He Liyun, Yang Na, Ping Fan, Xu Lingling, Li Wei, Li Yuxiu, Zhang Huabing
Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Nov 17;13:4423-4434. doi: 10.2147/DMSO.S265465. eCollection 2020.
High-sensitivity C-reactive protein (hs-CRP) has been shown as an important predictor of cardiovascular risk, and sleep duration is an important factor influencing health outcomes. However, the association between hs-CRP and sleep duration among Chinese adults remained unknown and controversial. We aimed to explore the associations between sleep duration and hs-CRP levels among Chinese adults, and the differences in sex and geographical regions.
This cross-sectional study was based on nationally representative Chinese samples from the 2009 China Health and Nutrition Survey, which employed multistage, random cluster designs. Habitual sleep duration was self-reported with short and long sleep duration defined as ≤6h and ≥9h per day, respectively. Participants were divided into 4 groups based on the categories of self-reported sleep duration (≤6h, 7h, 8h, ≥9h per day), excluding hs-CRP levels ≥10 mg/L. Subset samples were stratified by sex and geographical regions.
A total of 8170 Chinese adults with a mean age of 50.0±14.9 years and 4369 (53.5%) men were included. Participants sleeping eight hours had the lowest hs-CRP levels. Long sleep duration (≥9h) was significantly associated with elevated hs-CRP levels after adjusting for multiple covariates in full samples (β=0.0356; 95% CI: 0.0050-0.0663; P=0.0228), but the associations of short sleep duration (≤ 6h) were limited to the unadjusted model. Long sleep duration was associated with elevated hs-CRP levels in women (β= 0.0512; 95% CI: 0.0097-0.0927; P=0.0155) and in the northern region of China (β=0.0699; 95% CI: 0.0210-0.1187; P=0.0051), but not in men or the southern region.
Long but not short sleep duration was positively associated with elevated hs-CRP levels, independent from traditional risk factors among Chinese adults, and sex and geographical differences were observed. Our findings imply that modifications of long sleep duration might be added to behavioral therapy to reduce cardiovascular risk in Chinese adults.
高敏C反应蛋白（hs-CRP）已被证明是心血管风险的重要预测指标，而睡眠时间是影响健康结果的重要因素。然而，中国成年人中hs-CRP与睡眠时间之间的关联仍不明确且存在争议。我们旨在探讨中国成年人睡眠时间与hs-CRP水平之间的关联，以及性别和地理区域的差异。
这项横断面研究基于2009年中国健康与营养调查中具有全国代表性的中国样本，该调查采用多阶段随机整群设计。习惯性睡眠时间通过自我报告获得，短睡眠时间和长睡眠时间分别定义为每天≤6小时和≥9小时。根据自我报告的睡眠时间类别（每天≤6小时、7小时、8小时、≥9小时）将参与者分为4组，排除hs-CRP水平≥10mg/L的情况。子集样本按性别和地理区域分层。
共纳入8170名中国成年人，平均年龄为50.0±14.9岁，男性4369名（53.5%）。睡眠时间为8小时的参与者hs-CRP水平最低。在对全样本中的多个协变量进行调整后，长睡眠时间（≥9小时）与hs-CRP水平升高显著相关（β=0.0356；95%置信区间：0.0050-0.0663；P=0.0228），但短睡眠时间（≤6小时）的关联仅限于未调整模型。长睡眠时间与女性（β=0.0512；95%置信区间：0.0097-0.0927；P=0.0155）和中国北方地区（β=0.0699；95%置信区间：0.0210-0.1187；P=0.0051）的hs-CRP水平升高相关，但在男性或南方地区则不然。
在中国成年人中，长睡眠时间而非短睡眠时间与hs-CRP水平升高呈正相关，独立于传统风险因素，且观察到了性别和地理差异。我们的研究结果表明，在行为疗法中可能需要增加对长睡眠时间的调整，以降低中国成年人的心血管风险。
