Damay Vito A, Ivan Ignatius, Islami Nadhira A, Rubismo Kenza Y
Department of Cardiovascular Medicine, Universitas Pelita Harapan, Banten, Indonesia.
Resident Medical Officer, Mochtar Riady Comprehensive Cancer Center (MRCCC) Siloam Hospital Semanggi, Jakarta, Indonesia.
Narra J. 2025 Aug;5(2):e2003. doi: 10.52225/narra.v5i2.2003. Epub 2025 Apr 21.
Obesity and excessive daytime sleepiness (EDS) are known contributors to cardiovascular risk through their impact on endothelial function. Healthcare workers, frequently exposed to shift work, are particularly vulnerable to these risk factors. The aim of this study was to assess the relationship between anthropometric adiposity measures and EDS with endothelial function, measured via flow-mediated dilation (FMD), in healthcare workers. This cross-sectional study included 82 healthcare workers aged 20-50 years without pre-existing cardiovascular conditions. Anthropometric measures such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were collected to assess adiposity. EDS was evaluated using the Epworth sleepiness scale (ESS), with a score ≥10 indicating EDS. Endothelial function was measured via FMD, with values <7.1% indicating dysfunction. Multivariate logistic regression was used to identify predictors of endothelial dysfunction, adjusting for confounders such as age and sex. Collinearity diagnostics, including the Belsley-Kuh-Welsch method, were applied to confirm multicollinearity and refine the regression model. Overweight and obesity, high-risk WC, and increased risk WHtR were associated with endothelial dysfunction (<0.001), with WHtR showing an independent association (adjusted odds ratio (AOR): 8.48; 95%CI: 2.58-27.86; <0.001). EDS also showed a significant independent association with impaired FMD outcomes (AOR: 3.73; 95%CI: 1.23-11.26; =0.020). Pearson correlation analysis revealed significant negative correlations between BMI (=-0.483, <0.001), WC (=-0.473, <0.001), and WHtR (=-0.432, <0.001) with FMD, indicating that higher adiposity levels were linked to poorer endothelial function. Obesity and poor sleep quality, even in the absence of cardiovascular disease, are associated with an increased risk of endothelial dysfunction in healthcare workers. Early intervention focusing on weight management and improving sleep quality could mitigate future cardiovascular risks in this population.
肥胖和日间过度嗜睡（EDS）通过对内皮功能的影响，是已知的心血管风险因素。经常从事轮班工作的医护人员尤其容易受到这些风险因素的影响。本研究的目的是评估医护人员中人体测量肥胖指标和EDS与通过血流介导的血管舒张（FMD）测量的内皮功能之间的关系。这项横断面研究纳入了82名年龄在20至50岁之间、无心血管疾病史的医护人员。收集了体重指数（BMI）、腰围（WC）和腰高比（WHtR）等人体测量指标以评估肥胖程度。使用爱泼华嗜睡量表（ESS）评估EDS，得分≥10表明存在EDS。通过FMD测量内皮功能，值<7.1%表明功能障碍。采用多因素逻辑回归来确定内皮功能障碍的预测因素，并对年龄和性别等混杂因素进行校正。应用包括Belsley-Kuh-Welsch方法在内的共线性诊断来确认共线性并完善回归模型。超重和肥胖、高风险WC以及增加风险的WHtR与内皮功能障碍相关（<0.001），其中WHtR显示出独立关联（调整后的优势比（AOR）：8.48；95%置信区间：2.58 - 27.86；<0.001）。EDS也与FMD结果受损显示出显著的独立关联（AOR：3.73；95%置信区间：1.23 - 11.26；=0.020）。Pearson相关性分析显示BMI（=-0.483，<0.001）、WC（=-0.473，<0.001）和WHtR（=-0.432，<0.001）与FMD之间存在显著负相关，表明较高的肥胖水平与较差的内皮功能相关。肥胖和睡眠质量差，即使在没有心血管疾病的情况下，也与医护人员内皮功能障碍风险增加有关。专注于体重管理和改善睡眠质量的早期干预可以减轻该人群未来的心血管风险。
