克拉玛依石油工人睡眠障碍与高血压的关系

Relationship between sleep disorders and hypertension in oil workers in Karamay City

目的探讨石油工人睡眠障碍对高血压的影响及其中介效应分析。方法于2019年6—9月,采用二阶段随机整群抽样法,抽取克拉玛依市6所油田基地的1420名20~60岁(男性745名,女性675名;<30岁384名,30~45岁563名,>45岁473名)石油工人。通过基本情况问卷调查石油工人的性别、年龄、民族、个人月收入、文化程度、职称、吸烟、饮酒、身高、体重、倒班情况等信息,用匹兹堡睡眠指数量表评估睡眠状况,Logistic回归模型分析高血压的影响因素,用Process 3.3程序进行中介效应模型检验。结果 (1)睡眠障碍检出率为52.5%,高血压患病率为16.3%,其中女性21.6%(161人)高于男性10.5%(71人)(χ^(2)=31.877,P<0.001);随着年龄及体质指数增加,高血压患病率增加(χ^(2)=25.117,P<0.001);睡眠障碍组20.1%(149人)高于非睡眠障碍组12.2%(83人)(χ^(2)=16.113,P<0.001)。(2)调整了性别、年龄、民族、文化程度、个人月收入、吸烟、饮酒、倒班及体质指数后,睡眠障碍(OR=1.686,95%CI 1.232~2.308)、性别(OR=1.565,95%CI 1.035~2.367)、年龄(OR30~45=1.710,95%CI 1.085~2.697;OR>45=1.717,95%CI 1.055~2.797)、倒班(OR=2.698,95%CI 1.889~3.855)、体质指数(OR24.0~27.9=2.557,95%CI 1.736~3.765;OR≥28.0=4.001,95%CI 2.553~6.318)均增加高血压的患病风险。(3)分层分析结果显示,随着年龄(OR30~45=1.642,95%CI 1.019~2.645;OR>45=1.998,95%CI 1.223~3.263)及体质指数(OR24.0~27.9=1.652,95%CI 1.079~2.528;OR≥28.0=2.259,95%CI 1.165~4.381)增加,睡眠障碍引起高血压的患病风险增加;倒班组睡眠障碍(OR=2.002,95%CI 1.336~2.936)也是高血压的危险因素。(4)中介效应检验结果显示,睡眠障碍在年龄(β=0.240,Z=2.239)、倒班(β=0.656,Z=3.999)以及体质指数(β=0.516,Z=7.258)和高血压间存在中介效应(P<0.05)。结论睡眠障碍是影响克拉玛依石油工人患高血压的危险因素,且在年龄、倒班以及体质指数和高血压间存在中介效应。

OBJECTIVE To investigate the effect of sleep disorders on hypertension in oil workers and its mediating effect analysis. METHODS Between June and September 2019, 1420 workers aged 20-60 years(745 males and 675 females;384 aged 30 years, 563 aged 30-45 years and 473 aged 45 years) from six oilfield bases in Karamay City, Xinjiang Uygur Autonomous Region were surveyed using a two-stage randomized whole-group sampling method. Their current conditions, and the information on gender, age, ethnicity, personal monthly income, education level, job title, smoking, alcohol consumption, height, weight, and shift work of the oil workers were investigated by the basic questionnaire. The Pittsburgh Sleep Index was used to assess the sleep status, and the Logistic regression model was used to analyze the influencing factors of hypertension, and the Process program(version 3.3) was used to conduct the mediating effect model test. RESULTS(1) The detection rate of sleep disorders was 52.5% and the prevalence of hypertension was 16.3%, with 21.6%(161) higher in women than 10.5%(71) in men(χ^(2)=31.877, P<0.001). The prevalence of hypertension increased with increasing age and body mass index(BMI)(χ^(2)=25.117, P<0.001), 20.1%(149) in the sleep disorder group were higher than 12.2%(83) in the non-sleep disorder group(χ^(2)=16.113, P<0.001).(2) After adjusting for gender, age, ethnicity, education, personal monthly income, smoking, alcohol consumption, shift work and BMI, sleep disorders(OR=1.686, 95% CI 1.232-2.308), gender(OR=1.565, 95% CI 1.035-2.367), age(OR30-45=1.710, 95% CI 1.085-2.697;OR>45=1.717, 95% CI 1.055-2.797), shift work(OR=2.698, 95% CI 1.889-3.855), BMI(OR24.0-27.9=2.557, 95% CI 1.736-3.765;OR≥28.0=4.001, 95% CI 2.553-6.318) increased the risk of hypertension.(3) The result of stratified analysis showed that with age(OR30-45=1.642, 95% CI 1.019-2.645;OR>45=1.998, 95% CI 1.223-3.263) and BMI(OR24.0-27.9=1.652, 95% CI 1.079-2.528;OR≥28.0=2.259, 95% CI 1.165-4.381) increased, the risk of hypertension due to sleep disorders increased. Sleep disorders(OR=2.002, 95% CI 1.336-2.936) were also risk factors for hypertension in the shift work group.(4) The result of the mediating effect test showed that there was a mediating effect(P<0.05) between sleep disorders in age(β=0.240,Z=2.239), shift work(β=0.656,Z=3.999), and BMI(β=0.516,Z=7.258) and hypertension. CONCLUSION Sleep disorders may be a risk factor affecting hypertension in oil workers in Karamay City, and there were mediating effects between age, shift work, and BMI and hypertension.