睡眠与肥胖对中老年人功能损失的联合作用研究

Study on the combined effects of sleep and obesity on functional loss in middle⁃aged and elderly people

目的了解中老年人睡眠、肥胖的联合作用对中老年人功能损失的影响。方法数据来源于北京大学2015年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)数据库。采用logistic回归分析模型分析睡眠、肥胖对功能损失的联合作用。结果以腰围(waist circumference,WC)正常+夜间睡眠6~<8 h组为参照,腹型肥胖+夜间睡眠0~<4 h组功能损失患病风险最高(OR=1.655,P<0.001)。以WC正常+午睡0~<30 min组为参照,腹型肥胖+无午睡组功能损失患病风险最高(OR=3.360,P=0.008)。以非全身性肥胖+夜间睡眠6~<8 h组为参照,全身性肥胖+夜间睡眠4~<6 h组功能损失患病风险最高(OR=2.359,P<0.001)。以非全身性肥胖+午睡0~<30 min组为参照,全身性肥胖+午睡30~<90 min组功能损失患病风险最高(OR=1.905,95%CI:1.237~2.933,P=0.003)。结论夜间睡眠时间短、无午睡或午睡时间长分别与腹型肥胖或全身性肥胖共存会增加功能损失的患病风险,提示夜间睡眠时间短、无午睡或午睡时间长的中老年人控制BMI和WC有利于改善日常生活活动能力。

Objective The aim of this study was to investigate the combined effect of sleep and obesity on the prevalence of functional disability among middle⁃aged and older adults.Methods Data were collected from the 2015 China Health and Retirement Longitudinal Study(CHARLS).The logistic regression model was performed to estimate the combined effect of sleep and obesity on the prevalence of functional disability.Results Compared to participants with normal waist circumference(WC)and 6-<8 hours of nocturnal sleep,those with abdominal obesity and 0-<4 hours of nocturnal sleep exhibited an increased risk of functional disability(OR=1.655,P<0.001).Similarly,participants with abdominal obesity and no afternoon nap,compared to those with normal WC and 0-<30 minutes of afternoon nap,showed an elevated risk of functional disability(OR=3.360,P=0.008).When compared to non⁃systemically obese individuals with 6-<8 hours of nocturnal sleep,those with systemic obesity and 4-<6 hours of nocturnal sleep had an increased risk of functional disability(OR=2.359,P<0.001).Additionally,systemically obese individuals with 30-<90 minutes of afternoon nap,compared to non⁃systemically obese individuals with 0-<30 minutes of afternoon nap,showed an increased risk of functional disability(OR=1.905,95%CI:1.237-2.933,P=0.003).Conclusions The concurrent presence of short nocturnal sleep duration,absence of an afternoon nap or extended afternoon nap duration,and either abdominal or systemic obesity,increases the risk of functional disability.This suggests that controlling body mass index(BMI)and WC among middle⁃aged and older adults with short nocturnal sleep duration,absence of an afternoon nap,or extended afternoon nap duration could be beneficial in preventing functional disability.