Association Between Sleep Duration and Stroke in Different Status of Metabolic Syndrome: A Cross-Sectional Study in Shanghai Adult Residents

Abstract

Purpose

This study aimed to investigate the relationship between sleep duration (SD) and stroke, and examine the effects of SD on stroke with or without metabolic syndrome (Mets) and its components among the adult residents in Shanghai, China.

Participants and Methods

A total of 20,245 participants (51.72% male, mean age 44.66 years) were included from Shanghai Chronic Disease and Risk Factors Surveillance (SCDRFS) in 2017. The weighted logistic regressions were performed to examine the associations between SD and stroke in different status of Mets and its components.

Results

The mean SD was 7.51±0.03 h/d. After adjusting for all the potential factors, SD<6 h/d (OR=1.73, 95% CI: 1.35–2.20) or ≥10 h/d (OR=1.66, 95% CI: 1.08–2.57) was significantly positively associated with stoke in the total participants; moreover, in the non-Mets group, only SD<6 h/d (OR=1.77, 95% CI: 1.19, 2.64) significantly increased the risk of stroke; while, in the Mets group, SD<6 h/d (OR=1.80, 95% CI:1.17–2.76) and ≥10 h/d (OR=1.97, 95% CI: 1.00–3.88) both had a positive significantly association with stoke. In addition, the effects of SD<6 h/d on stroke were more pronounced among those with high WC (OR=2.24, 95% CI: 1.40–3.58) and high TG (OR=2.60, 95% CI: 1.86–3.62), and the effects of SD≥10 h/d on stroke were more evident among those with high TG (OR=2.28, 95% CI: 1.02–5.08) and high FBG (OR=2.58, 95% CI: 1.30–5.10).

Conclusion

Both short and long SD were significantly positively associated with stroke in the total participants, and the associations were stronger in the Mets group; conversely, in the non-Mets group, only short SD was significantly positively associated with stroke, and no significant association was observed between long SD and stroke. Therefore, more precise sleep measures may be needed to prevent stroke according to the different status of Mets.

Keywords:

• sleep duration
• metabolic syndrome
• stroke
• Shanghai

Abbreviations

CNS, central nervous system; GBD, Global Burden of Disease; DALYs, disability-adjusted life-years; SD, sleep duration; CHNS, China Health and Nutrition Survey; Mets, metabolic syndrome; BP, blood pressure; TG, triglycerides; HDL-C, high-density lipoprotein cholesterol; FBG, fasting glucose; SCDRFS, Shanghai Chronic Disease and Risk Factors Surveillance; WHO, World Health Organization; CCDRFS, China Chronic Disease and Risk Factors Surveillance; SCDC, Shanghai Municipal Center for Disease Control and Prevention; NCDs, chronic non-communicable diseases; WC, waist circumference; IDF, International Diabetes Federation; NHLBI, National Heart, Lung, and Blood Institute; GPAQ, Global Physical Activity Questionnaire; FFQ, Food Frequency Questionnaire; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; BMI, body mass index; CRP, C-reactive protein; IL-10, interleukin-10; HPA, hypothalamic-pituitary-adrenal.

Data Sharing Statement

The data used in this study are available on request from the corresponding authors. The data are not publicly available due to availability restrictions reported in the informed consent signed by all participants.

Ethics Approval and Informed Consent

All participants signed the consent forms after they were informed of the purpose and demands of the survey. The Ethics Committee of Shanghai Municipal Center for Disease Control and Prevention approved the study protocol (No.2016-10).

Acknowledgments

We thank the research grants from Shanghai Municipal Health Commission and Shanghai Medical and Health Development Foundation (1. Shanghai Municipal Health Commission Youth Projects [No. 20204Y0195]; 2. New Star in Medical Circle of Shanghai – Public Health Leader Project [No. 202199]; 3. The Shanghai New Three-year Action Plan for Public Health [No. GWV-10.1-XK16]). We appreciate all participants and researchers who participated in this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; have agreed on the journal to which the article has been submitted; reviewed and agreed on all versions of the article before submission, during revision, the final version accepted for publication, and any significant changes introduced at the proofing stage; and agree to take responsibility and be accountable for the contents of the article.

Disclosure

The authors declare no conflicts of interest in this work.

Additional information

Funding

This study was financially supported by the Shanghai Municipal Health Commission and Shanghai Medical and Health Development Foundation (1. Shanghai Municipal Health Commission Youth Projects [No. 20204Y0195]; 2. New Star in Medical Circle of Shanghai – Public Health Leader Project [No. 202199]); 3. The Shanghai New Three-year Action Plan for Public Health (No. GWV-10.1-XK16).