Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.
Sleep. 2021 Sep 13;44(9). doi: 10.1093/sleep/zsab089.
To prospectively investigate the association between sleep traits and lung cancer risk, accounting for the interactions with genetic predisposition of lung cancer.
We included 469 691 individuals free of lung cancer at recruitment from UK Biobank, measuring sleep behaviors with a standardized questionnaire and identifying incident lung cancer cases through linkage to national cancer and death registries. We estimated multivariable-adjusted hazard ratios (HRs) for lung cancer (2177 incident cases) across four sleep traits (sleep duration, chronotype, insomnia, and snoring) and examined the interaction and joint effects with a lung cancer polygenic risk score.
A U-shaped association was observed for sleep duration and lung cancer risk, with an 18% higher risk (95% confidence interval [CI]: 1.07 to 1.30) for short sleepers and a 17% higher risk (95% CI: 1.02 to 1.34) for long sleepers compared with normal sleepers (7-8 h/day). Evening preference was associated with elevated lung cancer risk compared with morning preference (HR: 1.25; 95% CI: 1.07 to 1.46), but no association was found for insomnia or snoring. Compared with participants with favorable sleep traits and low genetic risk, those with both unfavorable sleep duration (<7 hours or >8 hours) or evening preference and high genetic risk showed the greatest lung cancer risk (HRsleep duration: 1.83; 95% CI: 1.47 to 2.27; HRchronotype: 1.85; 95% CI: 1.34 to 2.56).
Both unfavorable sleep duration and evening chronotype were associated with increased lung cancer incidence, especially for those with low to moderate genetic risk. These results indicate that sleep behaviors as modifiable risk factors may have potential implications for lung cancer risk.
前瞻性研究睡眠特征与肺癌风险之间的关联，同时考虑肺癌遗传易感性的相互作用。
我们纳入了来自英国生物库的 469691 名无肺癌的个体，通过标准化问卷测量睡眠行为，并通过与国家癌症和死亡登记处的联系确定肺癌新发病例。我们估计了四个睡眠特征（睡眠时间、昼夜节律类型、失眠和打鼾）与肺癌（2177 例）之间的多变量调整后的风险比（HR），并检查了与肺癌多基因风险评分的相互作用和联合效应。
睡眠时间与肺癌风险呈 U 型关联，与正常睡眠时间（7-8 小时/天）相比，短睡眠者的风险增加 18%（95%置信区间 [CI]：1.07 至 1.30），长睡眠者的风险增加 17%（95% CI：1.02 至 1.34）。与晨型偏好相比，晚型偏好与肺癌风险升高相关（HR：1.25；95% CI：1.07 至 1.46），但失眠或打鼾与肺癌风险无关。与具有良好睡眠特征和低遗传风险的参与者相比，同时具有不良睡眠持续时间（<7 小时或>8 小时）或晚型偏好和高遗传风险的参与者表现出最大的肺癌风险（HR 睡眠时间：1.83；95% CI：1.47 至 2.27；HR 昼夜节律类型：1.85；95% CI：1.34 至 2.56）。
不良的睡眠持续时间和晚型昼夜节律类型均与肺癌发病率增加相关，特别是对于遗传风险低至中等的人群。这些结果表明，作为可改变的风险因素的睡眠行为可能对肺癌风险具有潜在意义。
