Division of Research, Kaiser Permanente Northern California, Oakland, California;
Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center.
Pediatrics. 2018 Jul;142(1). doi: 10.1542/peds.2017-4085. Epub 2018 Jun 15.
: media-1vid110.1542/5778442247001PEDS-VA_2017-4085 BACKGROUND AND OBJECTIVES: Shorter sleep duration is associated with childhood obesity. Few studies measure sleep quantity and quality objectively or examine cardiometabolic biomarkers other than obesity.
This cross-sectional study of 829 adolescents derived sleep duration, efficiency and moderate-to-vigorous physical activity from >5 days of wrist actigraphy recording for >10 hours/day. The main outcome was a metabolic risk score (mean of 5 sex-specific z-scores for waist circumference, systolic blood pressure, high-density lipoprotein cholesterol scaled inversely, and log-transformed triglycerides and homeostatic model assessment of insulin resistance), for which higher scores indicate greater metabolic risk. Secondary outcomes included score components and dual-energy radiograph absorptiometry fat mass. We measured socioeconomic status, race and/or ethnicity, pubertal status, and obesity-related behaviors (television-viewing and fast food and sugar-sweetened beverage consumption) using questionnaires.
The sample was 51.5% girls; mean (SD) age 13.2 (0.9) years, median (interquartile range) sleep duration was 441.1 (54.8) minutes per day and sleep efficiency was 84.0% (6.3). Longer sleep duration was associated with lower metabolic risk scores (-0.11 points; 95% CI: -0.19 to -0.02, per interquartile range). Associations with sleep efficiency were similar and persisted after adjustment for BMI score and physical activity, television-viewing, and diet quality. Longer sleep duration and greater sleep efficiency were also favorably associated with waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, and fat mass.
Longer sleep duration and higher sleep efficiency were associated with a more favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors. These results support the need to assess the role of sleep quantity and quality interventions as strategies for improving cardiovascular risk profiles of adolescents.
媒体-1vid110.1542/5778442247001PEDS-VA_2017-4085 背景和目的：睡眠时间较短与儿童肥胖有关。很少有研究客观地测量睡眠量和睡眠质量，也很少研究肥胖以外的心脏代谢生物标志物。 方法：本研究对 829 名青少年进行了横断面研究，通过 >5 天的手腕活动记录仪记录，每天记录 >10 小时，得出睡眠时间、效率和中高强度体力活动。主要结果是代谢风险评分（腰围、收缩压、高密度脂蛋白胆固醇按倒数、对数转换的甘油三酯和稳态模型评估的胰岛素抵抗 5 个性别特异性 z 评分的平均值），得分越高表明代谢风险越大。次要结果包括评分成分和双能 X 射线吸收法脂肪量。我们使用问卷测量社会经济地位、种族和/或民族、青春期状况以及与肥胖相关的行为（看电视、快餐和含糖饮料的消费）。 结果：样本中 51.5%为女孩；平均（SD）年龄为 13.2（0.9）岁，中位数（四分位距）睡眠时间为 441.1（54.8）分钟/天，睡眠效率为 84.0%（6.3）。睡眠时间较长与较低的代谢风险评分相关（-0.11 分；95%CI：-0.19 至-0.02，每四分位距）。与睡眠效率的关联相似，并且在调整 BMI 评分和体力活动、看电视和饮食质量后仍然存在。较长的睡眠时间和较高的睡眠效率也与腰围、收缩压、高密度脂蛋白胆固醇和脂肪量呈正相关。 结论：在青少年早期，较长的睡眠时间和较高的睡眠效率与更有利的心脏代谢特征相关，与其他肥胖相关行为无关。这些结果支持需要评估睡眠量和睡眠质量干预的作用，作为改善青少年心血管风险特征的策略。
