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未确诊慢性肾病的绝经后女性睡眠特征与肾功能的关联

Association of sleep characteristics with renal function in menopausal women without recognized chronic kidney disease.

作者信息

Tong Jianqian, Li Changbin, Hu Jiangshan, Teng Yincheng, Zhou Yang, Tao Minfang

机构信息

Department of Gynecology and Obstetrics, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, China.

Department of Gynecology and Obstetrics, Shanghai Eighth People's Hospital, Affiliated to Jiangsu University, Shanghai, China.

出版信息

Front Psychiatry. 2022 Nov 9;13:1024245. doi: 10.3389/fpsyt.2022.1024245. eCollection 2022.

Abstract

OBJECTIVE

To delineate the association between sleep characteristics and renal function in peri-post menopause free of Chronic kidney disease (CKD) as well as cardiometabolic and hormone indicators.

METHODS

Cross-sectional data from a total of 823 Han-Chinese women aged 40-67 years who visited the Menopause Clinic in the Shanghai Sixth People's Hospital from November 2011 to November 2020 were analyzed through the Pittsburgh Sleep Quality Index (PSQI) and serum cystatin C (Cys-C). Logistic regression models were used to assess the association between cumulative/each sleep parameter and renal function after adjusting for cardiometabolic variables.

RESULTS

After confounding factors, we identified that poor perceived sleep quality, shorter sleep duration (<6 h), low sleep efficiency (<75%), delayed sleep latency and worse sleep disturbance elevated more than doubled the odds ratio for declining renal function (≥0.91 mg/dL, the highest Cys-C) in postmenopause in a graded fashion. Meanwhile, multiple logistic regression analysis revealed that sleep disorder (PSQI ≥ 8), late postmenopause, highest quartile independently increased the odds ratio for declining renal function (OR 2.007, 95% CI: 1.408-2.861, OR = 3.287, 95%CI: 3.425-8.889, OR = 2.345, 95% CI: 1.310-4.199, respectively), while participants with menopausal hormone replacement (MHT) lower the odds of declining renal function (OR = 0.486, 95% CI: 0.324-0.728).

CONCLUSION

The findings proposed that maintaining good sleep quality should be attached great importance to postmenopausal women, which provides clinical evidence for the feasible early detection and effective prevention such as MHT of renal disease progression in postmenopausal women.

摘要

目的

明确围绝经期及绝经后无慢性肾脏病(CKD)的女性的睡眠特征与肾功能之间的关联,以及与心脏代谢和激素指标之间的关系。

方法

对2011年11月至2020年11月期间在上海第六人民医院更年期门诊就诊的823名年龄在40 - 67岁之间的汉族女性的横断面数据进行分析,采用匹兹堡睡眠质量指数(PSQI)和血清胱抑素C(Cys-C)。在调整心脏代谢变量后,使用逻辑回归模型评估累积/每个睡眠参数与肾功能之间的关联。

结果

在调整混杂因素后,我们发现,在绝经后女性中,睡眠质量差、睡眠时间短(<6小时)、睡眠效率低(<75%)、入睡延迟和睡眠障碍严重会使肾功能下降(Cys-C≥0.91mg/dL,最高值)的比值比以分级方式增加一倍以上。同时,多因素逻辑回归分析显示,睡眠障碍(PSQI≥8)、绝经后期、最高四分位数独立增加肾功能下降的比值比(分别为OR 2.007,95%CI:1.408 - 2.861;OR = 3.287,95%CI:3.425 - 8.889;OR = 2.345,95%CI:1.310 - 4.199),而接受绝经激素治疗(MHT)的参与者肾功能下降的几率降低(OR = 0.486,95%CI:0.324 - 0.728)。

结论

研究结果表明,绝经后女性应高度重视保持良好的睡眠质量,这为绝经后女性肾脏疾病进展的早期可行检测和有效预防(如MHT)提供了临床证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1d7/9681799/0bb9335284a7/fpsyt-13-1024245-g001.jpg

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