School of Public Health, University of Nevada Reno, Reno, Nevada; College of Applied Health Sciences/College of Medicine, University of Illinois at Chicago, Chicago, Illinois; USA.
College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Sleep Health. 2022 Dec;8(6):648-653. doi: 10.1016/j.sleh.2022.08.004. Epub 2022 Oct 8.
Examine the associations of sleep measures with kidney function changes over time among individuals from a community-based study.
The sample includes 1657 participants (287 with chronic kidney disease [CKD]) in the Multi-Ethnic Study of Atherosclerosis Sleep Cohort (mean age: 57.7 years, male: 46.0%). We examined associations between a large set of sleep variables (polysomnography, actigraphy, and questionnaires) and cardiovascular disease risk factors and changes in estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio over approximately 5 years using high-dimensional regression. We investigated the modifying effect of sleep on the associations between cardiovascular disease risk factors and kidney function.
Sleep metrics predicted kidney function decline only among individuals with baseline CKD. Among this group, eGFR decline was associated with decreased stage N3 sleep (0.32 mL/min/1.73 m/y per 10% decrease in N3, p < .001); increased actigraphy napping frequency (beta: -0.20 [-0.30, -0.07]); and actigraphy sleep midpoint trajectory in early morning (ref: midnight, beta: -0.84 [-1.19, -0.50]). Urinary albumin-to-creatinine ratio increase was associated with high wake bouts trajectory (ref: low, beta: 0.97 [0.28, 1.67]) and increased sleep-related hypoxemia (oxygen saturation %time<90 [≥5%], beta: 2.17 [1.26, 3.08]). Sleep metrics--N3 sleep, naps, and midpoint trajectory--significantly modified associations between hemoglobin A1C and eGFR decline.
Reduced deep sleep, daytime napping, increased wake bouts, delayed sleep rhythms, and overnight hypoxemia are associated with longitudinal kidney function decline, with effects most apparent in individuals with CKD. Deep sleep, napping, and sleep timing modified the association between hemoglobin A1C and kidney function.
在一项基于社区的研究中，研究睡眠指标与个体肾功能随时间变化的关系。
该样本包括动脉粥样硬化睡眠队列多民族研究中的 1657 名参与者（287 名患有慢性肾脏病[CKD]）（平均年龄：57.7 岁，男性：46.0%）。我们使用高维回归来检查一大组睡眠变量（多导睡眠图、活动记录仪和问卷）与心血管疾病危险因素以及大约 5 年内估计肾小球滤过率（eGFR）和尿白蛋白与肌酐比值变化之间的关系。我们研究了睡眠对心血管疾病危险因素与肾功能之间关系的修饰作用。
睡眠指标仅预测了基线 CKD 患者的肾功能下降。在这一组中，eGFR 下降与 N3 期睡眠减少有关（每 10%的 N3 减少 0.32 毫升/分钟/1.73 米/年，p <.001）；活动记录仪打盹频率增加（β：-0.20[-0.30，-0.07]）；以及清晨活动记录仪睡眠中点轨迹（午夜，β：-0.84[-1.19，-0.50]）。尿白蛋白与肌酐比值增加与高觉醒次数轨迹有关（低，β：0.97[0.28，1.67]）和睡眠相关低氧血症增加（氧饱和度%时间<90[≥5%]，β：2.17[1.26，3.08]）。睡眠指标——N3 睡眠、打盹和中点轨迹——显著改变了血红蛋白 A1C 与 eGFR 下降之间的关系。
深度睡眠减少、白天打盹、觉醒次数增加、睡眠节律延迟和夜间低氧血症与纵向肾功能下降有关，在 CKD 患者中影响最明显。深度睡眠、打盹和睡眠时间改变了血红蛋白 A1C 与肾功能之间的关系。
