Dai Fei, Cai Hui, Li Honglan, Yang Gong, Ji Bu-Tian, Zheng Wei, Xiang Yong-Bing, Shu Xiao-Ou
Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Sleep Med. 2017 Oct;38:135-141. doi: 10.1016/j.sleep.2017.07.024. Epub 2017 Sep 6.
To evaluate the association between sleep duration and the incidence of diabetes stratified by sleep-related factors among Chinese men.
This study included 34,825 men who provided information on sleep-related questions in the Shanghai Men's Health Study, a population-based cohort study conducted in Shanghai, China from 2002 to 2011. Participants were excluded who had a history of diabetes or who were diagnosed with diabetes within 2 years of recruitment. Cox regression was employed to evaluate the influence of sleep duration and its interaction with sleep-related factors on diabetes risk.
A total of 1521 incident cases were documented during a median of 5.6 follow-up years. Adjusted hazard ratios and 95% confidence intervals were 1.0 (0.9-1.1) and 1.2 (1.0-1.3) for men who slept <7 and ≥8 h per day, respectively, compared with those who slept 7 h per day (p = 0.01). Stratified analyses revealed that the association between sleep duration and risk of diabetes was only statistically significant among current smokers and regular drinkers, never tea drinkers, men with a high body mass index, hypertension or comorbidity, and men who did not work nightshift or who snored. A statistically significant interaction between tea drinking and sleep duration was observed (p = 0.01). The above association patterns remained when daytime nappers were excluded from the analyses.
The data suggested that longer sleep duration, particularly among individuals already exhibiting factors linked to poor quality of sleep, was associated with diabetes. The association between sleep duration and diabetes may be modified by tea drinking, especially in older men or men with more sleep-related factors.
评估中国男性中睡眠时长与按睡眠相关因素分层的糖尿病发病率之间的关联。
本研究纳入了34825名男性，他们在2002年至2011年于中国上海开展的一项基于人群的队列研究——上海男性健康研究中提供了与睡眠相关问题的信息。排除有糖尿病病史或在招募后2年内被诊断出糖尿病的参与者。采用Cox回归评估睡眠时长及其与睡眠相关因素的相互作用对糖尿病风险的影响。
在中位随访5.6年期间共记录了1521例新发病例。与每天睡眠7小时的男性相比，每天睡眠<7小时和≥8小时的男性的调整后风险比及95%置信区间分别为1.0（0.9 - 1.1）和1.2（1.0 - 1.3）（p = 0.01）。分层分析显示，睡眠时长与糖尿病风险之间的关联仅在当前吸烟者、经常饮酒者、从不饮茶者、体重指数高、患有高血压或合并症的男性以及不从事夜班工作或打鼾的男性中具有统计学意义。观察到饮茶与睡眠时长之间存在统计学显著的相互作用（p = 0.01）。当分析中排除白天小睡者时，上述关联模式依然存在。
数据表明，较长的睡眠时长，尤其是在已经表现出与睡眠质量差相关因素的个体中，与糖尿病有关。睡眠时长与糖尿病之间的关联可能会因饮茶而改变，尤其是在老年男性或具有更多睡眠相关因素的男性中。
