睡眠障碍与社区居民骨密度的相关性研究

Relationship between Sleep Disorders and Bone Mineral Density in Urban Community-dwelling Residents

背景睡眠是维护和促进身体健康的重要生理活动,占据人类生命近1/3的时间。近年国内外研究发现,睡眠障碍与骨质疏松症的发生有关,睡眠不足或睡眠过多均可造成骨密度降低,增加骨质疏松症的发病风险。因此,探究睡眠质量与骨密度的关系,可能有助于拓宽骨质疏松防治策略制订的思路。目的探讨城市社区居民睡眠障碍与骨密度的关系。方法选取2015年9月—2019年4月在西南大学医院健康管理中心完成桡骨远端骨密度检测以及综合健康测评问卷的汉族成年人10818例。采用双能X线检测法(DXA)测定骨密度,根据T值判定骨量减少、骨质疏松症并计算其检出率。采用匹兹堡睡眠质量指数(PSQI)评定睡眠质量。结果研究对象PSQI评分为(12.9±1.7)分,其中轻度睡眠障碍5033例(46.53%),中度睡眠障碍4133例(38.20%),重度睡眠障碍1652例(15.27%);骨量减少3652例(33.76%),骨质疏松症1604例(14.83%)。随着睡眠障碍程度的加重,无论是男性还是女性,其骨量异常的检出率逐渐上升(男性:χ^2趋势=7.236,P<0.010;女性:χ^2趋势=8.117,P<0.005)。20~29岁、30~39岁、40~49岁、50~59岁、≥60岁者,无论是男性还是女性,随着睡眠障碍程度加重,骨量异常检出率逐渐上升(男性:χ^2趋势=10.268,P=0.001;χ^2趋势=7.879,P=0.005;χ^2趋势=54.844,P<0.001;χ^2趋势=75.715,P<0.001;χ^2趋势=105.443,P<0.001;女性:χ^2趋势=10.642,P=0.001;χ^2趋势=17.585,P<0.001;χ^2趋势=208.814,P<0.001;χ^2趋势=186.930,P<0.001;χ^2趋势=157.582,P<0.001)。结论随着睡眠障碍程度加重,社区居民骨量流失逐渐严重,改善睡眠质量可能降低骨质疏松症及骨质疏松相关性骨折的群体患病风险。

Background Sleep,taking up nearly one third of the life of human beings,is an extremely important physiological activity to maintain and improve health.Recently,domestic and foreign studies have shown that sleep disturbances are associated with the occurrence of osteoporosis.Getting too little or too much sleep may lead to decreased bone mineral density(BMD)and increased risk of osteoporosis.Therefore,exploring the relationship between sleep quality and BMD may be a help to broaden the ways of thinking about preventive and therapeutic strategies of osteoporosis.Objective To explore the effects of sleep disorders on BMD in urban community-dwelling residents.Methods Participants were 10818 Han adults who measured the BMD at the distal radius using the dual-energy X-ray absorptiometry(DXA)and completed the self-developed General Health Assessment Questionnaire in Health Management Center,Southwest University from September 2015 to April 2019.Osteopenia and osteorosis were determined according to T-score and the detection rates were calculated respectively.The Pittsburgh Sleep Quality Index(PSQI)was used to measure sleep quality.Results The average PSQI score for the participants was(12.9±1.7).5033(46.53%)were found with mild sleep disorder,4133(38.20%)with moderate sleep disorder,and 1652(15.27%)with severe sleep disorder.3652(33.76%)were detected with osteopenia,and 1604(14.83%)with osteoporosis.As sleep disorder deteriorated,the detection rates of osteopenia and osteoporosis showed a gradual increase regardless of gender(male:χ^2 trend=7.236,P<0.010;female:χ^2 trend=8.117,P<0.005).Moreover,the detection rates of osteopenia and osteoporosis increased along with sleep disorder deteriorated across age groups 20-29,30-39,40-49,50-59,and≥60 of both men(χ^2 trend=10.268,P=0.001;χ^2 trend=7.879,P=0.005;χ^2 trend=54.844,P<0.001;χ^2 trend=75.715,P<0.001;χ^2 trend=105.443,P<0.001)and women(χ^2 trend=10.642,P=0.001;χ^2 trend=17.585,P<0.001;χ^2 trend=208.814,P<0.001;χ^2 trend=186.930,P<0.001;χ^2 trend=157.582,P<0.001).Conclusion With escalating severity of sleep disturbances,there is an increased BMD loss in urban community-dwelling residents.Improving sleep quality may help to reduce the prevailing risk of osteoporosis and osteoporosis-related fractures.