Li Y Y, Hu J J, Cheng M N, Yang Q P, Wu F, Fu C, Shi Y
Shanghai Municipal Center for Disease Control & Prevention, Shanghai 200336, China.
Center for Disease Control and Prevention of Yangpu District, Shanghai 200090, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Aug 10;41(8):1261-1265. doi: 10.3760/cma.j.cn112338-20191230-00919.
To analyze the relationship between both quality and duration of sleep and type 2 diabetes in middle-aged and elderly people in Shanghai. Baseline data was from the '2017 epidemiological survey in Shanghai community residents aged 35 and above on type 2 diabetes'. Restricted cubic splines were used to draw dose-response curves to show the relationship between PSQI score, sleep duration and type 2 diabetes. Logistic regression model was used to analyze the effects of quality and duration of sleep as well as the interaction, on type 2 diabetes. Results showed that the average PSQI score was (4.09±0.10) points, the proportion of poor sleep quality was 12.55% (95%: 10.77-14.58) and the average sleep duration was (7.19±0.03) hours. The relationship between PSQI score and diabetes appeared linear, with the relationship between sleep duration and diabetes as U-shaped. After adjusting for confounders, both poor sleep quality (>7 for PSQI score) and short sleep duration (sleep duration <6 hours) significantly increased the risk of type 2 diabetes, with =1.17 (95%: 1.06-1.30) and 1.20 (95%: 1.01-1.41), respectively. From the interaction analysis, data showed that after adjusting for confounders, both sleep duration <6 hours (=1.30, 95%: 1.12-1.52) and ≥8 hours (=1.79, 95%: 1.04-3.07) with poor sleep quality would increase the risks on diabetes. Both poor sleep quality and short sleep duration were associated with the risk of diabetes, while long sleep duration was only associated with the risk of diabetes when accompanied by poor quality of sleep.
分析上海中老年人睡眠质量和时长与2型糖尿病之间的关系。基线数据来自“2017年上海市35岁及以上社区居民2型糖尿病流行病学调查”。采用限制立方样条绘制剂量反应曲线，以显示匹兹堡睡眠质量指数（PSQI）评分、睡眠时长与2型糖尿病之间的关系。使用逻辑回归模型分析睡眠质量和时长以及交互作用对2型糖尿病的影响。结果显示，PSQI平均评分为（4.09±0.10）分，睡眠质量差的比例为12.55%（95%：10.77 - 14.58），平均睡眠时长为（7.19±0.03）小时。PSQI评分与糖尿病之间呈线性关系，睡眠时长与糖尿病之间呈U形关系。调整混杂因素后，睡眠质量差（PSQI评分>7）和睡眠时长较短（睡眠时长<6小时）均显著增加2型糖尿病风险，比值比分别为1.17（95%：1.06 - 1.30）和1.20（95%：1.01 - 1.41）。从交互作用分析来看，数据显示调整混杂因素后，睡眠时长<6小时（比值比=1.30，95%：1.12 - 1.52）以及睡眠时长≥8小时（比值比=1.79，95%：1.04 - 3.07）且睡眠质量差均会增加糖尿病风险。睡眠质量差和睡眠时长较短均与糖尿病风险相关，而只有在睡眠质量差的情况下，长睡眠时长才与糖尿病风险相关。
