新发男性2型糖尿病与睡眠行为的关系研究

Association between New-onset Type 2 Diabetes Mellitus and Sleep Behaviors in Male Patients

目的采用国际匹兹堡睡眠质量量表(PSQI)和自行设计的一般状况调查表对首次确诊的男性2型糖尿病(T2DM)患者进行调查,探讨男性T2DM与睡眠相关行为的关系。方法采用1∶1匹配的病例对照研究,病例组为>40岁的男性T2DM患者,对照组为>40岁非T2DM的男性患者,共156对。采用t检验及多元条件Logistic回归模型对睡眠质量及相关睡眠行为(午睡情况、晚睡情况、打鼾情况、入睡困难情况、夜间睡眠充足与否及睡眠质量)与男性T2DM间关系进行分析。结果病例组与对照组主观睡眠质量、睡眠潜伏期、睡眠持续时间、习惯性睡眠效率、睡眠紊乱、白天功能紊乱6个因子分值及PSQI总分与对照组比较,差异均有统计学意义(P<0.01)。最终进入多元条件Logistic回归模型的睡眠相关行为因子为午睡情况、晚睡情况、打鼾情况、入睡困难情况、夜间睡眠充足与否及总体睡眠质量(PSQI测评总分)等,与男性T2DM发病存在关联。结论晚睡、打鼾、入睡困难、夜间睡眠不足、睡眠质量差等因素可能为男性T2DM发病的危险因素,适当午睡可能是男性T2DM发病的保护性因素。

Objective To explore the association between sleep behaviors and new -onset type 2 diabetes mellitus （T2DM） in male patients. Methods In this case - control study, 156 pairs of T2DM patients and controls （ without T2DM）aged 〉40 years were enrolled. The sleep quality was assessed using Pittsburgh Sleep Quality Index （PSQI） and self- designed general condition questionnaire. Correlations of sleep quality and relevant sleep behaviors （ nap, late bedtime, snoring, sleep- ing difficulty, lack of sleep at night, and poor sleep quality） with T2DM were analyzed by t test and multivariate conditional lo-gistic regression analysis. Results The subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disorder, 6 items concerning daytime dysfunction, and total PSQI score were significantly different between the case groupand control group （P 〈0. 01 ）. Multivariate conditional logistic regression analysis showed nap, late bedtime, snoring, sleeping difficulty, lack of sleep at night, and poor sleep quality were significantly correlated with T2DM. Conclusion Late bedtime, snoring, sleeping difficulty, lack of sleep at night, and poor sleep quality are risk factors of T2DM in males, whereas moderatenap may be protective for T2DM.