实用医学杂志 ›› 2021, Vol. 37 ›› Issue (17): 2282-2286.doi: 10.3969/j.issn.1006⁃5725.2021.17.023

• 调查研究 • 上一篇    下一篇

睡眠时间和糖尿病肾病尿蛋白进展风险的前瞻性队列研究

郭正勇, 赵观进, 张慧泽, 江波, 张宇 ,许洪涛   

  1. 南京梅山医院肾内科(南京210039)




  • 出版日期:2021-09-10 发布日期:2021-09-10
  • 通讯作者: 许洪涛 E⁃mail: xhtxjw@163.com
  • 基金资助:
    江苏省南京市卫生科技发展基金(编号 :YKK18224)

A prospective cohort study on the sleep duration and risk of progression of proteinuria among patients with early diabetic kidney disease

GUO Zhengyong,ZHAO Guanjin,ZHANG Huize,JIANG Bo,ZHANG Yu, XU Hongtao.   

  1. Department of NephrologyNanjing Meishan HospitalNanjing 210039China
  • Online:2021-09-10 Published:2021-09-10
  • Contact: XU Hongtao E⁃mail:xhtxjw@163.com

摘要:

目的 探讨不同睡眠时间与早期糖尿病肾病(DKD)尿蛋白进展风险的关联。方法 收集 2015 6 月至 2017 10 月本院肾内科就诊的 857 例早期 DKD 患者作为前瞻性观察队列研究。利用多因 Cox 回归分析模型分析不同睡眠时间与早期 DKD 尿蛋白进展风险的关系。结果 共有 765 例早期 DKD 患者纳入本研究,平均年龄(59.1 ± 6.2)岁,中位随访时间 2.8 年,DKD 尿蛋白进展者 123 例,进展发生率为 16.1%。睡眠时间 < 6、6~8、> 8 h/d 进展发生率分别为 29.4%(45/153)、12.5%(70/560)、15.4%(8/52)。睡眠时间< 6 h/d 尿蛋白进展发生率明显升高,差异有统计学意义(P < 0.05)。以睡眠时间 6~8 h/d 为基准相 比,调整混杂因素后,睡眠时间< 6、> 8 h/d 发生尿蛋白进展的 HR(95%CI)分别为 1.82(1.14~2.91)、1.04 (0.75~1.44)。对性别、年龄、体质量指数、每日运动量、吸烟、饮酒等进行分层分析,结果显示与调整相关 影响因素后人群结果相似,睡眠时间不足与 DKD 尿蛋白进展风险有统计学关联,但睡眠时间过长与 DKD 尿蛋白进展风险无统计学关联。结论 睡眠不足可能是早期糖尿病肾病尿蛋白进展的危险因素。

关键词:

睡眠时间, 糖尿病肾病, 前瞻性研究

Abstract:

Objective To investigate the relationship between sleep duration and the risk of progression of proteinuria in patients with early diabetic kidney disease(DKD). Methods 857 patients with early DKD admit⁃ ted to our hospital were studied. Cox proportional hazards regression models were used to evaluate the associations between different levels of the sleep duration and the risk of progression of proteinuria in patients with early DKD. Results A total of 765 patients with early DKD were enrolled in our study with an age of(59.1 ± 6.2)years and the median follow⁃up time was 2.8 years. A total of 123 cases with progression of proteinuria were identified in the cohort study. The total incidence of progression of proteinuria was 16.1%,and those in sleep duration < 6,6 8,> 8 h/d were 29.4%(45/153),12.5%(70/560)and 15.4%(8/52),respectively,with significant difference (P < 0.05). Compared with sleep duration 6~8 h,the multivariate adjusted hazard ratio(95% CI)of progression of proteinuria were 1.82(1.14 2.91)for < 6 h and 1.04(0.75 1.44)for > 8 h. According to gender,age BMI,physical activity,smoking and drinking habits,date of the stratified analysis showed that this was consistent with the whole adjusted population. Shorter sleep duration was associated with the risk of progression of proteinuria but no significant association was found between longer sleep duration and the risk. Conclusion Shorter sleep duration seemed to have increased the risk of proteinuria in patients with early DKD.

Key words:

sleep duration, diabetic kidney disease, prospective study