睡眠時數與代謝症候群相關性研究

Abstract

背景：代謝症候群是增加罹患心臟血管疾病的風險。它包括前期高血壓及與第2型糖尿病。睡眠時數不足會大大增加高血壓，糖尿病及肥胖的風險。文獻研究有關睡眠及代謝症候群的關係還不太明確。 目的：研究睡眠時間與代謝症候群之間的關係 研究設計：橫斷面觀察研究。 研究對象：台灣地區高科技工廠員工年度體檢及自我評估的健康的問卷（12762例，收集於2006-2007年之間）。 測量方法：代謝症候群以亞洲版的National Education Cholesterol Program的標準來診斷(至少符合以下標準其中3項：空腹血糖> 100 mg/dl，男性腰圍>= 90 cm、女性腰圍> 80 cm，三酸甘油酯>=150 mg /dl，男性高密度脂蛋白< 40、女性< 50，血壓> 135/85 mmHg) 不同的生活方式和睡眠時數變相。 結果： 代謝症候群盛行率佔此研究人口之5.66%。約有80 % 代謝症候群的員工自述每天睡眠小於7小時。相對於那些沒有代謝症候群的員工，比較多的代謝症候群的員工在工作日及休假日睡眠時數顯著的睡少於7個小時(工作日(Odds ratio(OR) = 1.36，95%信賴區間(CI)，1.10-1.70)和休假日(OR=1.36, 95%CI, 1.10-1.70))。 校正過干擾因子如性別、年齡及抽菸習慣後，睡眠時數和代謝症候群的關係仍然顯著 (工作日OR=1.35 95%CI, 1.09-1.68); 休假日OR=1.26, 95%CI, 1.01-1.56)。其他重要的相關性因子包括男性，目前年齡超過30歲、吸煙歷史及輪班工作。 結論：每天睡眠數量少於7小時似乎與代謝症候群有關。今後工作的目的和研究會需要釐清睡眠和代謝症候群的因果關係。

Metabolic syndrome is a cluster of risk factors that increases the risk of heart disease. It includes pre-hypertension and pre-diabetic status. Shorter sleep durations were associated with hypertension, and diabetes mellitus. However, the relationship between sleep duration and metabolic syndrome was not certain. In this cross-sectional observational study, we aim to examine the relations between sleep duration and presence of metabolic syndrome. Twelve-thousand, seven hundred and sixty two employees completed annual physical examinations of semi-conductor factories in Taiwan in the year of 2006. Metabolic syndrome was measured following the modified Asian National Cholesterol Education Program NECP criteria. Employees were also assessed with a self-filled questionnaire including demographic characteristics, health behaviors, healthcare resource utilizations, health status, sleep-related characteristics, life and work stresses, and musculoskeletal system symptoms. Multivariate logistic regression was used for statistical analysis. The mean age was 31.4 years with 44.4 % female. The prevalence of metabolic syndrome in this study was 5%. Overall on a daily basis, nearly 80 % reported to sleep less than 7 hours on work days and 26.5% sleep less than 7 hours on off days. Comparing to those without metabolic syndrome, those with the syndrome are more likely to sleep less than 7 hours per day on work days (Odds ratio (OR)=1.37, 95% confidence interval (CI), 1.11-1.70) and on off days (OR=1.37, 95%CI, 1.10-1.70). While adjusting additionally for smoking and shift work, more workers with metabolic syndrome who sleep less than 7 hours per day on work days (OR=1.35, 95%CI, 1.09-1.68) and on off days (OR=1.26, 95%CI, 1.01-1.56). Other significant correlates of metabolic syndrome in the multivariate logistic regression model included being male, being older than 30 years of age, being an ever smoker, and being a shift worker. Daily sleep quantity of less than 7 hours was associated with having metabolic syndrome. Although direction of implication is still to be determined, this could lead to potential discussion of preventive strategy in the realm of occupational medicine with further work.