上海市真新社区正常老年人群睡眠质量与肥胖相关性研究

Study on the relationship between sleep quality and obesity in normal elderly people in Zhenxin Community of Shanghai

目的 了解上海市真新社区老年人群睡眠质量情况并探讨不同肥胖指标对其影响,为社区老年人群睡眠障碍干预提供参考依据。方法 抽取2020年5—8月在上海市真新社区卫生服务中心参加60岁以上老年人健康体检者1 037例,通过匹兹堡睡眠质量指数量表评估老年人睡眠质量,根据体重指数将老年人分为低体重、正常体重、超重和肥胖,根据腰围、腰臀比、颈围、体脂率、内脏脂肪指数四分位数分别分为a1~a4、b1~b4、c1~c4、d1~d4、e1~e4四个等级,分析老年人睡眠质量及不同维度与体质指标之间的关系,采用一元线性回归及多元线性回归分析探讨老年人群睡眠质量的影响因素。结果 上海市真新社区老年人群睡眠障碍患病率为36.0%,女性睡眠质量评价等级高于男性,差异有统计学意义(P<0.05)。不同体质指标两分类组间睡眠质量评价等级比较及不同睡眠质量评价等级组间体质指标比较,差异均无统计学意义(P>0.05)。Spearman等级相关分析显示,体质指标与睡眠质量评价等级间无相关性(P>0.05)。肥胖指标不同等级间总体睡眠质量及各维度得分比较发现:颈围分级中c3与c1相比,内脏脂肪指数分级中e2、e3与e1相比,睡眠质量更好;BMI分级中肥胖与正常体重比较,颈围分级中c4与c2比较,体脂率分级中d4与d1、d2、d3比较,内脏脂肪指数分级中e4与e1、e2、e3及e3与e2比较,睡眠障碍更严重;内脏脂肪指数分级中e4与e2、e3比较,总体睡眠质量更差,以上差异均有统计学意义(P<0.05)。一元线性回归分析结果显示,性别、年龄、婚姻、失独、冠心病、脑血管病、体脂率是老年人群总体睡眠质量的危险因素,退休金、吸烟、颈围是老年人群总体睡眠质量的保护因素(P<0.05)。多元线性回归(逐步法)分析结果显示,性别、年龄、失独、冠心病、脑血管病是老年人群总体睡眠质量的危险因素,而不同体质指标与总体睡眠质量无相关性。结论 上海市真新社区老年人群睡眠质量不佳,体质指标对老年人总体睡眠质量的影响较弱,应加强对女性、高龄、患慢性疾病、失独老年人健康教育并采取干预措施,提高睡眠质量。

Objective To investigate the relationship between sleep quality and obesity in community-dwelling elderly. Methods A total 1 037 healthy residents aged over 60 years were enrolled from Shanghai Zhenxin Community Health Service Center from May to August 2020. The sleep quality was evaluated with Pittsburgh Sleep quality Index scale. According to body mass index(BMI) the elderly were divided into low weight, normal, overweight and obesity groups;according to waist circumference, waist-to-hip ratio, neck circumference, body fat rate and visceral fat index quartile, they were divided into four grades: a1-a4, b1-b4, c1-c4, d1-d4 and e1-e4. The relationship between sleep quality and physical indexes was analyzed, and the influencing factors of sleep quality were investigated with univariate and multivariate linear regression analysis. Results The prevalence of sleep disorder in this series was 36.0%, and the sleep evaluation level in females was higher than that in males(P<0.05). Spearman rank correlation analysis showed that there was no rank correlation between physical fitness index and sleep evaluation level(P>0.05). Results showed that elderly with c3 in the neck circumference grading had better sleep quality than those with c1;and elderly with e2 and e3 in the visceral fat index grade had better sleep quality than those with e1. Compared to normal BMI, elderly with higher BMI;compared to c2, elderly with c4 in neck circumference grading;compared to d1, d2, d3, elderly with d4 in body fat rate grading;and compared to e1, e2, e3, elderly with e4 in visceral fat index grading had more severe sleep disorders(all P<0.05). The univariace linear regression analysis showed that female gender, higher age, marriage, loneliness, coronary heart disease, cerebrovascular disease and higher body fat rate were associated with the poor overall sleep quality of the elderly, while pension, smoking and neck circumference were associated with good sleep quality(P<0.05). Multivariate regression analysis showed that female gender, higher age, loneliness, coronary heart disease and cerebrovascular disease were the risk factors for the poor overall sleep quality of the elderly, while different physical indexes had no correlation with the overall sleep quality. Conclusion The sleep quality of the elderly in Shanghai Zhenxin community is generally poor, and the influence of physical indexes on the overall sleep quality is weak. Intervention measures should be taken for the community-dwelling elderly with risk factors to improve the sleep quality.