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美国中老年人睡眠时间与骨关节炎的非线性关联。

Non-linear association of sleep duration with osteoarthritis among U.S. middle-aged and older adults.

作者信息

Ma Guoliang, Xu Bo, Wang Zhizhuang, Duan Weili, Chen Xin, Zhu Liguo, Yang Bowen, Zhang Dian, Qin Xiaokuan, Yin He, Wei Xu

机构信息

Wangjing Hospital, China Academy of Chinese Medical Sciences, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China.

Nanyang Hospital of Traditional Chinese Medicine (Dushan Campus), Henan , 473003, China.

出版信息

BMC Public Health. 2024 Dec 23;24(1):3565. doi: 10.1186/s12889-024-21140-1.

Abstract

BACKGROUND

The duration of sleep is linked to a range of disorders. Osteoarthritis (OA) stands as one of the most prevalent forms of arthritis and serves as a leading cause of disability. The correlation between the duration of sleep and OA remains ambiguous. Research indicates that waist circumference correlates with sleep duration and OA, respectively. This study aimed to investigate the association of sleep duration with OA and the mediated effect of waist circumference.

METHODS

The study sample comprised adults who were participants in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Insufficient sleep is characterized by a duration of less than seven hours, whereas 7-8 h is considered appropriate, and 9 h or more is categorized as a long sleep duration. Three models were employed in this study. Model 1 was not adjusted for any covariates, while Model 2 was adjusted for sex, age, and race. Model 3 has been adjusted to account for all covariates. Utilizing multivariable logistic regression, subgroup analysis, interaction tests and smoothing curve fitting, the correlation between sleep duration and OA was explored. The mediating effect of waist circumference on the association between sleep duration and OA was investigated through mediation analysis.

RESULTS

In this study, 9380 did not have OA, while 2424 were diagnosed with the ailment. After multivariable adjustment, the odds ratios (OR) for OA were 1.19 (95% CI 1.06, 1.34; P = 0.0026) for people with insufficient sleep duration and 1.18 (95% CI 1.03, 1.35 P = 0.0142) for participants with long sleep duration. Sleep duration and the incidence of OA were found to be related in a U-shaped manner. Additionally, 12.1% of the correlation between sleep duration and OA appeared to be mediated by waist circumference.

CONCLUSIONS

Increased OA was found to be correlated in a U-shaped manner with sleep duration in the middle-aged and elderly cohorts. Both insufficient and long sleep duration contribute to an elevated risk of developing OA. A potential mediating factor in the association between OA and sleep duration is waist circumference. Focus on sleep health and visceral obesity in middle-aged and older adults is necessary.

摘要

背景

睡眠时长与一系列疾病相关。骨关节炎(OA)是最常见的关节炎形式之一,也是导致残疾的主要原因。睡眠时长与OA之间的相关性仍不明确。研究表明,腰围分别与睡眠时长和OA相关。本研究旨在探讨睡眠时长与OA的关联以及腰围的中介作用。

方法

研究样本包括2011年至2018年参加美国国家健康与营养检查调查(NHANES)的成年人。睡眠不足的特征是时长少于7小时,而7 - 8小时被认为是合适的,9小时及以上则被归类为长睡眠时长。本研究采用了三种模型。模型1未对任何协变量进行调整,而模型2对性别、年龄和种族进行了调整。模型3已针对所有协变量进行了调整。利用多变量逻辑回归、亚组分析、交互检验和平滑曲线拟合,探讨了睡眠时长与OA之间的相关性。通过中介分析研究了腰围在睡眠时长与OA关联中的中介作用。

结果

在本研究中,9380人没有患OA,而2424人被诊断患有该疾病。经过多变量调整后,睡眠时长不足的人群患OA的优势比(OR)为1.19(95%可信区间1.06, 1.34;P = 0.0026),睡眠时长长于9小时的参与者患OA的优势比为1.18(95%可信区间1.03, 1.35;P = 0.0142)。发现睡眠时长与OA的发病率呈U形关系。此外,睡眠时长与OA之间12.1%的相关性似乎由腰围介导。

结论

在中老年人群中,OA发病率的增加与睡眠时长呈U形相关。睡眠不足和睡眠时长长均会增加患OA的风险。腰围是OA与睡眠时长关联中的一个潜在中介因素。关注中老年人群的睡眠健康和内脏肥胖是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b974/11665091/c3ac2da5b00b/12889_2024_21140_Fig1_HTML.jpg

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