Lin Xia, Lv Jiali, Zhang Shuai, Ma Xiaoyan, Zhang Xiaofeng, Wang Cheng, Zhang Tao
Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250002, China.
Nutrients. 2024 Dec 8;16(23):4238. doi: 10.3390/nu16234238.
This study aimed to assess the impact of modifiable lifestyle behaviors on the association between sleep patterns and chronic kidney disease (CKD) risk.
This study included 294,215 UK Biobank participants initially without CKD, followed until 13 October 2023. Sleep patterns were derived from five sleep factors, including sleep duration, chronotype, insomnia, snoring, and daytime dozing. The healthy lifestyle score (HLS) was newly calculated based on smoking status, physical activity, diet, body mass index, and mental health. Cox's proportional hazards models were used to assess the associations between sleep patterns, HLS, and CKD risk.
A total of 17,357 incident CKD cases were identified during a median follow-up of 14.5 (interquartile range: 13.7-15.3) years. Both sleep patterns and HLS were independently associated with increased CKD risk (-trend < 0.001). Importantly, the HLS was found to modify the association between sleep patterns and CKD risk (-interaction = 0.026). Among participants with a low HLS, medium (HR = 1.12; 95% CI 1.05-1.19) and poor sleep patterns (HR = 1.23; 95% CI 1.17-1.30) increased CKD risk to varying degrees, whereas no significant association was observed for a high HLS. Moreover, the combination of a low HLS and poor sleep pattern significantly increased the risk of incident CKD (HR = 2.19; 95% CI 2.00-2.40).
A high HLS may significantly reduce CKD risk associated with poor sleep, whereas a low HLS may exacerbate this risk. These findings underscore the critical importance of lifestyle interventions as a primary prevention strategy for CKD.
本研究旨在评估可改变的生活方式行为对睡眠模式与慢性肾脏病（CKD）风险之间关联的影响。
本研究纳入了294,215名最初无CKD的英国生物银行参与者，随访至2023年10月13日。睡眠模式由五个睡眠因素得出，包括睡眠时间、昼夜节律类型、失眠、打鼾和日间嗜睡。基于吸烟状况、身体活动、饮食、体重指数和心理健康新计算了健康生活方式评分（HLS）。采用Cox比例风险模型评估睡眠模式、HLS与CKD风险之间的关联。
在中位随访14.5年（四分位间距：13.7 - 15.3年）期间，共识别出17,357例CKD新发病例。睡眠模式和HLS均与CKD风险增加独立相关（-趋势<0.001）。重要的是，发现HLS可改变睡眠模式与CKD风险之间的关联（-交互作用=0.026）。在HLS低的参与者中，中等（风险比[HR]=1.12；95%置信区间[CI] 1.05 - 1.19）和差的睡眠模式（HR = 1.23；95% CI 1.17 - 1.30）会不同程度增加CKD风险，而HLS高时未观察到显著关联。此外，HLS低与睡眠模式差的组合显著增加了CKD新发病例的风险（HR = 2.19；95% CI 2.00 - 2.40）。
高HLS可能显著降低与睡眠差相关的CKD风险，而低HLS可能会加剧这种风险。这些发现强调了生活方式干预作为CKD一级预防策略至关重要性。
