我国30~79岁成年人中睡眠状况与衰弱的相关性研究

目的 描述我国30~79岁成年人的睡眠状况与衰弱的相关性，并探讨肥胖对二者关系的效应修饰作用。方法 基于中国慢性病前瞻性研究项目的基线调查数据，采用多分类logistic回归，分别分析全体研究对象、不同肥胖状态者睡眠时长较长（≥9 h/d）、较短（≤6 h/d）、失眠障碍、打鼾、不健康睡眠评分与衰弱前期、衰弱期的相关性，并根据分层分析判断肥胖的效应修饰作用。结果 在512 724名研究对象中，2.3%处于衰弱状态，40.1%处于衰弱前期状态。睡眠时长与衰弱评分之间呈U形关系。睡眠时长较短（OR=1.21，95%CI：1.19~1.23）、较长（OR=1.19，95%CI：1.17~1.21）、失眠障碍（OR=2.09，95%CI：2.02~2.17）、打鼾（OR=1.61，95%CI：1.59~1.63）、不健康睡眠评分为1分（OR=1.46， 95%CI：1.44~1.48）、2分（OR=1.97，95%CI：1.93~2.00）、3分（OR=3.43，95%CI：3.21~3.67）均与处于衰弱前期正相关。上述睡眠问题亦与处于衰弱期正相关。在正常体重组中，睡眠时长较短者处于衰弱或衰弱前期、失眠者处于衰弱前期的相关性高于超重肥胖组；而打鼾者处于衰弱或衰弱前期的相关性低于超重肥胖组，按中心性肥胖分层结果类似（交互P值均<0.007）。结论 睡眠时长较长或较短、失眠障碍、打鼾、不健康睡眠评分较高，均与处于衰弱前期或衰弱期正相关，超重肥胖对二者关系具有效应修饰作用。

Correlation between sleep status and frailty in adults aged 30-79 years in China

Objective To explore the correlation between sleep status and frailty in adults aged 30-79 years in China,and explore the potential effect modification of general and central obesity.Methods Based on the baseline data of the China Kadoorie Biobank,we used multinomial logistic regression to analyze the correlation between long and short sleep duration,insomnia disorder,snoring,and unhealthy sleep score with risks of pre-frailty and frailty.Both overall and obesity-stratified analyses were performed.Result Among the 512 724 participants,2.3% had frailty and 40.1% had pre-frailty.There was a U-shaped relationship between sleep duration and frailty score.Short (OR=1.21,95%CI:1.19-1.23) or long sleep duration (OR=1.19,95%CI:1.17-1.21),insomnia disorder (OR=2.09,95%CI:2.02-2.17),and snoring (OR=1.61,95%CI:1.59-1.63) were all positively correlated with pre-frailty,and dose-response relationships were observed between unhealthy sleep score and pre-frailty (P for trend<0.001),with OR values of 1.46(1.44-1.48),1.97(1.93-2.00) and 3.43(3.21-3.67) respectively for those having unhealthy sleep score of 1 to 3.These sleep problems were also positively correlated with frailty.Compared with the overweight or obesity group,stronger relationships were observed between short sleep duration and frailty or pre-frailty and between insomnia disorder and pre-frailty,while the relationships between snoring and frailty and pre-frailty were weaker in the participants with normal weight (P for interaction<0.007 for all).We also observed similar effect modification by central obesity.Conclusion Long or short sleep duration,insomnia disorder,snoring and higher unhealthy sleep scores were positively correlated with pre-frailty or frailty,general and central obesity status could modify the relationships.