CAJ | 학술논문

目的探讨睡眠和2型糖尿病(T2DM)之间的关系.方法病例组为2013年徐州市慢病基线调查时首次确诊的T2DM患者,年龄25～70岁,在本地居住5年以上,排除其他类型糖尿病、神经系统相关疾病、现患其他内分泌系统疾病、心肝肾功能不全、呼吸衰竭、恶性肿瘤等严重疾病者.对照组为无T2DM者,排除标准同病例组.采用1∶1匹配的病例对照研究方法,病例和对照共771对.匹配条件按年龄(相差不超过3岁)、性别、居住地、T2DM家族史四个方面,每个病例匹配1个对照,减少混杂因素的影响.采用自行设计的一般状况调查表和国际匹兹堡睡眠质量指数(PSQI)量表对病例组和对照组进行调查;采用t检验、x2检验和多元条件logistic回归进行统计学分析.结果病例组PSQI平均得分为(5.15±2.40)分,对照组PSQI平均得分为(2.71±1.93)分,两组PSQI分值差异有统计学意义(t=21.96,P＜0.01).在主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物的应用、日间功能障碍7个维度得分方面,病例组分值均高于对照组(P＜0.01).除了夜间易醒早醒、睡眠中感觉寒冷、做恶梦睡眠障碍行为3个因素之外,病例组睡眠障碍相关行为所占的比例均高于对照组(P＜0.01).单因素logistic回归分析显示,睡眠质量差者患T2DM的风险比睡眠质量好者增加1.06倍(OR=2.06,95％CI:1.46 ～ 2.90),调整混杂因素后,风险仍增加0.72倍(OR=1.72,95％CI:1.38～2.43).5个睡眠维度——主观睡眠差、入睡困难、睡眠不足、睡眠效率低、睡眠障碍和T2DM存在关联(OR值分别为3.34、1.63、1.10、1.87、3.89).结论睡眠质量差与T2DM发病密切相关.
목적 탐토수면화2형당뇨병(T2DM)지간적관계.방법 병례조위2013년서주시만병기선조사시수차학진적T2DM환자,년령25～70세,재본지거주5년이상,배제기타류형당뇨병、신경계통상관질병、현환기타내분비계통질병、심간신공능불전、호흡쇠갈、악성종류등엄중질병자.대조조위무T2DM자,배제표준동병례조.채용1∶1필배적병례대조연구방법,병례화대조공771대.필배조건안년령(상차불초과3세)、성별、거주지、T2DM가족사사개방면,매개병례필배1개대조,감소혼잡인소적영향.채용자행설계적일반상황조사표화국제필자보수면질량지수(PSQI)량표대병례조화대조조진행조사;채용t검험、x2검험화다원조건logistic회귀진행통계학분석.결과 병례조PSQI평균득분위(5.15±2.40)분,대조조PSQI평균득분위(2.71±1.93)분,량조PSQI분치차이유통계학의의(t=21.96,P＜0.01).재주관수면질량、입수시간、수면시간、수면효솔、수면장애、최면약물적응용、일간공능장애7개유도득분방면,병례조분치균고우대조조(P＜0.01).제료야간역성조성、수면중감각한랭、주악몽수면장애행위3개인소지외,병례조수면장애상관행위소점적비례균고우대조조(P＜0.01).단인소logistic회귀분석현시,수면질량차자환T2DM적풍험비수면질량호자증가1.06배(OR=2.06,95％CI:1.46 ～ 2.90),조정혼잡인소후,풍험잉증가0.72배(OR=1.72,95％CI:1.38～2.43).5개수면유도——주관수면차、입수곤난、수면불족、수면효솔저、수면장애화T2DM존재관련(OR치분별위3.34、1.63、1.10、1.87、3.89).결론 수면질량차여T2DM발병밀절상관.
Objective To explore the association between sleep quality and the increasing risk of type 2 diabetes mellitus (T2DM).Methods A total of 771 patients aged 25-70 years living in Xuzhou City of Jiangsu Province for at least 5 years were enrolled for the survey of risk factor related noninfectious chronic disease in 2013.In this investigation,those who suffered from other types of diabetes,neuropathy,other endocrine disease,cardiovascular,renal and hepatic dysfunction,dyspnea or cancer were excluded.To reduce the influence of confounding factors,another 771 participants were enrolled as controls.Each case was arranged to have a control who was matched in age (difference not more than 3 years),gender,residence and family history.All the participants were interviewed with self-designed questionnaire,and sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI) questionnaire.Student's t test,Chi-square and multivariate logistic regression were used for data analysis.Results The PSQI score in the T2DM patients vs.the controls were 5.15±2.40 vs.2.71 ± 1.93 (t=21.96,P＜0.01).The scores of sleep-related factors,including subjective poor sleep quality,bedtime resistance,short sleep duration,sleep efficiency,sleep disturbance,use of sleep medication and daytime dysfunction,of the T2DM patients were higher than those of the controls.The proportion of sleep related behaviors of the T2DM patients was higher,except for early awakening,cold feeling and nightmare.Poor sleep quality was associated with the increasing risk of T2DM (odds ratio 2.06,95％ CI 1.69-2.52).In multivariate logistic regression,when adjusted for confounding factors,the risk of T2DM was still increased (odds ratio 1.72,95％ CI 1.62-1.83).Sleep-related factors (e.g.subjective poor sleep quality,bedtime resistance,short sleep duration,sleep efficiency and sleep disturbance) were correlated with the risk of T2DM (odds ratio was 3.34,1.63,1.10,1.87 and 3.89,respectively).Conclusion Low quality of sleep may be strongly associated with an increased risk of T2DM.