Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Sleep Med. 2023 Oct;110:123-131. doi: 10.1016/j.sleep.2023.07.031. Epub 2023 Jul 28.
This paper utilized a person-centered approach to examine whether sleep patterns on school and free days are associated with obesity risk in preschool children aged 3-6 years.
The cross-sectional analysis included 204 children from the Wuhan Healthy Start Project with valid sleep data in at least four consecutive days gathered via Actigraph GT3X+. Based on three domains of sleep duration, sleep onset, and sleep offset, we used latent profile analysis to identify distinct sleep patterns on school and free days separately. Additionally, we conducted latent transition analysis to explore the probabilities of sleep patterns transitions between school and free days. The multivariate logistic regression model investigated the associations of sleep patterns with overweight/obesity (OWO) (BMI ≥ age- and sex-specific 85th percentile) and abdominal obesity (AO) (WC ≥ age- and sex-specific 75th percentile).
Two sleep patterns were identified for school days: "EL-sc" (early-to-sleep/longer-duration) (n = 119; 58.3%) and "LS-sc" (late-to-sleep/shorter-duration) (n = 85; 41.7%). Similarly, "LES-fr" (late-to-sleep/early-to-wake/shorter-duration) (n = 118; 57.8%) and "ELL-fr" (early-to-sleep/late-to-wake/longer-duration) (n = 86; 42.2%) patterns were identified for free days. LTA categorized the participants into four distinct transition groups, i.e., "EL-sc→ELL-fr" (32.9%), "EL-sc→LES-fr" (24.0%), "LS-sc→LES-fr" (33.8%), and "LS-sc→ELL-fr" (9.3%). Compared with the "ELsc→ELL-fr", the "LS-sc→LES-fr" had a higher risk of OWO (AOR 4.76; 95% CI: 1.39-20.33) and AO (AOR, 2.78; 95% CI, 1.21-6.62), respectively. Neither "EL-sc→LES-fr" (AOR, 1.11; 95% CI, 0.14-6.67) nor "LS-sc→ELL-fr" (AOR, 0.74; 95% CI, 0.03-6.14) was significantly associated with OWO. Likewise, no significant association was observed for "EL-sc→LES-fr" (AOR, 0.96; 95% CI, 0.35-2.62) and "LS-sc→ELL-fr" (AOR, 0.56; 95% CI, 0.11-2.18) with AO.
"LS-sc→LES-fr" pattern is significantly associated with an increased risk of general and abdominal obesity, indicating its obesogenic nature. Furthermore, although not statistically associated with obesity outcomes, "LS-sc→ELL-fr" and "EL-sc→LES-fr" patterns exhibit a semi-obesogenic characteristic. In addition, we identified a concerning trend that preschool children are at risk of transitioning to and persisting in sleep patterns characterized by delayed and shorter sleep. These findings underscore the importance of implementing interventions and strategies to address sleep patterns as a crucial step to minimize the risk of obesity.
本文采用以个体为中心的方法，探讨学龄前儿童（3-6 岁）在上学日和休息日的睡眠模式是否与肥胖风险相关。
本横断面研究共纳入 204 名来自武汉健康启动项目的儿童，他们至少连续 4 天佩戴 Actigraph GT3X+记录了有效的睡眠数据。根据睡眠持续时间、入睡时间和醒来时间三个领域，我们使用潜在剖面分析分别识别出上学日和休息日的不同睡眠模式。此外，我们进行了潜在转变分析，以探索睡眠模式在上学日和休息日之间转变的概率。多变量逻辑回归模型调查了睡眠模式与超重/肥胖（BMI≥年龄和性别特定第 85 百分位）和腹型肥胖（WC≥年龄和性别特定第 75 百分位）之间的关联。
确定了两种上学日的睡眠模式：“EL-sc”（早睡/长时睡眠）（n=119；58.3%）和“LS-sc”（晚睡/短时间睡眠）（n=85；41.7%）。同样，“LES-fr”（晚睡/早醒/短时间睡眠）（n=118；57.8%）和“ELL-fr”（早睡/晚醒/长时睡眠）（n=86；42.2%）两种模式被确定为休息日的睡眠模式。LTA 将参与者分为四个不同的转变组，即“EL-sc→ELL-fr”（32.9%）、“EL-sc→LES-fr”（24.0%）、“LS-sc→LES-fr”（33.8%）和“LS-sc→ELL-fr”（9.3%）。与“EL-sc→ELL-fr”相比，“LS-sc→LES-fr”模式具有更高的超重/肥胖（OR 4.76；95%CI：1.39-20.33）和腹型肥胖（OR，2.78；95%CI，1.21-6.62）风险。“EL-sc→LES-fr”（OR，1.11；95%CI，0.14-6.67）和“LS-sc→ELL-fr”（OR，0.74；95%CI，0.03-6.14）均与超重/肥胖无关。同样，“EL-sc→LES-fr”（OR，0.96；95%CI，0.35-2.62）和“LS-sc→ELL-fr”（OR，0.56；95%CI，0.11-2.18）与腹型肥胖也没有显著关联。
“LS-sc→LES-fr”模式与一般和腹型肥胖风险显著相关，表明其具有致肥胖的性质。此外，尽管与肥胖结果没有统计学关联，但“LS-sc→ELL-fr”和“EL-sc→LES-fr”模式表现出半致肥胖的特征。此外，我们发现一个令人担忧的趋势，即学龄前儿童有风险转变并持续存在延迟和较短睡眠时间的睡眠模式。这些发现强调了实施干预和策略的重要性，以解决睡眠模式作为降低肥胖风险的关键步骤。
