睡眠时长与不同缺血性卒中亚型的相关性

李曼; 吴瑶; 田耀华; 曹亚英; 黄哲; 黄少平; 刘晓芬; 秦雪英; 唐迅; 李劲; 吴涛; 陈大方; 许蓓蓓; 胡永华

doi:10.16462/j.cnki.zhjbkz.2019.07.010

睡眠时长与不同缺血性卒中亚型的相关性

doi: 10.16462/j.cnki.zhjbkz.2019.07.010

李曼¹,
吴瑶¹,
田耀华¹,
曹亚英¹,
黄哲¹,
黄少平²,
刘晓芬³,
秦雪英¹,
唐迅¹,
李劲¹,
吴涛¹,
陈大方¹,
许蓓蓓⁴,
胡永华^{1, 4, ,}

1.
100191 北京, 北京大学公共卫生学院流行病与卫生统计学系
2.
102401 北京, 北京市房山区疾病预防控制中心办公室
3.
102401 北京, 北京市房山区疾病预防控制中心慢性病防治科
4.
100191 北京, 北京大学医学信息学中心

基金项目:

国家自然科学基金 81230066

国家自然科学基金 81473043

详细信息

通讯作者:
胡永华, E-mail: yhhu@bjmu.edu.cn

中图分类号: R161.1
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- 文章访问数: 306
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- PDF下载量: 32
- 被引次数: 0
出版历程
- 收稿日期: 2018-12-28
- 修回日期: 2019-05-10
- 刊出日期: 2019-07-10

Associations between sleep duration and different ischemic stroke subtypes

1.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
2.
General Office, Fangshan District Center for Disease Control and Prevention, Beijing 102401, China
3.
Department of Chronic Disease Control and Prevention, Fangshan District Center for Disease Control and Prevention, Beijing 102401, China
4.
Peking University Medical Informatics Center

Funds:

Key Project of National Natural Science Foundation of China 81230066

Key Project of National Natural Science Foundation of China 81473043

More Information

Corresponding author: HU Yong-hua, E-mail: yhhu@bjmu.edu.cn

摘要

摘要: 目的探讨睡眠时长与不同缺血性卒中(ischemic stroke，IS)亚型的相关性。方法以北京市农村社区居民为研究对象，开展问卷调查、体格检查以及血生化检测。睡眠时长作为分类变量，分为睡眠时长≤ 5 h/d(< 5.5 h/d)、6 h/d(5.5~6.5 h/d)、7 h/d(6.5~7.5 h/d)、8 h/d(7.5~8.5 h/d)、≥ 9 h/d(≥ 8.5 h/d)，依据急性卒中Org 10172治疗试验(trial of org 10172 in acute stroke treatment，TOAST)分型对IS进行分型，采用Logistic回归分析模型睡眠时长与不同IS亚型的相关性。结果共纳入6 370名研究对象，平均年龄为(58.34±9.37)岁。Logistic回归分析模型显示，在调整年龄、性别、行为生活方式、社会经济状况和健康状态后，与睡眠时长为7 h/d的相比，睡眠时长≤ 5 h/d的患IS、大动脉粥样硬化型卒中，小动脉闭塞型卒中和不明原因型卒中的风险分别是对照组的1.75倍(95%CI：1.42~2.15，P < 0.001)、1.98倍(95%CI：1.46~2.70，P < 0.001)、5.73倍(95%CI：3.34~9.83，P < 0.001)和4.43倍(95%CI：1.86~10.53，P=0.001)。然而，睡眠时长8 h/d和≥ 9 h/d仅在IS和大动脉粥样硬化型卒中中表现出有统计学意义(P < 0.05)。结论睡眠不足与IS、大动脉粥样硬化型卒中、小动脉闭塞型卒中和不明原因型卒中风险增加有关，而睡眠过长仅与IS和大动脉粥样硬化型卒中风险增加有关。
- 睡眠时长 /
- 缺血性卒中 /
- 亚型 /
- 危险因素
Abstract: Objective To explore the relationship between sleep duration and different ischemic stroke (IS) subtypes. Methods Participants in the study were recruited from rural communities in Beijing. The survey questionnaires, physical examination and biochemical tests were performed. Sleep duration was categorized into 5 groups, namely ≤ 5 hours/day, 6 hours/day (5.5-6.5 h/d), 7 hours/day (6.5-7.5 h/d), 8 hours/day (7.5-8.5 h/d) and ≥ 9 hours/day(≥ 8.5 h/d). Classification of ischemic stroke was based on Trial of org 10172 in acute stroke treatment(TOAST)classification. Logistic models were used to evaluate the associations between sleep duration and different IS subtypes. Results A total of 6 370 participants were recruited. The average age was (58.34±9.37) years old. Logistic regression analysis showed that after adjusting for age, sex, behavioral lifestyle, socioeconomic status and health status, compared to subjects with 7 hours/day, subjects with sleep duration ≤ 5 hours/day was significantly associated with increased risk of IS (OR=1.75, 95% CI: 1.42-2.15, P < 0.001), large-artery atherosclerosis (OR=1.98, 95% CI: 1.46-2.70, P < 0.001), small-artery occlusion lacunar (OR=5.73, 95% CI: 3.34-9.83, P < 0.001) and stroke of undetermined etiology (OR=4.43, 95% CI: 1.86-10.53, P=0.001). Subjects with sleep duration 8 hours/day and ≥ 9 hours/day was only found to be significantly associated with IS and large-artery atherosclerosis (P < 0.05). Conclusions Short sleep duration is associated with increased risk of IS, large-artery atherosclerosis, small-artery occlusion lacunar and stroke of undetermined etiology. But long sleep duration is only associated with increased risk of IS and large-artery atherosclerosis.
- Sleep duration /
- Ischemic stroke /
- Subtype /
- Risk factors

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表 1 不同睡眠时长研究对象的基本特征[n(%)]

Table 1. Basic characteristics of study subjects according to different sleep durations [n(%)]

特征	睡眠时长					F/χ²值	P值
特征	≤5 h/d	6 h/d	7 h/d	8 h/d	≥9 h/d	F/χ²值	P值
n(%)	940(14.76)	734(11.52)	1 184(18.59)	1 709(26.83)	1 803(28.30)	-	-
年龄(岁)	57.61±9.71	57.82±9.19	57.44±8.93	58.20±9.17	59.65±0.59	13.70	＜0.001
性别						4.20	0.379
男性	443(47.13)	330(44.96)	563(47.55)	835(48.86)	882(48.92)
女性	497(52.87)	404(55.04)	621(52.45)	874(51.14)	921(51.08)
教育程度						41.56	＜0.001
小学及以下	420(44.68)	293(39.92)	430(36.32)	662(38.74)	838(46.48)
初中及以上	520(55.32)	441(60.08)	754(63.68)	1047(61.26)	965(53.52)
职业						224.97	＜0.001
农民	546(58.09)	304(41.42)	405(34.21)	560(32.77)	567(31.45)
非农民	394(41.91)	430(58.58)	779(65.79)	1 149(67.23)	1236(68.55)
人均月收入(元)						129.74	＜0.001
＜800	858(91.28)	577(78.61)	881(74.41)	1 259(73.67)	1 351(74.93)
≥800	82(8.72)	157(21.39)	303(25.59)	450(26.33)	452(25.07)
婚姻状况						5.47	0.243
在婚	840(89.36)	650(88.56)	1 055(89.10)	1 535(89.82)	1 577(87.47)
非在婚	100(10.64)	84(11.44)	129(10.90)	174(10.18)	226(12.53)
吸烟						2.77	0.596
吸烟	442(47.02)	329(44.82)	519(43.83)	760(44.47)	825(45.76)
非吸烟	498(52.98)	405(55.18)	665(56.17)	949(55.53)	978(54.24)

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表 2 睡眠时长与IS及其亚型的多因素Logistic回归分析

Table 2. Multivariate logistic regression analysis of the relationship between sleep duration and IS and its subtypes

	睡眠时长					R²
	≤5 h/d	6 h/d	7 h/d	8 h/d	≥9 h/d	R²
缺血性卒中
模型1^a	2.19(1.80~2.66)	1.27(1.02~1.58)	1.00	1.27(1.07~1.51)	1.51(1.28~1.80)	0.057
模型2^b	1.69(1.38~2.06)	1.20(0.96~1.50)	1.00	1.28(1.07~1.53)	1.53(1.28~1.82)	0.084
模型3^c	1.75(1.42~2.15)	1.19(0.95~1.49)	1.00	1.29(1.07~1.54)	1.57(1.31~1.88)	0.118
LAA
模型1^a	2.18(1.64~2.90)	1.22(0.87~1.70)	1.00	1.30(1.00~1.70)	1.64(1.27~2.12)	0.057
模型2^b	1.81(1.35~2.43)	1.17(0.84~1.64)	1.00	1.32(1.01~1.73)	1.61(1.24~2.09)	0.099
模型3^c	1.98(1.46~2.70)	1.20(0.85~1.69)	1.00	1.32(1.00~1.74)	1.71(1.31~2.23)	0.138
SAO
模型1^a	11.03(6.64~18.31)	1.74(0.90~3.38)	1.00	1.14(0.62~2.07)	1.13(0.62~2.06)	0.139
模型2^b	6.12(3.64~10.28)	1.43(0.73~2.81)	1.00	1.15(0.63~2.10)	1.22(0.66~2.24)	0.217
模型3^c	5.73(3.34~9.83)	1.37(0.70~2.72)	1.00	1.12(0.61~2.08)	1.32(0.71~2.44)	0.259
SUE
模型1^a	4.10(1.79~9.38)	0.44(0.09~2.09)	1.00	1.46(0.62~3.43)	2.08(0.93~4.69)	0.054
模型2^b	4.14(1.77~9.70)	0.45(0.09~2.11)	1.00	1.43(0.61~3.36)	2.02(0.89~4.55)	0.077
模型3^c	4.43(1.86~10.53)	0.46(0.10~2.19)	1.00	1.46(0.62~3.45)	2.27(0.99~5.16)	0.117
注：^a模型1：调整年龄、性别(男性、女性)；^b模型2：在模型1的基础上进一步调整教育程度(小学及以下、初中及以上)、职业(农民、非农民)、婚姻状况(在婚、非在婚)、人均月收入(＜800元、≥800元)、吸烟(是、否)、饮酒(是、否)、水果摄入(较多、较少)、体力活动情况(规律活动、非规律活动)；^c模型3：在模型2的基础上进一步调整缺血性卒中家族史(是、否)、BMI、高血压(是、否)、糖尿病(是、否)和TC。

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特征	睡眠时长					F/χ²值	P值
特征	≤5 h/d	6 h/d	7 h/d	8 h/d	≥9 h/d	F/χ²值	P值
n(%)	940(14.76)	734(11.52)	1 184(18.59)	1 709(26.83)	1 803(28.30)	-	-
年龄(岁)	57.61±9.71	57.82±9.19	57.44±8.93	58.20±9.17	59.65±0.59	13.70	＜0.001
性别						4.20	0.379
男性	443(47.13)	330(44.96)	563(47.55)	835(48.86)	882(48.92)
女性	497(52.87)	404(55.04)	621(52.45)	874(51.14)	921(51.08)
教育程度						41.56	＜0.001
小学及以下	420(44.68)	293(39.92)	430(36.32)	662(38.74)	838(46.48)
初中及以上	520(55.32)	441(60.08)	754(63.68)	1047(61.26)	965(53.52)
职业						224.97	＜0.001
农民	546(58.09)	304(41.42)	405(34.21)	560(32.77)	567(31.45)
非农民	394(41.91)	430(58.58)	779(65.79)	1 149(67.23)	1236(68.55)
人均月收入(元)						129.74	＜0.001
＜800	858(91.28)	577(78.61)	881(74.41)	1 259(73.67)	1 351(74.93)
≥800	82(8.72)	157(21.39)	303(25.59)	450(26.33)	452(25.07)
婚姻状况						5.47	0.243
在婚	840(89.36)	650(88.56)	1 055(89.10)	1 535(89.82)	1 577(87.47)
非在婚	100(10.64)	84(11.44)	129(10.90)	174(10.18)	226(12.53)
吸烟						2.77	0.596
吸烟	442(47.02)	329(44.82)	519(43.83)	760(44.47)	825(45.76)
非吸烟	498(52.98)	405(55.18)	665(56.17)	949(55.53)	978(54.24)

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文章访问数: 306
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睡眠时长与不同缺血性卒中亚型的相关性

doi: 10.16462/j.cnki.zhjbkz.2019.07.010

通讯作者:
胡永华, E-mail: yhhu@bjmu.edu.cn

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Associations between sleep duration and different ischemic stroke subtypes

Corresponding author: HU Yong-hua, E-mail: yhhu@bjmu.edu.cn

计量

目录

留言板

睡眠时长与不同缺血性卒中亚型的相关性

doi: 10.16462/j.cnki.zhjbkz.2019.07.010

通讯作者: 胡永华, E-mail: yhhu@bjmu.edu.cn

计量

出版历程

Associations between sleep duration and different ischemic stroke subtypes

Corresponding author: HU Yong-hua, E-mail: yhhu@bjmu.edu.cn

计量

出版历程

目录

通讯作者:
胡永华, E-mail: yhhu@bjmu.edu.cn