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成人睡眠时间与慢性肾脏病和蛋白尿的关系:系统评价和剂量-反应荟萃分析。

Association of sleep duration with chronic kidney disease and proteinuria in adults: a systematic review and dose-response meta-analysis.

机构信息

The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.

Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China.

出版信息

Int Urol Nephrol. 2020 Jul;52(7):1305-1320. doi: 10.1007/s11255-020-02488-w. Epub 2020 May 16.

DOI:10.1007/s11255-020-02488-w
PMID:32418007
Abstract

BACKGROUND AND OBJECTIVES

Previous studies have found that sleep duration may be associated with chronic kidney disease (CKD) and proteinuria in adults. However, the correlation remains controversial. In this study, we aimed to assess the effects of sleep duration on CKD and proteinuria.

METHODS

PubMed, EMBASE, and Cochrane Library were searched from their inception up to April 5, 2019 for observational study. The outcomes were CKD and/or proteinuria and the exposure was sleep duration assessed by self-reported questionnaire or interview. Studies were included if they provided risk estimates of effects of sleep duration on patients with CKD or proteinuria. The overall effects were measured by odds ratios (OR) and 95% confidence intervals (CI). Heterogeneity was quantified using Q statistics and the I statistics. The potential causes of heterogeneity were investigated using sensitivity analysis.

RESULTS

Eleven observational studies with 521,242 individuals were included. The adjusted ORs of CKD in individuals who slept ≤ 6 h/night and ≥ 8 h/night were 1.13 (95% CI, 1.02-1.25; I = 29%) and 1.14 (95% CI, 1.07-1.22; I= 0%), respectively. Meanwhile, the adjusted ORs of proteinuria in those who slept ≤ 6 h/night and ≥ 8 h/night were 1.24 (95% CI, 1.06-1.44; I = 61%) and 1.15 (95% CI, 1.04-1.29; I = 0%), respectively. Furthermore, a U-shaped relationship was observed between sleep duration and CKD or proteinuria, with the lowest risk at 7 h/night of sleep.

CONCLUSIONS

Both short and long sleep durations are significantly associated with CKD and proteinuria. Our findings suggest curvilinear dose-response associations of sleep duration with CKD and proteinuria.

摘要

背景和目的

先前的研究发现,睡眠时间可能与成人慢性肾脏病(CKD)和蛋白尿有关。然而,这种相关性仍存在争议。在本研究中,我们旨在评估睡眠时间对 CKD 和蛋白尿的影响。

方法

从建库起至 2019 年 4 月 5 日,我们在 PubMed、EMBASE 和 Cochrane Library 中检索了观察性研究。结局为 CKD 和/或蛋白尿,暴露为通过自我报告问卷或访谈评估的睡眠时间。如果研究提供了睡眠时间对 CKD 或蛋白尿患者影响的风险估计值,则纳入研究。使用比值比(OR)和 95%置信区间(CI)来衡量总体效应。使用 Q 统计量和 I 统计量来量化异质性。使用敏感性分析来研究异质性的潜在原因。

结果

纳入了 11 项包含 521242 人的观察性研究。睡眠时间≤6 小时/晚和≥8 小时/晚的个体患 CKD 的调整后 OR 分别为 1.13(95%CI,1.02-1.25;I=29%)和 1.14(95%CI,1.07-1.22;I=0%)。同时,睡眠时间≤6 小时/晚和≥8 小时/晚的个体患蛋白尿的调整后 OR 分别为 1.24(95%CI,1.06-1.44;I=61%)和 1.15(95%CI,1.04-1.29;I=0%)。此外,睡眠时间与 CKD 或蛋白尿之间呈 U 形关系,睡眠时间为 7 小时/晚时风险最低。

结论

短时间和长时间睡眠均与 CKD 和蛋白尿显著相关。我们的研究结果表明,睡眠时间与 CKD 和蛋白尿之间存在曲线剂量反应关系。

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