Al-Rashed Fatema, Sindhu Sardar, Al Madhoun Ashraf, Alghaith Abdulwahab, Azim Rafaat, Al-Mulla Fahd, Ahmad Rasheed
Immunology & Microbiology Department, Dasman Diabetes Institute, Dasman, Kuwait.
Animal and Imaging Core Facility, Dasman Diabetes Institute, Dasman, Kuwait.
Nat Sci Sleep. 2021 Jul 24;13:1225-1241. doi: 10.2147/NSS.S311415. eCollection 2021.
Efficient sleep duration and its quality are increasingly recognized as important contributors for maintaining normal body weight. However, lifestyle and social structure within the Arab-gulf region differ compared to those in the western world. This study was specifically conducted in Kuwait's population to investigate the link between sleep quality (SQ) and obesity in the absence of sleep apnea (SA) onset.
SQ was measured by the Pittsburgh Sleep Quality Index (PQSI) in 984 participants, then verified in 60 individuals including 20 lean (Body mass index/BMI: 18.5-24.9 kg/m), 20 overweight (BMI: 25-29.9 kg/m) and 20 obese (BMI: ≥30 kg/m) through actigraph worn over the right-hip for 7 consecutive days to characterize their sleep-wake cycle, rest-activity, and physical activity. Blood samples were collected for metabolic markers.
59.6% of participants reported a PSQI score higher than 5, with 57.6% of the participants reporting less than 6 hours of sleep per day. The data show that both SQ and sleep duration are considered inadequate in comparison to the international SQ standards. We found a significant association between SQ and obesity independent of age and sex. Actigraph data further supported the independent association of sleep duration on BMI within the population (p < 0.001). Additionally, total sleep time (TST) was found to significantly correlate with several other metabolic factors including diastolic blood pressure, elevated resting heart rate (RHR), triglycerides, total cholesterol, homeostatic model assessment for insulin resistance (HOMA-IR), C-peptide, and C-Reactive Protein (CRP) secretion. Further multiple-regression analysis showed a significant independent association between blood pressure (p < 0.03), HOMA-IR (p < 0.04), and C-peptide (p < 0.3) and sleep duration.
These findings suggest that sleep deprivation and disturbance could be indirect factors involved in the development of not only obesity in Kuwait but also other metabolic syndromes such as type 2 diabetes.
有效睡眠时间及其质量日益被认为是维持正常体重的重要因素。然而，与西方世界相比，阿拉伯海湾地区的生活方式和社会结构有所不同。本研究专门针对科威特人群进行，以调查在无睡眠呼吸暂停（SA）发作情况下睡眠质量（SQ）与肥胖之间的联系。
采用匹兹堡睡眠质量指数（PQSI）对984名参与者的睡眠质量进行测量，然后在60名个体中进行验证，其中包括20名瘦人（体重指数/BMI：18.5 - 24.9 kg/m²）、20名超重者（BMI：25 - 29.9 kg/m²）和20名肥胖者（BMI：≥30 kg/m²），通过连续7天佩戴在右髋部的活动记录仪来描述他们的睡眠 - 觉醒周期、休息 - 活动和身体活动情况。采集血样检测代谢指标。
59.6%的参与者报告PSQI得分高于5分，57.6%的参与者报告每天睡眠时间不足6小时。数据显示，与国际睡眠质量标准相比，睡眠质量和睡眠时间均被认为不足。我们发现睡眠质量与肥胖之间存在显著关联，且不受年龄和性别的影响。活动记录仪数据进一步支持了人群中睡眠时间与BMI之间的独立关联（p < 0.001）。此外，发现总睡眠时间（TST）与其他几个代谢因素显著相关，包括舒张压、静息心率升高（RHR）、甘油三酯、总胆固醇、胰岛素抵抗稳态模型评估（HOMA - IR）、C肽和C反应蛋白（CRP）分泌。进一步的多元回归分析显示，血压（p < 0.03）、HOMA - IR（p < 0.04）和C肽（p < 0.3）与睡眠时间之间存在显著的独立关联。
这些发现表明，睡眠不足和睡眠障碍可能不仅是科威特肥胖症发展的间接因素，也是其他代谢综合征如2型糖尿病发展的间接因素。
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