CAJ | 학술논문

目的：探讨糖尿病家族史和睡眠时间对罹患2型糖尿病(T2DM)风险的交互作用。方法于2013年5月采用多阶段随机抽样，对徐州市18～75岁的常住居民进行基线调查，在此基础上，收集未确诊为T2DM的人群对其开展为期5年的随访，并对随访人群糖尿病家族史和睡眠时间与罹患T2DM风险之交互作用进行评估。采用非条件Logistic回归分析糖尿病家族史和睡眠时间与T2DM之间的关系。结果15939名居民纳入随访研究，5年后共随访到11842名（74.3%）。受试者平均每晚睡眠时间为(7.2±1.1) h，T2DM发病率为3.10%。调整混杂因素后，与睡眠时间6～8 h/晚相比，睡眠时间不足(<6h/晚)可增加罹患T2DM的风险(RR=1.54，95%CI：1.21～2.13，P<0.01)；睡眠时间过长(>8 h/晚)未增加罹患T2DM的风险[风险比(RR）=1.31，95%可信区间（CI）：0.96～1.74，P>0.05]。有糖尿病家族史者罹患T2DM的风险是无家族史者的4.35倍(RR=4.35，95%CI：2.01～7.14，P<0.01)。调整潜在混杂因素后，睡眠时间不足(<6 h/晚)合并糖尿病家族史者发生T2DM的风险显著高于睡眠时间6～8 h/晚且无糖尿病家族史者(RR=7.98，95%CI：3.86～12.95，P<0.01)；未发现睡眠时间过长(>8 h/晚)合并糖尿病家族史者与罹患T2DM相关联(RR=1.12，95%CI：0.88～1.59，P>0.01)；调整潜在的混杂因素后，睡眠时间不足(<6 h/晚)和糖尿病家族史的交互作用的相对超额危险度比(RERI)、归因比(AP)和交互作用指数(S)分别为3.51(1.41～6.77)、0.46(0.26～0.62)和1.98(1.24～3.13)，糖尿病家族史和睡眠时间过长交互作用的RERI、AP和S分别为0.07(-0.18～0.31)、0.02(-0.15～0.10)和0.95(-0.04～2.01)。结论糖尿病家族史和睡眠时间不足对增加T2DM罹患风险存在交互作用，糖尿病家族史和睡眠时间过长对T2DM罹患风险不存在交互作用。
목적：탐토당뇨병가족사화수면시간대리환2형당뇨병(T2DM)풍험적교호작용。방법우2013년5월채용다계단수궤추양，대서주시18～75세적상주거민진행기선조사，재차기출상，수집미학진위T2DM적인군대기개전위기5년적수방，병대수방인군당뇨병가족사화수면시간여리환T2DM풍험지교호작용진행평고。채용비조건Logistic회귀분석당뇨병가족사화수면시간여T2DM지간적관계。결과15939명거민납입수방연구，5년후공수방도11842명（74.3%）。수시자평균매만수면시간위(7.2±1.1) h，T2DM발병솔위3.10%。조정혼잡인소후，여수면시간6～8 h/만상비，수면시간불족(<6h/만)가증가리환T2DM적풍험(RR=1.54，95%CI：1.21～2.13，P<0.01)；수면시간과장(>8 h/만)미증가리환T2DM적풍험[풍험비(RR）=1.31，95%가신구간（CI）：0.96～1.74，P>0.05]。유당뇨병가족사자리환T2DM적풍험시무가족사자적4.35배(RR=4.35，95%CI：2.01～7.14，P<0.01)。조정잠재혼잡인소후，수면시간불족(<6 h/만)합병당뇨병가족사자발생T2DM적풍험현저고우수면시간6～8 h/만차무당뇨병가족사자(RR=7.98，95%CI：3.86～12.95，P<0.01)；미발현수면시간과장(>8 h/만)합병당뇨병가족사자여리환T2DM상관련(RR=1.12，95%CI：0.88～1.59，P>0.01)；조정잠재적혼잡인소후，수면시간불족(<6 h/만)화당뇨병가족사적교호작용적상대초액위험도비(RERI)、귀인비(AP)화교호작용지수(S)분별위3.51(1.41～6.77)、0.46(0.26～0.62)화1.98(1.24～3.13)，당뇨병가족사화수면시간과장교호작용적RERI、AP화S분별위0.07(-0.18～0.31)、0.02(-0.15～0.10)화0.95(-0.04～2.01)。결론당뇨병가족사화수면시간불족대증가T2DM리환풍험존재교호작용，당뇨병가족사화수면시간과장대T2DM리환풍험불존재교호작용。
Objective To explore the interaction between family history of diabetes and sleep duration on prevalence of type 2 diabetes mellitus (T2DM). Methods A cohort study was conducted among permanent residents aged from 18 to 75 years in Xuzhou in May 2013. On the basis of this, a followed?up study of five years was conducted among a collection of participants without T2DM, and the interaction between family history of diabetes and sleep duration on prevalence of T2DM in followed?up participants was evaluated. Non-conditional logistic regression analysis was used to analyse the association between family history of diabetes and sleep duration on prevalence of T2DM. Results Total of 15 939 participants were involved inthe followed?up study, and after five years, finally 11 842 participants were still in the cohort. The average sleep duration of total participants was (7.2 ± 1.1) hours per night. The accumulative rate of T2DM among the followed?up participants was 3.10%.After adjusting for the confounding factors, compared with that participants with sleep duration of 6?8 h/night, individuals with sleep duration<6 hours per night had a higher prevalence of T2DM (RR=1.54, 95%CI:1.21?2.13, P<0.01), and the risk of T2DM did not increase in individuals with sleep duration>8 hours per night (RR=1.31, 95%CI:0.96?1.74, P>0.05). Individuals with family history of diabetes were more likely to suffer from T2DM than those without(RR=4.35, 95%CI:2.01?7.14, P<0.01). After adjusted for potential confounding factors, individuals withfamily history of diabetes and sleep duration<6 hours per night had significantly increased risk prevalence of T2DM (RR=7.98, 95%CI:3.86?12.95, P<0.01) and the risk of T2DM in participants with the family history of diabetesand sleep duration>8 hours per night didn′t increase significantly(RR=1.12, 95%CI:0.88?1.59, P>0.05) when compared with participants with sleep duration of 6-8 hours per night without family history of diabetes. After adjusted for potential confounding factors, values of the relative excess risk of interaction (RERI),the attributable proportion(AP) ,and the synergy index(S) for the additive interaction betweenthe family history of diabetes and sleep duration<6 hours per night were 3.51(1.41?6.77), 0.46(0.26?0.62) and 1.98(1.24?3.13) respectively, while 0.07(-0.18?0.31)、0.02(-0.15?0.10)and 0.95(-0.04? 2.01) for the additive interaction between the family history of diabetes and sleep duration>8 hours per night. Conclusions Additive interactions exist between family history of diabetes and sleep duration<6 hours per night. There is not combined interaction to the increased risk of T2DM when family history of diabetes and sleep duration>8 hours per night at the same time.