Li Yuqian, Sun Feifei, Ji Chao, Yang Honghao, Ma Zheng, Zhao Yuhong, Zhao Zhiying, Xia Yang
Department of Clinical Epidemiology, Shengjing Hospital of China Mdical University, Shenyang, China.
Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China.
Am J Hematol. 2025 Apr;100(4):616-625. doi: 10.1002/ajh.27620. Epub 2025 Jan 30.
Previous research indicates an association between sleep traits and venous thromboembolism (VTE) risk, though causal relationships remain uncertain. This study evaluated combined and independent associations between sleep traits and VTE risk using UK Biobank data and explored the causal associations between sleep traits and VTE through two-sample Mendelian randomization (MR) analyses. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations between the healthy sleep score, as well as individual sleep traits (including sleep duration, insomnia, daytime sleepiness, snoring, and chronotype), and VTE risk were calculated using Cox proportional hazards regression models. Additionally, the two-sample MR analyses used the inverse-variance weighted method to determine odds ratios (ORs) and 95% CIs for causal associations. In the cohort analysis, 314 077 VTE-free participants were followed for a median of 12.3 years, during which 7176 VTE cases occurred. In comparison to those with a sleep score of 0-1, participants with a score of 5 were associated with a 30% lower risk of VTE (HR: 0.70; 95% CI: 0.61-0.80). A U-shaped association was noted between sleep duration and VTE risk. Both short (≤ 6 h) and long (≥ 9 h) sleep durations increased VTE risk. Excessive daytime sleepiness, snoring, and evening chronotype also elevated VTE risk. MR analyses supported a causal relationship for short sleep duration (OR: 1.24; 95% CI: 1.04-1.47) with VTE risk, while other sleep traits showed no causal association. These findings underscore the importance of optimal sleep in reducing VTE risk.
先前的研究表明睡眠特征与静脉血栓栓塞(VTE)风险之间存在关联,尽管因果关系仍不确定。本研究使用英国生物银行的数据评估了睡眠特征与VTE风险之间的综合和独立关联,并通过两样本孟德尔随机化(MR)分析探索了睡眠特征与VTE之间的因果关联。使用Cox比例风险回归模型计算健康睡眠评分以及个体睡眠特征(包括睡眠时间、失眠、日间嗜睡、打鼾和昼夜节律类型)与VTE风险之间关联的风险比(HRs)和95%置信区间(95% CIs)。此外,两样本MR分析使用逆方差加权法确定因果关联的优势比(ORs)和95% CIs。在队列分析中,对314077名无VTE的参与者进行了中位数为12.3年的随访,在此期间发生了7176例VTE病例。与睡眠评分为0 - 1的参与者相比,评分为5的参与者VTE风险降低30%(HR:0.70;95% CI:0.61 - 0.80)。睡眠时间与VTE风险之间呈现U形关联。短睡眠时间(≤6小时)和长睡眠时间(≥9小时)均增加VTE风险。日间过度嗜睡、打鼾和晚睡型昼夜节律也会增加VTE风险。MR分析支持短睡眠时间与VTE风险之间存在因果关系(OR:1.24;95% CI:1.04 - 1.47),而其他睡眠特征未显示出因果关联。这些发现强调了最佳睡眠对降低VTE风险的重要性。