Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, Munich, Germany.
Obesity (Silver Spring). 2024 Jan;32(1):200-213. doi: 10.1002/oby.23918. Epub 2023 Oct 24.
This study aimed to identify sleep clusters based on objective multidimensional sleep characteristics and test their associations with adolescent cardiometabolic health.
The authors included 1090 participants aged 14.3 to 16.4 years (mean = 15.2 years) who wore 7-day accelerometers during the 15-year follow-up of the German Infant Study on the influence of Nutrition Intervention PLUS environmental and genetic influences on allergy development (GINIplus) and the Influence of Lifestyle factors on the development of the Immune System and Allergies in East and West Germany (LISA) birth cohorts. K-means cluster analysis was performed across 12 sleep characteristics reflecting sleep quantity, quality, schedule, variability, and regularity. Cardiometabolic risk factors included fat mass index (FMI), blood pressure, triglycerides, high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and insulin resistance (n = 505). Linear and logistic regression models were examined.
Five sleep clusters were identified: good sleep (n = 337); delayed sleep phase (n = 244); sleep irregularity and variability (n = 108); fragmented sleep (n = 313); and prolonged sleep latency (n = 88). The "prolonged sleep latency" cluster was associated with increased sex-scaled FMI (β = 0.39, 95% CI: 0.15-0.62) compared with the "good sleep" cluster. The "sleep irregularity and variability" cluster was associated with increased odds of high triglycerides only in male individuals (odds ratio: 9.50, 95% CI: 3.22-28.07), but this finding was not confirmed in linear models.
The prolonged sleep latency cluster was associated with higher FMI in adolescents, whereas the sleep irregularity and variability cluster was specifically linked to elevated triglycerides (≥1.7 mmol/L) in male individuals.
本研究旨在根据多维客观睡眠特征识别睡眠簇，并检验其与青少年心血管代谢健康的关联。
作者纳入了在德国婴儿研究营养干预的影响 PLUS 环境和遗传因素对过敏发展的影响（GINIplus）和生活方式因素对免疫和过敏在东西德的发展的影响（LISA）出生队列的 15 年随访期间佩戴 7 天加速度计的 1090 名 14.3 至 16.4 岁（平均 15.2 岁）的参与者。通过跨 12 项睡眠特征进行 K-均值聚类分析，这些特征反映了睡眠量、质量、时间安排、变异性和规律性。心血管代谢危险因素包括脂肪质量指数（FMI）、血压、甘油三酯、高密度脂蛋白胆固醇、高敏 C 反应蛋白和胰岛素抵抗（n=505）。线性和逻辑回归模型进行了检验。
确定了五个睡眠簇：良好睡眠（n=337）；延迟睡眠阶段（n=244）；睡眠不规则和变异性（n=108）；碎片化睡眠（n=313）；和延长的睡眠潜伏期（n=88）。与“良好睡眠”簇相比，“延长的睡眠潜伏期”簇与增加的性别比例 FMI 相关（β=0.39，95%CI：0.15-0.62）。仅在男性中，“睡眠不规则和变异性”簇与高甘油三酯的几率增加相关（比值比：9.50，95%CI：3.22-28.07），但在线性模型中未得到证实。
延长的睡眠潜伏期簇与青少年的 FMI 升高有关，而睡眠不规则和变异性簇与男性个体的甘油三酯升高（≥1.7mmol/L）特别相关。
