Ingram D G, Irish L A, Tomayko E J, Prince R J, Cronin K A, Parker T, Kim K, Carmichael L, Grant V M, Sheche J N, Adams A K
Division of Pulmonary and Sleep Medicine, Children's Mercy Hospital, Kansas City, MO, USA.
Department of Psychology, North Dakota State University, Fargo, ND, USA.
Pediatr Obes. 2018 Jul;13(7):406-412. doi: 10.1111/ijpo.12281. Epub 2018 Apr 26.
Sleep has emerged as a potentially modifiable risk factor for obesity in children.
The purpose of this investigation was to evaluate the association between overnight sleep duration and obesity among American Indian (AI) children ages 2-5 years.
Data were examined from the baseline assessment of children enrolling in the Healthy Children, Strong Families study, which is a randomized lifestyle intervention trial in five diverse rural and urban AI communities nationally among children ages 2-5 years. Multivariable models were built to assess the relationship between sleep duration and BMI z-score while controlling for potential sociodemographic and behavioural covariates.
Three hundred and ninety-eight children had sufficient data to be included in analysis. In multivariable models controlling for potential covariates, overnight sleep duration was significantly and inversely associated with BMI z-score (B = -0.158, t = -1.774, P = 0.006). Similarly, when controlling for covariates, children who slept 12 or more hours had significantly lower BMI z-scores compared with those who slept 8 to 10 h (P = 0.018) or less than 8 h (P = 0.035); the difference between 12+ hours and 10 to 12-h groups did not reach statistical significance (P = 0.073) but supported a linear relationship between overnight sleep duration and BMI. Weekday-to-weekend variability in overnight sleep duration was not associated with BMI z-score (B = 0.010, t = 0.206, P = 0.837).
Overnight sleep duration is independently and inversely related to BMI z-score among AI children ages 2-5 years, even when controlling for important sociodemographic and obesogenic lifestyle factors. This represents the first report, to our knowledge, of sleep duration as a risk factor for obesity among AI children.
睡眠已成为儿童肥胖一个潜在的可改变风险因素。
本调查旨在评估2至5岁美国印第安（AI）儿童夜间睡眠时间与肥胖之间的关联。
数据来自参与“健康儿童，强壮家庭”研究的儿童基线评估，该研究是一项针对全国五个不同城乡AI社区中2至5岁儿童的随机生活方式干预试验。构建多变量模型以评估睡眠时间与BMI z评分之间的关系，同时控制潜在的社会人口统计学和行为协变量。
398名儿童有足够数据纳入分析。在控制潜在协变量的多变量模型中，夜间睡眠时间与BMI z评分显著负相关（B = -0.158，t = -1.774，P = 0.006）。同样，在控制协变量时，睡眠时间达12小时及以上的儿童，其BMI z评分显著低于睡眠时间为8至10小时（P = 0.018）或不足8小时（P = 0.035）的儿童；睡眠时间12小时及以上与10至12小时组之间的差异未达到统计学显著性（P = 0.073），但支持夜间睡眠时间与BMI之间的线性关系。夜间睡眠时间的工作日至周末变异性与BMI z评分无关（B = 0.010，t = 0.206，P = 0.837）。
在2至5岁的AI儿童中，即使控制了重要的社会人口统计学和致肥胖生活方式因素，夜间睡眠时间仍与BMI z评分独立且呈负相关。据我们所知，这是首份关于睡眠时间是AI儿童肥胖风险因素的报告。
