National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Department of Nephrology, Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital at Central South University, Changsha, 410011, China.
Sci Rep. 2023 Jul 26;13(1):12124. doi: 10.1038/s41598-023-37883-7.
Daytime napping, a habit widely adopted globally, has an unclear association with obesity. In this study, we executed a meta-analysis to explore the relationship between daytime napping and obesity. We conducted a comprehensive search of the PubMed, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science databases for pertinent articles published up to April 2023. Random-effects models were utilized to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and we assessed the heterogeneity of the included studies using the I statistic. To explore potential sources of heterogeneity, subgroup analyses were performed. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS), and funnel plots were employed to detect any publication bias. Sensitivity analyses were conducted by sequentially omitting each study. We conducted a meta-analysis of twelve studies that included one each from the UK and Spain, five from the USA, and five from China, totalling 170,134 participants, to probe the association between napping and obesity. The pooled analysis suggested a higher risk of obesity in individuals who nap (OR: 1.22 [1.10-1.35], p < 0.001, I = 87%) compared to non-nappers. The meta-analysis results revealed variations in the summary ORs for studies conducted in China, Spain, the USA, and the UK. The ORs for China, Spain, the USA, and the UK were 1.05 (95% CI 0.90-1.23), 9.36 (95% CI 4.74-18.45), 1.27 (95% CI 1.10-1.47), and 1.39 (95% CI 1.32-1.47), respectively. A subgroup analysis based on age within the American population disclosed that napping in both adults and children heightened obesity incidence. A subgroup analysis based on nap duration found a significant rise in obesity occurrence when nap duration exceeded one hour, but no clear relationship emerged when nap duration was less than 1 h. In a subgroup analysis based on the definition of obesity, napping did not demonstrate a significant relationship with obesity when diagnostic criteria set obesity at a BMI of 25 or above. However, when the criteria were set at a BMI of 28 or 30 or more, napping significantly increased obesity risk. Our meta-analysis indicates a positive association between daytime napping and the risk of obesity. However, given the limited number of included studies, potential confounding factors might not have been fully addressed. Future well-designed prospective studies are required to further investigate this relationship. Large-scale studies are necessary to confirm our findings and elucidate the underlying mechanisms that drive these associations and causation.
日间小睡是一种在全球范围内广泛采用的习惯，但其与肥胖的关联尚不明确。本研究通过荟萃分析探讨了日间小睡与肥胖之间的关系。我们全面检索了 PubMed、Embase、Cochrane 图书馆、Scopus、PsycINFO 和 Web of Science 数据库，以获取截至 2023 年 4 月发表的相关文章。采用随机效应模型计算优势比（OR）及其 95%置信区间（CI），并使用 I ² 统计量评估纳入研究的异质性。为了探究潜在的异质性来源，我们进行了亚组分析。使用纽卡斯尔-渥太华量表（NOS）评估研究的方法学质量，并采用漏斗图检测任何发表偏倚。通过依次剔除每项研究进行敏感性分析。我们对 12 项研究进行了荟萃分析，其中 1 项来自英国，1 项来自西班牙，5 项来自美国，5 项来自中国，共纳入 170134 名参与者，以探究小睡与肥胖之间的关联。汇总分析表明，与非小睡者相比，小睡者肥胖的风险更高（OR：1.22 [1.10-1.35]，p<0.001，I=87%）。荟萃分析结果显示，在中国、西班牙、美国和英国进行的研究中，汇总 OR 存在差异。中国、西班牙、美国和英国的 OR 分别为 1.05（95%CI 0.90-1.23）、9.36（95%CI 4.74-18.45）、1.27（95%CI 1.10-1.47）和 1.39（95%CI 1.32-1.47）。基于美国人群的年龄进行的亚组分析显示，成年人和儿童的小睡均会增加肥胖的发生率。基于小睡持续时间的亚组分析发现，当小睡持续时间超过 1 小时时，肥胖发生率显著增加，但当小睡持续时间小于 1 小时时，没有明显的相关性。基于肥胖定义的亚组分析显示，当诊断标准将 BMI 设定为 25 或以上时，小睡与肥胖无显著相关性。然而，当标准设定为 BMI 为 28 或 30 或更高时，小睡显著增加肥胖风险。本荟萃分析表明，日间小睡与肥胖风险之间存在正相关关系。然而，由于纳入研究的数量有限，可能未充分考虑到潜在的混杂因素。需要进一步进行设计良好的前瞻性研究来探讨这种关系。需要开展大规模研究来验证我们的发现，并阐明驱动这些关联和因果关系的潜在机制。
