Zhou M, Lalani C, Banda J A, Robinson T N
Stanford University School of Medicine Stanford CA USA.
Department of Health and Kinesiology Purdue University West Lafayette IN USA.
Obes Sci Pract. 2018 Oct 18;4(6):535-544. doi: 10.1002/osp4.303. eCollection 2018 Dec.
Sleep disruption in laboratory studies increases adiposity and decreases glucose tolerance. However, few epidemiological studies have used objective measures of sleep. This study aims to assess associations between sleep duration, timing and regularity with measures of adiposity.
This is a cross-sectional study of 188 children with obesity (age: 10.50 ± 1.39 years; body mass index: 29.24 ± 5.04 kg m). Nightly sleep duration, bedtime and wake time were measured by multiple-day actigraphy and parent reports. Per cent overweight (per cent over median body mass index for age and sex) was chosen as the primary measure of obesity status. Objective measures of height, weight, waist circumference, blood pressure, fasting blood lipids, glucose, insulin, glycated haemoglobin and C-reactive protein were obtained. Television screen time and total caloric intake were assessed via parent questionnaire.
Each hour later in weekday bedtime was associated with an additional 6.17 per cent overweight (95% confidence interval [CI]: 1.42-10.92). Each hour greater in day-to-day variability in weekday bedtime and weekday wake time was associated with an additional 10.20 (95% CI: 0.50-19.91) and 10.02 (95% CI: 1.55-18.50) per cent overweight, respectively. Associations were similar after controlling for other obesity-related behaviours (television screen time, total caloric intake and physical activity.).
Among children with obesity, later bedtime and greater variability in bedtime and wake time are associated with greater adiposity, independent of other obesity-related behaviours. Early bedtime and wake time and consistent day-to-day sleep timing may be strategies to reduce adiposity in high-risk children.
实验室研究表明，睡眠中断会增加肥胖程度并降低葡萄糖耐量。然而，很少有流行病学研究采用客观的睡眠测量方法。本研究旨在评估睡眠时间、时间安排和规律性与肥胖指标之间的关联。
这是一项针对188名肥胖儿童的横断面研究（年龄：10.50±1.39岁；体重指数：29.24±5.04kg/m）。通过多天的活动记录仪和家长报告来测量夜间睡眠时间、就寝时间和起床时间。选择超重百分比（超过年龄和性别的体重指数中位数的百分比）作为肥胖状态的主要指标。获取身高、体重、腰围、血压、空腹血脂、血糖、胰岛素、糖化血红蛋白和C反应蛋白的客观测量值。通过家长问卷评估看电视屏幕时间和总热量摄入。
工作日就寝时间每推迟一小时，超重百分比就增加6.17%（95%置信区间[CI]：1.42-10.92）。工作日就寝时间和工作日起床时间的日常变化每增加一小时，超重百分比分别增加10.20%（95%CI：0.50-19.91）和10.02%（95%CI：1.55-18.50）。在控制了其他与肥胖相关的行为（看电视屏幕时间、总热量摄入和体育活动）后，关联情况相似。
在肥胖儿童中，就寝时间较晚以及就寝时间和起床时间的变异性较大与更高的肥胖程度相关，且独立于其他与肥胖相关的行为。早睡早起以及日常睡眠时间保持一致可能是降低高危儿童肥胖程度的策略。
