Al-Shoaibi Abubakr A, Helmer Christiane K, Shim Joan, Choi William, Dooley Erin E, Gooding Holly C, Pettee Gabriel Kelley, Baker Fiona C, Nagata Jason M
Department of Pediatrics, University of California, San Francisco, California, USA.
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Child Obes. 2025 Jun 6. doi: 10.1089/chi.2025.0022.
We examined the independent and joint prospective associations of screen time, sleep disturbance, and sleep duration with body mass index (BMI) and waist circumference (WC) stratified by sex. Data are from 7445 participants (47.3% females) aged 9-10 years at baseline (2016-2018) in the Adolescent Brain Cognitive Development Study. Missing data were imputed, and weighted multivariable linear regression models estimated the independent and joint effects of screen time and sleep disturbance or sleep duration on BMI and WC after 2 years. Joint associations grouped participants by combinations of screen time and sleep, with low screen time and sufficient sleep or no sleep disturbance as the reference groups. Screen time was significantly associated with higher BMI (B = 0.32; 95% CI: 0.19, 0.45; < 0.001) and WC (B = 0.40; 95% CI: 0.23, 0.56; < 0.001). Sleep disturbance was associated with higher BMI (B = 1.23; 95% CI: 0.14, 2.33; 0.026) in males. Insufficient sleep (<9 hours) (B = 1.30; 95% CI: 0.53, 2.07; < 0.001) was associated with higher BMI. Medium screen time without sleep disturbance or insufficient sleep, and medium and high screen time with either sleep problem were associated with higher BMI and WC. Low screen time with insufficient sleep and high screen time with sufficient sleep were associated with higher BMI. Associations were generally stronger among males, particularly with high screen time. Screen time and insufficient sleep were independently and jointly associated with higher BMI and WC 2 years later, especially when both were present.
我们研究了按性别分层的屏幕使用时间、睡眠障碍和睡眠时间与体重指数（BMI）和腰围（WC）之间的独立和联合前瞻性关联。数据来自青少年大脑认知发展研究中7445名基线（2016 - 2018年）年龄为9 - 10岁的参与者（47.3%为女性）。对缺失数据进行了插补，加权多变量线性回归模型估计了2年后屏幕使用时间和睡眠障碍或睡眠时间对BMI和WC的独立和联合影响。联合关联按屏幕使用时间和睡眠的组合对参与者进行分组，以低屏幕使用时间和充足睡眠或无睡眠障碍作为参照组。屏幕使用时间与较高的BMI（B = 0.32；95%置信区间：0.19，0.45；P < 0.001）和WC（B = 0.40；95%置信区间：0.23，0.56；P < 0.001）显著相关。男性的睡眠障碍与较高的BMI相关（B = 1.23；95%置信区间：0.14，2.33；P = 0.026）。睡眠不足（<9小时）（B = 1.30；95%置信区间：0.53，2.07；P < 0.001）与较高的BMI相关。无睡眠障碍或睡眠不足的中等屏幕使用时间，以及存在睡眠问题的中等和高屏幕使用时间与较高的BMI和WC相关。睡眠不足的低屏幕使用时间和睡眠充足的高屏幕使用时间与较高的BMI相关。这些关联在男性中通常更强，尤其是高屏幕使用时间的情况。屏幕使用时间和睡眠不足在2年后分别与较高的BMI和WC独立且联合相关，尤其是两者都存在时。
