Department of Endocrinology and Metabolism, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
BMJ Open. 2019 Feb 11;9(2):e023817. doi: 10.1136/bmjopen-2018-023817.
Short sleep duration is independently associated with an increased risk of developing cardiovascular disease; however, the association has not yet been examined in obese populations. We assessed the associations between sleep duration, metabolic phenotype and apolipoprotein variables in a nationally representative Chinese population with overweight/obesity.
Cross-sectional study.
The study conducted in nine provinces of China that vary substantially in geography and economic development.
Data were obtained from 4149 adults with overweight/obesity aged 18 to 94 years from the 2009 China Health and Nutrition Survey. Sleep duration was categorised as ≤6, 7-8 or ≥9 hour. Phenotypes were determined based on body mass index and metabolic health status and categorised as metabolically healthy overweight/obesity (MHOO) and metabolically unhealthy overweight/obesity (MUOO).
The outcome variables were elevated apolipoproteins.
Compared with MHOO phenotype, MUOO phenotypes were more likely to report shorter sleep duration (12.2%vs9%). In the MUOO group, the multivariate-adjusted OR (95% CI) for elevated apolipoprotein B (apoB) was 1.66 (1.23 to 2.23) for those with ≤6 hours of sleep and 1.12 (0.86 to 1.45) for those with ≥9 hours of sleep, using 7-8 hours of sleep as a reference. Similar results were obtained in the subgroup of subjects who were ≥45 or<45 years old, but shorter sleep duration was more strongly associated with elevated apoB in those <45 years (p interaction=0.023). However, no association was observed in the MHOO phenotype.
The high prevalence of short sleep duration and its strong association with elevated apoB in adults who are metabolically unhealthy overweight/obese suggest an increased risk of cardiovascular disease in this population. The differences in sleep sufficiency among obese phenotypes may account for the disparities in their cardiovascular outcomes.
睡眠时长较短与心血管疾病风险增加独立相关；然而，这种关联尚未在肥胖人群中得到验证。我们评估了在中国超重/肥胖的代表性人群中，睡眠时长与代谢表型和载脂蛋白变量之间的关系。
横断面研究。
研究在中国九个省份进行，这些省份在地理位置和经济发展方面存在显著差异。
数据来自于 2009 年中国健康与营养调查中年龄在 18 至 94 岁的 4149 名超重/肥胖成年人。睡眠时长分为≤6 小时、7-8 小时和≥9 小时。表型根据体重指数和代谢健康状况确定，分为代谢健康的超重/肥胖（MHOO）和代谢不健康的超重/肥胖（MUOO）。
结局变量为载脂蛋白升高。
与 MHOO 表型相比，MUOO 表型更有可能报告睡眠时长较短（12.2%vs9%）。在 MUOO 组中，与 7-8 小时睡眠相比，睡眠时长≤6 小时的调整后多变量 OR（95%CI）为 1.66（1.23 至 2.23），睡眠时长≥9 小时的调整后 OR（95%CI）为 1.12（0.86 至 1.45）。在年龄≥45 岁或<45 岁的亚组中得到了相似的结果，但在年龄<45 岁的人群中，较短的睡眠时长与载脂蛋白 B（apoB）升高的关联更强（p 交互=0.023）。然而，在 MHOO 表型中没有观察到这种关联。
代谢不健康的超重/肥胖成年人中短睡眠时长的高患病率及其与 apoB 升高的强烈关联提示该人群患心血管疾病的风险增加。肥胖表型之间睡眠充足程度的差异可能导致其心血管结局的差异。
