Gafarov V V, Gromova E A, Panov D O, Gagulin I V, Gafarova A V
Research Institute of Therapy and Preventive Medicine of the Branch of the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia.
Collaborative laboratory of Cardiovascular Diseases Epidemiology, Novosibirsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(5):98-104. doi: 10.17116/jnevro202112105198.
To determine the gender differences in the effect of sleep disorders (SD) on the risk of myocardial infarction (MI) and stroke in an open population, aged 25-64 years, of Russia/Siberia over 16 years of follow-up.
Within the framework of the III screening of WHO's MONICA-psychosocial program, a random representative sample of the Novosibirsk population, which comprised both sexes (657 men, 689 women), aged 25-64 years, was examined in 1994. The screening included socio-demographic data, the assessment of SD according to the Jenkins scale. The analysis included people without MI, stroke. In 16 years, new-onset cases of MI and stroke were identified in women (15 and 35 cases, respectively) and in men (30 and 22 cases, respectively).
In the open population among the population of 25-64 years, 48.6% of men and 65.9% of women had SD (c=24.427, df=1, =0.0001). In people with SD, a single-factor Cox regression analysis revealed that the risk of stroke was higher in men than in women within a 16-year period. Multivariate Cox regression analysis revealed that in people with SD, the risk of stroke in men and women is approximately the same. Widowed men with SD had an increased risk of stroke. The risk of stroke was higher in men with incomplete secondary / primary education than in women. There was an increased risk of stroke in women with secondary education and those having sleep problems. Cox single-factor regression analysis showed an increased risk of MI (by 2.4 times) in men with SD for a 16-year period. SD did not influence the risk of MI in women. The risk of MI was 3 times higher in never-married men, 4.3 times higher in divorced men and 7.5 times higher in widowed men.
SD are a risk factor for stroke in men and women, and a risk factor of MI in men. A negative social gradient increases the risk of cardiovascular diseases in people with SD.
确定在16年随访期内，睡眠障碍（SD）对俄罗斯/西伯利亚25 - 64岁开放人群中心肌梗死（MI）和中风风险影响的性别差异。
在世界卫生组织MONICA - 心理社会项目的第三次筛查框架内，1994年对新西伯利亚人群中年龄在25 - 64岁的男女随机代表性样本（657名男性，689名女性）进行了检查。筛查包括社会人口统计学数据，根据詹金斯量表对睡眠障碍进行评估。分析对象为无心肌梗死、中风的人群。16年间，女性中新发心肌梗死和中风病例分别为15例和35例，男性分别为30例和22例。
在25 - 64岁的开放人群中，48.6%的男性和65.9%的女性存在睡眠障碍（c = 24.427，自由度 = 1，P = 0.0001）。在有睡眠障碍的人群中，单因素Cox回归分析显示，在16年期间男性中风风险高于女性。多因素Cox回归分析显示，在有睡眠障碍的人群中，男性和女性的中风风险大致相同。丧偶且有睡眠障碍的男性中风风险增加。初中/小学教育程度不完全的男性中风风险高于女性。受过中等教育且有睡眠问题的女性中风风险增加。Cox单因素回归分析显示，有睡眠障碍的男性在16年期间心肌梗死风险增加（2.4倍）。睡眠障碍对女性心肌梗死风险无影响。从未结婚的男性心肌梗死风险高3倍，离婚男性高4.3倍，丧偶男性高7.5倍。
睡眠障碍是男性和女性中风的危险因素，是男性心肌梗死的危险因素。负面的社会梯度增加了有睡眠障碍人群患心血管疾病的风险。
