Godin Ophélia, Henry Chantal, Leboyer Marion, Azorin Jean-Michel, Aubin Valerie, Bellivier Frank, Polosan Mircea, Courtet Philippe, Gard Sebastien, Kahn Jean-Pierre, Loftus Josephine, Passerieux Christine, Costagliola Dominique, Etain Bruno
a Université Pierre et Marie Curie, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP UMRS , Paris , France.
b INSERM , UMRS, Paris , France.
Chronobiol Int. 2017;34(8):1114-1124. doi: 10.1080/07420528.2017.1332071. Epub 2017 Sep 14.
Data on sleep or circadian abnormalities and metabolic disturbances in euthymic bipolar disorders are scarce and based on small sample sizes. The aim of this study was to explore the associations between sleep disturbances, chronotype and metabolic components in a large sample of euthymic patients with bipolar disorders (BD). From 2009 to 2015, 752 individuals with bipolar disorders from the FACE-BD cohort were included and assessed for sleep quality, chronotype and metabolic components. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to confirm the diagnosis of BD. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index and chronotype with the Composite Scale of Morningness. Sociodemographic and clinical characteristics, psychotropic treatment, psychiatric comorbidities and blood samples were collected. In our sample, 22.4% of individuals with BD presented with a metabolic syndrome, 53.7% had sleep disturbances, 25.4% were considered as having an evening chronotype and 12.6% as having a morning chronotype. Independently of potential confounders, euthymic patients with sleep disturbances had a higher abdominal circumference, and patients with evening chronotype had a significantly higher level of triglycerides. There was an association between evening chronotype and an increased atherogenic index of plasma (OR = 4.8, 95%CI = 1.6-14.7). Our findings contribute the scant literature on the relationship between sleep quality, chronotype and cardiometabolic components in euthymic individuals with BD and highlight the need to improve quality of sleep and patient education about healthier sleep-hygiene practices.
关于心境正常的双相情感障碍患者睡眠或昼夜节律异常与代谢紊乱的数据稀缺且基于小样本量。本研究的目的是在一大群心境正常的双相情感障碍(BD)患者中探讨睡眠障碍、昼夜节律类型与代谢成分之间的关联。2009年至2015年,纳入了来自FACE - BD队列的752名双相情感障碍患者,并对其睡眠质量、昼夜节律类型和代谢成分进行评估。使用《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈(SCID)来确诊BD。用匹兹堡睡眠质量指数测量主观睡眠质量,用晨型综合量表测量昼夜节律类型。收集社会人口学和临床特征、精神药物治疗、精神共病情况及血液样本。在我们的样本中,22.4%的双相情感障碍患者存在代谢综合征,53.7%有睡眠障碍,25.4%被认为是夜型昼夜节律,12.6%是晨型昼夜节律。独立于潜在混杂因素,有睡眠障碍的心境正常患者腹围更大,夜型昼夜节律的患者甘油三酯水平显著更高。夜型昼夜节律与血浆致动脉粥样硬化指数升高之间存在关联(比值比=4.8,95%置信区间=1.6 - 14.7)。我们的研究结果为关于心境正常的双相情感障碍患者睡眠质量、昼夜节律类型与心脏代谢成分之间关系的稀少文献做出了贡献,并强调了改善睡眠质量以及对患者进行更健康睡眠卫生习惯教育的必要性。