青少年睡眠与C-反应蛋白及胰岛素代谢的相关性

唐玉青; 李丽雯; 吕佳骏; 陈仪婷; WANGXiaobin; 李生慧

doi:10.16835/j.cnki.1000-9817.2021.06.005

青少年睡眠与C-反应蛋白及胰岛素代谢的相关性

doi: 10.16835/j.cnki.1000-9817.2021.06.005

1.
上海交通大学医学院公共卫生学院, 上海 200025
2.
Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine

基金项目:

国家自然科学基金项目 81874266

国家自然科学基金项目 81673183

上海市科学技术委员会科技创新行动计划研究专项 18411951600

详细信息

作者简介:
唐玉青(1998-), 女, 湖南省人, 在读本科, 主要研究方向为睡眠与儿童、青少年生长内分泌代谢的相关性

通讯作者:
李生慧, E-mail: lsh9907@163.com

中图分类号: R 179 R 446
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- 文章访问数: 553
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- 被引次数: 0
出版历程
- 收稿日期: 2021-02-01
- 修回日期: 2021-05-20
- 网络出版日期: 2021-06-22
- 刊出日期: 2021-06-25

Association between sleep with C-reactive protein and insulin metabolism in adolescents

1.
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai(200025), China

摘要

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。
- 睡眠 /
- C反应蛋白质 /
- 胰岛素 /
- 回归分析 /
- 青少年
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.
- 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
性别	人数	< 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/%。

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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
睡眠情况	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。

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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
睡眠情况	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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