昼夜节律紊乱综合征比代谢综合征能更好地预测中国成年人的心血管疾病。

The circadian syndrome predicts cardiovascular disease better than metabolic syndrome in Chinese adults.

机构信息

From the, Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.

Department of Public Health, University of Helsinki, Helsinki, Finland.

出版信息

J Intern Med. 2021 Jun;289(6):851-860. doi: 10.1111/joim.13204. Epub 2020 Dec 19.

DOI:10.1111/joim.13204

PMID:33340184

Abstract

BACKGROUND

To compare the predictive value of the circadian syndrome (CircS) and Metabolic syndrome (MetS) for cardiovascular disease.

METHOD

We used the data of 9360 Chinese adults aged ≥40 years from the 2011 China Health and Retirement Longitudinal Study (CHARLS). Of the participants, 8253 people were followed in the 2015 survey. MetS was defined using the harmonized criteria. CircS was based on the components of the International Diabetes Federation (IDF) MetS plus short sleep and depression. The cut-off for CircS was set as ≥4. Multivariable logistic regression analysis was used to examine the associations.

RESULTS

The prevalence of CircS and MetS was 39.0% and 44.7%. Both MetS and CircS were directly associated with prevalent CVD. The odds ratios for prevalent CVD comparing CircS with MetS, respectively, were 2.83 (95%CI 2.33-3.43) and 2.34 (1.93-2.83) in men, and 2.33 (1.98-2.73) and 1.79 (1.53-2.10) in women. Similar associations were found for incident CVD. The five-year incidence of CVD was 15.1% in CircS and 14.0% in MetS. The number of CircS components has a better predictive power for both prevalent and incident CVD than those of Mets components as indicated by the area under the ROC (AUC). AUC values for CVD in 2011 were higher for CircS than MetS in both men (0.659 (95%CI 0.634-0.684) vs 0.635 (95%CI 0.610-0.661)) and women (0.652 (95%CI 0.632-0.672) vs 0.619 (95%CI 0.599-0.640)).

CONCLUSION

The circadian syndrome is a strong and better predictor for CVD than the metabolic syndrome in Chinese adults.

摘要

背景

比较昼夜节律紊乱综合征（CircS）和代谢综合征（MetS）对心血管疾病的预测价值。

方法

我们使用了 2011 年中国健康与退休纵向研究（CHARLS）中 9360 名年龄≥40 岁的中国成年人的数据。在参加者中，8253 人在 2015 年的调查中进行了随访。采用协调标准定义 MetS。CircS 基于国际糖尿病联合会（IDF）MetS 加上短睡眠和抑郁的成分。CircS 的截断值设定为≥4。采用多变量逻辑回归分析来检查关联。

结果

CircS 和 MetS 的患病率分别为 39.0%和 44.7%。MetS 和 CircS 均与现患 CVD 直接相关。男性 CircS 与 MetS 相比，现患 CVD 的比值比分别为 2.83（95%CI 2.33-3.43）和 2.34（1.93-2.83），女性分别为 2.33（1.98-2.73）和 1.79（1.53-2.10）。对于新发 CVD 也发现了类似的关联。CircS 的五年 CVD 发生率为 15.1%，MetS 为 14.0%。CircS 成分的数量对现患和新发 CVD 的预测能力均优于 Mets 成分，ROC 下面积（AUC）表明。2011 年男性 CircS 的 CVD AUC 值高于 MetS（0.659（95%CI 0.634-0.684）比 0.635（95%CI 0.610-0.661））和女性（0.652（95%CI 0.632-0.672）比 0.619（95%CI 0.599-0.640））。