Yuan Shuai, Levin Michael G, Titova Olga E, Chen Jie, Sun Yuhao, Million Veteran Program Veterans Affairs, Åkesson Agneta, Li Xue, Damrauer Scott M, Larsson Susanna C
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, Stockholm, 17177, Stockholm, Sweden.
Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3400 Spruce St, Philadelphia, PA 19104, USA.
Eur Heart J Open. 2023 Mar 16;3(2):oead008. doi: 10.1093/ehjopen/oead008. eCollection 2023 Mar.
Sleep duration has been associated with cardiovascular disease, however the effect of sleep on peripheral artery disease (PAD) specifically remains unestablished. We conducted observational and Mendelian randomization (MR) analyses to assess the associations of sleep duration and daytime napping with PAD risk.
Sleep traits were assessed for associations with incident PAD using cohort analysis among 53 416 Swedish adults. Replicated was sought in a case-control study of 28 123 PAD cases and 128 459 controls from the veterans affairs Million Veteran Program (MVP) and a cohort study of 452 028 individuals from the UK Biobank study (UKB). Two-sample Mendelian randomization (MR) was used for casual inference-based analyses of sleep-related traits and PAD (31 307 PAD cases 211 753 controls). Observational analyses demonstrated a U-shaped association between sleep duration and PAD risk. In Swedish adults, incident PAD risk was higher in those with short sleep [<5 h; hazard ratio (HR) 1.74; 95% confidence interval (CI) 1.31-2.31] or long sleep (≥8 h; HR 1.24; 95% CI 1.08-1.43), compared to individuals with a sleep duration of 7 to <8 h/night. This finding was supported by the analyses in MVP and UKB. Observational analysis also revealed positive associations between daytime napping (HR 1.32, 95% CI 1.18-1.49) with PAD. MR analysis supported an inverse association between sleep duration [odds ratio (OR) per hour increase: 0.79, 95% CI, 0.55, 0.89] and PAD and an association between short sleep and increased PAD (OR 1.20, 95% CI, 1.04-1.38).
Short sleep duration was associated with an increased risk of PAD.
睡眠时间已被证明与心血管疾病有关，然而，睡眠对周围动脉疾病（PAD）的具体影响仍未明确。我们进行了观察性研究和孟德尔随机化（MR）分析，以评估睡眠时间和白天小睡与PAD风险之间的关联。
在53416名瑞典成年人中，通过队列分析评估睡眠特征与PAD发病之间的关联。在一项病例对照研究中进行了重复验证，该研究纳入了来自退伍军人事务部百万退伍军人计划（MVP）的28123例PAD病例和128459例对照，以及来自英国生物银行研究（UKB）的452028名个体的队列研究。采用两样本孟德尔随机化（MR）方法，对睡眠相关特征和PAD进行基于因果推断的分析（31307例PAD病例和211753例对照）。观察性分析表明，睡眠时间与PAD风险之间呈U形关联。在瑞典成年人中，睡眠时间短（<5小时）或长（≥8小时）的人发生PAD的风险较高，与每晚睡眠时间为7至<8小时的人相比，睡眠时间短的人风险比（HR）为1.74；95%置信区间（CI）为1.31 - 2.31，睡眠时间长的人HR为1.24；95%CI为1.08 - 1.43。这一发现得到了MVP和UKB分析的支持。观察性分析还显示，白天小睡与PAD之间呈正相关（HR 1.32，95%CI 1.18 - 1.49）。MR分析支持睡眠时间与PAD之间呈负相关[每增加一小时优势比（OR）：0.79，95%CI，0.55，0.89]，以及短睡眠时间与PAD增加之间的关联（OR 1.20，95%CI，1.04 - 1.38）。
睡眠时间短与PAD风险增加有关。
