睡眠质量与心脑血管疾病发病中、低危人群颈动脉粥样硬化的相关性分析
R541.4%R743.3; 目的·探讨睡眠质量与心脑血管疾病发病中、低危人群颈动脉粥样硬化的相关性.方法·基于新疆地区心脑血管自然人群队列,于2019年7月—2021年9月采用两阶段整群随机抽样的方法选取新疆北部(北疆)地区乌鲁木齐市和南疆地区库尔勒市共2个固定社区35～75岁的居民.在既往无冠心病且未发生脑血管事件的人群中,运用中国动脉粥样硬化性心血管疾病风险预测[prediction for atherosclerotic cardiovascular disease(ASCVD)risk in China,China-PAR]模型进行发病风险评估,纳入心脑血管疾病发病中、低危人群.所有...
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| Published in | 上海交通大学学报（医学版） Vol. 43; no. 11; pp. 1366 - 1373 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
新疆医科大学第一附属医院心脏中心,乌鲁木齐 830054%新疆医科大学第一附属医院心脏中心,乌鲁木齐 830054
01.11.2023
新疆维吾尔自治区人民医院心内科,乌鲁木齐 830001 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-8115 |
| DOI | 10.3969/j.issn.1674-8115.2023.11.004 |
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| Abstract | R541.4%R743.3; 目的·探讨睡眠质量与心脑血管疾病发病中、低危人群颈动脉粥样硬化的相关性.方法·基于新疆地区心脑血管自然人群队列,于2019年7月—2021年9月采用两阶段整群随机抽样的方法选取新疆北部(北疆)地区乌鲁木齐市和南疆地区库尔勒市共2个固定社区35～75岁的居民.在既往无冠心病且未发生脑血管事件的人群中,运用中国动脉粥样硬化性心血管疾病风险预测[prediction for atherosclerotic cardiovascular disease(ASCVD)risk in China,China-PAR]模型进行发病风险评估,纳入心脑血管疾病发病中、低危人群.所有纳入的研究对象均完成体格检查、问卷调查[包括新疆地区心脑血管疾病危险因素评测量表、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、国际体力活动问卷(International Physical Activity Questionnaire,IPAQ)、食物频率问卷]、心血管代谢相关的实验室检查和颈动脉超声检查.根据颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)和是否有斑块形成判断研究对象颈动脉粥样硬化情况.采用多因素Logistic回归模型和限制性立方样条(restricted cubic spline,RCS)分析心脑 血管疾病发病中、低危人群颈动脉粥样硬化与睡眠质量的相关性.结果·共1 528名心脑血管疾病发病中、低危人群纳入研究,平均年龄(49.4±8.2)岁,其中男性685人(44.8％).纳入的人群中颈动脉内膜中层增厚581人(38.0％),颈动脉斑块形成305人(20.0％);其中,内膜中层增厚且斑块形成154人(10.1％).因此颈动脉粥样硬化患病率为47.9％(732人).相较于颈动脉无增厚组,颈动脉内膜中层增厚/斑块组的一般心脑血管危险因素水平较高,包括年龄、男性比例、血脂水平和肥胖程度等,同时PSQI睡眠评分较高[(7.06±2.13)分vs(7.43±2.51)分,P=0.001],睡眠质量较差组的比例较高(6.5％vs 12.1％,P=0.001).多因素Logistic回归分析在校正了与颈动脉粥样硬化相关的影响因素后,提示睡眠质量差是心脑血管疾病发病中、低危人群颈动脉粥样硬化形成的独立危险因素[校正的 OR( |
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| AbstractList | R541.4%R743.3; 目的·探讨睡眠质量与心脑血管疾病发病中、低危人群颈动脉粥样硬化的相关性.方法·基于新疆地区心脑血管自然人群队列,于2019年7月—2021年9月采用两阶段整群随机抽样的方法选取新疆北部(北疆)地区乌鲁木齐市和南疆地区库尔勒市共2个固定社区35～75岁的居民.在既往无冠心病且未发生脑血管事件的人群中,运用中国动脉粥样硬化性心血管疾病风险预测[prediction for atherosclerotic cardiovascular disease(ASCVD)risk in China,China-PAR]模型进行发病风险评估,纳入心脑血管疾病发病中、低危人群.所有纳入的研究对象均完成体格检查、问卷调查[包括新疆地区心脑血管疾病危险因素评测量表、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、国际体力活动问卷(International Physical Activity Questionnaire,IPAQ)、食物频率问卷]、心血管代谢相关的实验室检查和颈动脉超声检查.根据颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)和是否有斑块形成判断研究对象颈动脉粥样硬化情况.采用多因素Logistic回归模型和限制性立方样条(restricted cubic spline,RCS)分析心脑 血管疾病发病中、低危人群颈动脉粥样硬化与睡眠质量的相关性.结果·共1 528名心脑血管疾病发病中、低危人群纳入研究,平均年龄(49.4±8.2)岁,其中男性685人(44.8％).纳入的人群中颈动脉内膜中层增厚581人(38.0％),颈动脉斑块形成305人(20.0％);其中,内膜中层增厚且斑块形成154人(10.1％).因此颈动脉粥样硬化患病率为47.9％(732人).相较于颈动脉无增厚组,颈动脉内膜中层增厚/斑块组的一般心脑血管危险因素水平较高,包括年龄、男性比例、血脂水平和肥胖程度等,同时PSQI睡眠评分较高[(7.06±2.13)分vs(7.43±2.51)分,P=0.001],睡眠质量较差组的比例较高(6.5％vs 12.1％,P=0.001).多因素Logistic回归分析在校正了与颈动脉粥样硬化相关的影响因素后,提示睡眠质量差是心脑血管疾病发病中、低危人群颈动脉粥样硬化形成的独立危险因素[校正的 OR( |
| Abstract_FL | Objective·To explore the relationship between sleep quality and carotid atherosclerosis in the population with low or moderate risk of cardiovascular and cerebrovascular diseases.Methods·Based on the population-based cohort study of chronic diseases in Xinjiang,the researchers selected residents aged 35-75 from two fixed communities in Urumqi and Korla,in Northern and Southern Xinjiang,respectively,using a two-stage random cluster sampling method from July 2019 to September 2021.In the population without a history of coronary heart disease and cerebrovascular events,the prediction model for atherosclerotic cardiovascular disease(ASCVD)risk in China(China-PAR)was used to evaluate the risk of cardiovascular and cerebrovascular diseases.Low and moderate risk population of cardiovascular and cerebrovascular diseases were included.Participants completed physical examinations,questionnaires[including the Risk Factors Assessment Scale of Cardiovascular and Cerebrovascular Diseases in Xinjiang,Pittsburgh Sleep Quality Index(PSQI),International Physical Activity Questionnaire(IPAQ),and Food Frequency Questionnaire],cardiovascular and metabolic biochemical examinations,and carotid color doppler.Carotid intima-media thickness(CIMT)and plaque formation were used to determine the carotid atherosclerosis of the study subjects.Multivariate Logistic regression model and restricted cubic spline(RCS)were used to analyze the relationship between sleep quality and carotid intima-media thickening/plaque formation in the population with low and moderate risk of cardiovascular and cerebrovascular diseases.Results·A total of 1 528 subjects were included in the study,the mean age was(49.4±8.2)years,and 685(44.8％)were male.In the included population,there were 581(38.0％)subjects with carotid intima-media thickening and 305(20.0％)subjects with carotid plaque formation.Among them,intima-media thickening and plaque formation both occurred in 154(10.1％)people.Therefore,the prevalence of carotid atherosclerosis was 47.9％(732 subjects).Compared with the group without carotid artery thickening,the group with carotid intima-media thickening/plaque formation had higher levels of general cardiovascular and cerebrovascular risk factors,including age,male ratio,blood lipid levels and obesity,and higher PSQ1 sleep score[(7.06±2.13)vs(7.43±2.51),P=0.001].The proportion of patients with poor sleep quality was higher(6.5％vs 12.1％,P=0.001).Multivariate Logistic regression analysis showed that poor sleep quality was an independent risk factor for carotid atherosclerosis[adjusted OR(aOR)=1.22,95％CI 1.004-1.492,P=0.040].RCS analysis suggested that PSQI and the risk of carotid atherosclerosis showed a positive linear correlation,that is,the worse quality of sleep,the higher risk of carotid atherosclerosis.Conclusion·Although the traditional metabolic risk factors are at a low risk level,the prevalence of carotid atherosclerosis is high and poor sleep quality is an independent risk factor for carotid atherosclerosis in the low and moderate risk population of cardiovascular and cerebrovascular diseases. |
| Author | 李晓梅 古丽洁合热·吐尔逊 赵倩 王颖 杨毅宁 谢依热·哈木拉提 |
| AuthorAffiliation | 新疆医科大学第一附属医院心脏中心,乌鲁木齐 830054%新疆医科大学第一附属医院心脏中心,乌鲁木齐 830054;新疆维吾尔自治区人民医院心内科,乌鲁木齐 830001 |
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| Author_FL | ZHAO Qian TUERXUN Gulijiehere YANG Yining LI Xiaomei WANG Ying HAMULATI Xieyire |
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| Keywords | atherosclerosis 睡眠质量 risk stratification cardiovascular and cerebrovascular disease 危险分层 动脉粥样硬化 sleep quality 心脑血管疾病 |
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