Association between sleep with C-reactive protein and insulin metabolism in adolescents
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摘要:
目的 探讨青少年睡眠状况与C-反应蛋白(CRP)异常及高胰岛素血症的相关性, 为代谢异常相关疾病的预防提供参考。 方法 基于中国安徽代谢综合征研究, 共选取653名12~19岁青少年, 分析晨起时间、就寝时间、睡眠呼吸障碍(SDB)与CRP异常及高胰岛素血症之间的相关性。 结果 晨起时间晚与空腹高胰岛素血症发生风险上升相关(OR=1.68, 95%CI=1.03~2.75)。就寝时间晚(OR=1.96, 95%CI=1.29~2.99)与餐后2 h高胰岛素血症发生风险上升呈正相关。在高CRP浓度状态下, 晨起时间晚和就寝时间晚与高胰岛素血症相关性的效应强度增大, 且SDB与高胰岛素血症呈正相关。 结论 晨起时间晚和就寝时间晚可能是青少年高胰岛素血症的危险因素。高浓度CRP可能会使睡眠问题所致的高胰岛素血症的发生风险进一步提高。青少年晨起及就寝时间应尽可能提早。 Abstract:Objective To explore the relationship of sleep with C-reactive protein (CRP) abnormality and hyperinsulinemia in adolescents, and to provide reference for early prevention of metabolic disorders. Methods Based on the Chinese Metabolic Syndrome Cohort Study in Anhui Province, a total of 653 adolescents aged 12 to 19 were selected to examine the relationship between wakeup time, bedtime, sleep disordered breathing (SDB) and CRP abnormality as well as hyperinsulinemia. Results Later wakeup time (OR=1.68, 95%CI=1.03-2.75) was positively correlated with a higher risk of fasting hyperinsulinemia. Late bedtime (OR=1.96, 95%CI=1.29-2.99) was associated with 2 h postprandial hyperinsulinemia. Among those with high CRP concentration, late wakeup time and late bedtime were positely associated with hyperinsulinemia than those with normal CRP concentration; and the correlation between SDB and hyperinsulinemia was observed. Conclusion Later wakeup and late bedtime may be risk factors for hyperinsulinemia in adolescents. High concentrations of CRP may further increase the risk of hyperinsulinemia, a condition associated with sleep problems.Teenagers should get up and go to bed as early as possible. -
Key words:
- Sleep /
- C-reactive protein /
- Insulin /
- Regression analysis /
- Adolescent
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表 1 不同性别青少年睡眠情况构成比较
Table 1. Comparison of sleep composition among adolescents with different genders
性别 人数 晨起时间 就寝时间 SDB < 7:20 ≥7:20 < 22:30 ≥22:30 否 是 男 329 261(79.3) 68(20.7) 253(76.9) 76(23.1) 286(86.9) 43(13.1) 女 324 211(65.1) 113(34.9) 229(70.7) 95(29.3) 272(84.0) 52(16.0) 合计 653 472(72.3) 181(27.7) 482(73.8) 171(26.2) 558(85.5) 95(14.5) χ2值 16.45 3.27 1.17 P值 < 0.01 0.07 0.28 注:()内数字为构成比/%。 表 2 青少年睡眠情况与CRP异常及高胰岛素血症的Logistic回归分析[OR值(OR值95%CI),n=653]=653]
Table 2. Logistic regression analysis of sleep and abnormal CRP levels and hyperinsulinemia in adolescents[OR(95%CI), n=653]
睡眠情况 CRP异常 空腹高胰岛素血症 餐后2 h高胰岛素血症 未校正 校正后 未校正 校正后 未校正 校正后 晨起时间 ≥7:20 1.23(0.81~1.86) 1.14(0.74~1.75) 1.68(1.03~2.75)* 1.34(0.79~2.27) 1.53(1.00~2.34) 1.28(0.83~1.99) < 7:20 1.00 1.00 1.00 1.00 1.00 1.00 就寝时间 ≥22:30 1.55(1.03~2.35)* 1.54(1.00~2.38) 1.25(0.75~2.09) 1.27(0.72~2.22) 1.96(1.29~2.99)** 1.73(1.12~2.69)* < 22:30 1.00 1.00 1.00 1.00 1.00 1.00 SDB 是 1.23(0.73~2.07) 1.16(0.69~1.97) 1.04(0.54~2.00) 0.91(0.46~1.81) 1.34(0.78~2.27) 1.23(0.72~2.12) 否 1.00 1.00 1.00 1.00 1.00 1.00 注:以CRP>3 mg/L为CRP异常,以空腹胰岛素水平>15 μU/mL为高胰岛素血症,以餐后2 h胰岛素水平>75 μU/mL为高胰岛素血症;校正模型控制了BMI、性别和年龄;*P < 0.05,**P < 0.01。 表 3 青少年晨起时间、就寝时间和SDB与CRP异常及高胰岛素血症的Logistic回归分析[OR值(OR值95%CI),n=653]
Table 3. Logistic regression analysis of wakeup time, bedtime, SDB and CRP abnormalities and hyperinsulinemia in adolescents [OR(95%CI), n=653]
睡眠情况 CRP异常合并空腹高胰岛素血症 CRP异常合并餐后2 h高胰岛素血症 未校正 校正后 未校正 校正后 晨起时间 ≥7:20 5.07(2.10~12.25)** 3.24(1.28~8.22)* 2.76(1.29~5.90)** 2.05(0.93~4.53) < 7:20 1.00 1.00 1.00 1.00 就寝时间 ≥22:30 2.38(1.02~5.58)* 2.01(0.79~5.12) 4.76(2.20~10.31)** 4.96(2.09~11.77)** < 22:30 1.00 1.00 1.00 1.00 SDB 是 2.54(1.01~6.41)* 1.85(0.69~4.93) 1.71(0.67~4.38) 1.39(0.52~3.68) 否 1.00 1.00 1.00 1.00 注:以CRP>3 mg/L为CRP异常,以空腹胰岛素水平>15 μU/mL为高胰岛素血症,以餐后2 h胰岛素水平>75 μU/mL为高胰岛素血症;校正模型控制了BMI、性别和年龄;*P < 0.05,**P < 0.01。 -
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