Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Armed Forces Capital Hospital, Gyeonggi-do, Korea.
J Am Soc Nephrol. 2020 Dec;31(12):2937-2947. doi: 10.1681/ASN.2020050666. Epub 2020 Oct 1.
Studies have found sleeping behaviors, such as sleep duration, to be associated with kidney function and cardiovascular disease risk. However, whether short or long sleep duration is a causative factor for kidney function impairment has been rarely studied.
We studied data from participants aged 40-69 years in the UK Biobank prospective cohort, including 25,605 self-reporting short-duration sleep (<6 hours per 24 hours), 404,550 reporting intermediate-duration sleep (6-8 hours), and 35,659 reporting long-duration sleep (≥9 hours) in the clinical analysis. Using logistic regression analysis, we investigated the observational association between the sleep duration group and prevalent CKD stages 3-5, analyzed by logistic regression analysis. We performed Mendelian randomization (MR) analysis involving 321,260 White British individuals using genetic instruments (genetic variants linked with short- or long-duration sleep behavior as instrumental variables). We performed genetic risk score analysis as a one-sample MR and extended the finding with a two-sample MR analysis with CKD outcome information from the independent CKDGen Consortium genome-wide association study meta-analysis.
Short or long sleep duration clinically associated with higher prevalence of CKD compared with intermediate duration. The genetic risk score for short (but not long) sleep was significantly related to CKD (per unit reflecting a two-fold increase in the odds of the phenotype; adjusted odds ratio, 1.80; 95% confidence interval, 1.25 to 2.60). Two-sample MR analysis demonstrated causal effects of short sleep duration on CKD by the inverse variance weighted method, supported by causal estimates from MR-Egger regression.
These findings support an adverse effect of a short sleep duration on kidney function. Clinicians may encourage patients to avoid short-duration sleeping behavior to reduce CKD risk.
研究发现，睡眠行为（如睡眠时间）与肾功能和心血管疾病风险有关。然而，睡眠时间过短或过长是否是肾功能损害的致病因素，很少有研究探讨。
我们研究了英国生物库前瞻性队列中年龄在 40-69 岁的参与者的数据，其中 25605 人自述睡眠时间较短（<6 小时/24 小时），404550 人自述睡眠时间中等（6-8 小时），35659 人自述睡眠时间较长（≥9 小时）。我们采用逻辑回归分析，通过逻辑回归分析，调查了睡眠时间组与普遍存在的 CKD 3-5 期之间的观察性关联。我们使用 321260 名白种英国人的遗传工具（与短或长睡眠行为相关的遗传变异作为工具变量）进行孟德尔随机化（MR）分析。我们进行了遗传风险评分分析，作为一种单样本 MR 分析，并通过独立的 CKDGen 联盟全基因组关联研究荟萃分析中的 CKD 结果信息进行了两样本 MR 分析来扩展发现。
与中等睡眠时间相比，短时间或长时间睡眠与 CKD 的患病率升高相关。短时间睡眠的遗传风险评分（但不是长时间睡眠）与 CKD 显著相关（反映表型发生几率增加两倍的单位；调整后的比值比，1.80；95%置信区间，1.25 至 2.60）。两样本 MR 分析通过逆方差加权法表明短睡眠持续时间对 CKD 的因果效应，MR-Egger 回归中的因果估计结果也支持该结论。
这些发现支持短睡眠时间对肾功能的不良影响。临床医生可能会鼓励患者避免短时间睡眠行为，以降低 CKD 风险。
