Chen Meijie, Ma Xiaotong, Xue Yuan, Wang Xiang, Zhao Yuanyuan, Yan Peng, Liu Xiaohui, Du Yifeng, Qiu Chengxuan, Sun Qinjian
Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong P. R. China.
Aging Research Center, Department of Neurobiology Care Sciences and Society, Karolinska Institutet-Stockholm University Stockholm Sweden.
J Am Heart Assoc. 2025 May 6;14(9):e039215. doi: 10.1161/JAHA.124.039215. Epub 2025 May 2.
Sleep is an important determinant of cardiovascular health. We sought to investigate the longitudinal association between sleep duration and incident carotid plaque in a rural Chinese population.
This population-based prospective cohort study included 1004 rural residents (age ≥40 years) who were free of carotid plaque and had no history of clinical stroke and transient ischemic attack at baseline (2017). Incident carotid plaques were detected by carotid ultrasound images at follow-up (2021). Multivariable Cox regression was used to associate sleep duration with the presence and severity of incident carotid plaques. Restricted cubic splines analyses were conducted to assess dose-response association between sleep duration and incident carotid plaques.
During the mean follow-up of 3.95 (SD=0.14) years, 214 (21.3%) of the 1004 participants were found to have incident carotid plaques. A short sleep duration (<7 versus 7-9 hours) was associated with multivariable-adjusted hazard ratio (95% CI) of 1.58 (1.10-2.28) for carotid plaques, 2.96 (1.38-6.36) for greater carotid plaque thickness, and 2.57 (1.33-4.97) for multiple carotid plaques; those associations remained significant in participants with low-to-intermediate traditional cardiovascular disease risk. Long sleep duration (>9 versus 7-9 hours) was not significantly associated with carotid plaques. Restricted cubic splines supported the association of short, but not long, sleep duration with increased risk of incident carotid plaques.
A short sleep duration is a risk factor for carotid plaques, even among individuals with low-to-intermediate cardiovascular disease risk. This suggests that short sleep duration may be a potential target for early interventions to delay carotid atherosclerosis.
URL: https://www.chictr.org.cn; Unique Identifier: ChiCTR1800017197.
睡眠是心血管健康的重要决定因素。我们试图在中国农村人群中研究睡眠时间与颈动脉斑块发生之间的纵向关联。
这项基于人群的前瞻性队列研究纳入了1004名农村居民（年龄≥40岁），他们在基线时（2017年）无颈动脉斑块，且无临床中风和短暂性脑缺血发作病史。随访时（2021年）通过颈动脉超声图像检测新发颈动脉斑块。采用多变量Cox回归分析睡眠时间与新发颈动脉斑块的存在及严重程度之间的关联。进行受限立方样条分析以评估睡眠时间与新发颈动脉斑块之间的剂量反应关系。
在平均3.95（标准差=0.14）年的随访期间，1004名参与者中有214名（21.3%）被发现有新发颈动脉斑块。睡眠时间短（<7小时与7-9小时相比）与多变量调整后的颈动脉斑块风险比（95%置信区间）为1.58（1.10-2.28）、颈动脉斑块厚度增加的风险比为2.96（1.38-6.36）以及多发颈动脉斑块的风险比为2.57（1.33-4.97）相关；在传统心血管疾病风险低至中等的参与者中，这些关联仍然显著。睡眠时间长（>9小时与7-9小时相比）与颈动脉斑块无显著关联。受限立方样条分析支持睡眠时间短而非长与新发颈动脉斑块风险增加之间的关联。
即使在心血管疾病风险低至中等的个体中，睡眠时间短也是颈动脉斑块的一个危险因素。这表明睡眠时间短可能是延迟颈动脉粥样硬化早期干预的一个潜在靶点。
