广州地区健康体检人群睡眠模式及其与糖尿病关系的分析

Analysis of sleep patterns and their relationship with diabetes among adults under health examination in Guangzhou

目的了解广州地区成年人睡眠模式的特征,并探讨睡眠模式对糖尿病(diabetes mellitus, DM)患病的影响。方法回顾性分析2012年11月至2013年12月在广东省人民医院参加体检的5 666名广州市职工的生活方式调查和体检资料。采用潜在类别分析(latent class analysis, LCA)对人群睡眠的潜在模式及分布特征进行探索性分析,通过多因素Logistic回归模型分析睡眠模式与DM的关系。结果 LCA识别出5种睡眠模式,分别为"睡眠时间过短伴失眠"(类别1,5.6%)、"睡眠不足伴日间功能轻度减退"(类别2,20.4%)、"睡眠状况良好"(类别3,47.7%)、"睡眠不足伴日间功能障碍"(类别4,4.7%)、"睡眠不足伴夜间睡眠质量差"(类别5,21.6%)。调整相关混杂因素后,与类别3相比,类别1(OR=2.28, 95%CI:1.51～3.43,P<0.001)、类别4(OR=2.48, 95%CI:1.54～4.00,P<0.001)和类别5(OR=1.31, 95%CI:1.01～1.71,P=0.045)人群罹患DM的风险升高。结论成年人群的睡眠因素之间存在关联,并表现为不同的睡眠模式;不良睡眠模式可增加DM患病风险。

Objective To investigate the characteristics of sleep patterns and their effects on the risk of diabetes mellitus(DM)among adults in Guangzhou.Methods A retrospective study was conducted using data collected by the lifestyle survey and health outcomes of 5 666 employees from Guangzhou who underwent physical examination between November 2012 and October 2013 at Guangdong Provincial People’s Hospital.Sleep patterns and their distribution profiles were analysed using latent class analysis(LCA).Multiple logistic regression models were performed to investigate the association between sleep patterns and DM.Results LCA identified five sleep patterns:"very short sleep duration with insomnia"(class 1,5.6%),"sleep insufficiency with mild daytime dysfunction"(class 2,20.4%),"normal sleep"(class 3,47.7%),"sleep insufficiency with daytime functioning complaints"(class 4,4.7%)and "sleep insufficiency with poor nocturnal sleep"(class 5,21.6%).After adjustment for the confounding factors,subjects of class 1(OR=2.28,95% CI:1.51-3.43,<0.001),class 4(OR=2.48,95% CI:1.54-4.00,P<0.001)and class 5(OR=1.31,95% CI:1.01-1.71,P=0.045)had a higher risk of DM when compared with those of class 3.Conclusions There were significant associations between various sleep-related factors,leading to distinct sleep behavioral patterns among adults.Poor sleep patterns could increase the risk of DM.