Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province 215123, China.
School of Nursing, Medical College of Soochow University, Suzhou, Jiangsu Province 215006, China.
Eur J Prev Cardiol. 2022 Nov 8;29(15):1982-1991. doi: 10.1093/eurjpc/zwac123.
Sleep disorders are associated with an increased risk of cardiometabolic diseases in observational studies, but the causality remains unclear. In this study, we leveraged two-sample Mendelian randomization (MR) analyses to assess the causal associations of self-reported daytime napping, daytime sleepiness, and other sleep phenotypes with cardiometabolic diseases including ischaemic stroke (IS), coronary artery disease (CAD), heart failure (HF), and Type 2 diabetes mellitus (T2DM).
We selected genetic variants as instrumental variables for self-reported daytime napping, daytime sleepiness, morning person, insomnia, short sleep duration, and long sleep duration from European-descent genome-wide association studies (GWASs). Summary statistics for cardiometabolic diseases originated from four different GWASs with a total of 2 500 086 participants. We used the inverse-variance weighted method to explore the role of self-reported sleep phenotypes on the aetiology of cardiometabolic diseases in the main analyses, followed by several sensitivity analyses for robustness validation. Genetically predicted self-reported daytime napping [T2DM: OR, 1.56 (95% confidence interval, 1.21-2.02)], insomnia [IS: OR, 1.07 (1.04-1.11)]; CAD: OR, 1.13 (1.08-1.17); HF: OR, 1.10 (1.07-1.14); T2DM: OR, 1.16 (1.11-1.22); and short sleep duration [CAD: OR, 1.37 (1.21-1.55)] were causally associated with an elevated risk of cardiometabolic diseases. Moreover, genetically determined self-reported daytime sleepiness [CAD: OR, 2.05 (1.18-3.57); HF: OR, 1.82 (1.15-2.87)] and morning person [HF: 1.06 OR, (1.01-1.11)] had potential detrimental effect on cardiometabolic risks.
Self-reported daytime napping, insomnia, and short sleep duration had causal roles in the development of cardiometabolic diseases, while self-reported daytime sleepiness and morning person was the potential risk factor for cardiometabolic diseases.
观察性研究表明，睡眠障碍与心脏代谢疾病的风险增加有关，但因果关系尚不清楚。在这项研究中，我们利用两样本孟德尔随机化（MR）分析来评估日间小睡、日间嗜睡和其他睡眠表型与心脏代谢疾病（包括缺血性中风（IS）、冠心病（CAD）、心力衰竭（HF）和 2 型糖尿病（T2DM））的因果关系。
我们从欧洲血统的全基因组关联研究（GWAS）中选择遗传变异作为日间小睡、日间嗜睡、早起者、失眠、睡眠时间短和睡眠时间长的自述工具变量。心脏代谢疾病的汇总统计数据源自四项不同的 GWAS，共有 2500086 名参与者。我们使用逆方差加权法在主要分析中探讨了自述睡眠表型在心脏代谢疾病发病机制中的作用，随后进行了几项稳健性验证的敏感性分析。遗传预测的自述日间小睡[T2DM：OR，1.56（95%置信区间，1.21-2.02）]、失眠[IS：OR，1.07（1.04-1.11）]；CAD：OR，1.13（1.08-1.17）；HF：OR，1.10（1.07-1.14）；T2DM：OR，1.16（1.11-1.22）和短睡眠时间[CAD：OR，1.37（1.21-1.55）]与心脏代谢疾病的风险增加有因果关系。此外，遗传决定的自述日间嗜睡[CAD：OR，2.05（1.18-3.57）；HF：OR，1.82（1.15-2.87）]和早起者[HF：1.06 OR，（1.01-1.11）]对心脏代谢风险可能有不利影响。
自述日间小睡、失眠和短睡眠时间与心脏代谢疾病的发生有因果关系，而自述日间嗜睡和早起者是心脏代谢疾病的潜在危险因素。
