上海市中老年人群睡眠质量和睡眠时间与2型糖尿病患病关系研究

Relationship between both quality and duration of sleep and type 2 diabetes in middle-aged and elderly people in Shanghai

目的分析睡眠质量和睡眠时间与上海市中老年人群2型糖尿病患病之间的关系。方法利用2017年上海市社区≥35岁居民2型糖尿病流行病学调查数据,采用限制性立方样条曲线绘制PSQI得分和睡眠时间与2型糖尿病关系的剂量-反应曲线,采用logistic回归模型分析睡眠质量、睡眠时间对2型糖尿病患病的影响,并对睡眠质量和睡眠时间与2型糖尿病患病风险的交互作用进行分析。结果上海市中老年人PSQI分数为(4.09±0.10)分,睡眠质量差的比例为12.55%(95%CI:10.77~14.58),睡眠时间为(7.19±0.03)h。PSQI得分与糖尿病患病呈线性关系,睡眠时间与糖尿病患病呈近似"U"形关系。多因素调整后,睡眠质量差(PSQI得分>7分)和睡眠时间过短(睡眠时间<6 h)能显著增加2型糖尿病的患病风险,OR值分别为1.17(95%CI:1.06~1.30)和1.20(95%CI:1.01~1.41)。进一步分层分析结果显示,仅睡眠时间<6 h且睡眠质量差和睡眠时间≥8 h且睡眠质量差者糖尿病患病风险增加,OR值分别为1.30(95%CI:1.12~1.52)和1.79(95%CI:1.04~3.07)。结论睡眠质量差和睡眠时间过短与糖尿病患病风险密切相关,而睡眠过长只有在伴随睡眠质量差的情况下与糖尿病患病风险相关。

Objective To analyze the relationship between both quality and duration of sleep and type 2 diabetes in middle-aged and elderly people in Shanghai.Method Baseline data was from the'2017 epidemiological survey in Shanghai community residents aged 35 and above on type 2 diabetes’.Restricted cubic splines were used to draw dose-response curves to show the relationship between PSQI score,sleep duration and type 2 diabetes.Logistic regression model was used to analyze the effects of quality and duration of sleep as well as the interaction,on type 2 diabetes.Results Results showed that the average PSQI score was(4.09±0.10)points,the proportion of poor sleep quality was 12.55%(95%CI:10.77-14.58)and the average sleep duration was(7.19±0.03)hours.The relationship between PSQI score and diabetes appeared linear,with the relationship between sleep duration and diabetes as U-shaped.After adjusting for confounders,both poor sleep quality(>7 for PSQI score)and short sleep duration(sleep duration<6 hours)significantly increased the risk of type 2 diabetes,with OR=1.17(95%CI:1.06-1.30)and 1.20(95%CI:1.01-1.41),respectively.From the interaction analysis,data showed that after adjusting for confounders,both sleep duration<6 hours(OR=1.30,95%CI:1.12-1.52)and≥8 hours(OR=1.79,95%CI:1.04-3.07)with poor sleep quality would increase the risks on diabetes.Conclusion Both poor sleep quality and short sleep duration were associated with the risk of diabetes,while long sleep duration was only associated with the risk of diabetes when accompanied by poor quality of sleep.