = .067).
Short sleep duration is strongly associated with obesity and hyperglycemia (in 6-12 years old), along with adverse adipokine secretion patterns among Chinese children. The associations with cardiometabolic risk factors appear to be more pronounced in younger children, and could be explained, at least partially, by leptin levels.
评估中国学龄儿童睡眠时间与心血管代谢危险因素之间的关联，并探讨脂肪因子可能的中介作用。
从北京儿童与青少年代谢综合征研究中收集了3166名儿童的睡眠时间。评估了葡萄糖稳态及其他心血管代谢危险因素。测定了血清脂肪因子，包括瘦素、总脂联素和高分子量（HMW）脂联素、抵抗素、成纤维细胞生长因子21（FGF21）和视黄醇结合蛋白4（RBP4）。
在6至12岁儿童中，在调整包括青春期等协变量后，睡眠时间短与体重指数（BMI）增加、腰围、空腹血糖、胰岛素及胰岛素抵抗稳态模型评估值升高（均p < 0.0001）、甘油三酯升高和高密度脂蛋白胆固醇降低（p < 0.05）相关，同时瘦素（p < 0.0001）、FGF21（p < 0.05）升高及HMW - 脂联素降低（p≤0.01）；在进一步调整BMI后，与瘦素的关联仍显著。然而，除葡萄糖外（p < 0.0001），这些关联在进一步调整瘦素后消失。对于13至18岁组，睡眠时间短与较高的BMI、腰围和RBP4相关（均p < 0.05），但在调整BMI后与RBP4的关联减弱（p = 0.067）。
睡眠时间短与肥胖和高血糖（6至12岁儿童）密切相关，同时中国儿童存在不良的脂肪因子分泌模式。与心血管代谢危险因素的关联在年幼儿童中似乎更为明显，并且至少部分可由瘦素水平解释。
