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The average age of the participants was 47.3 y (SD = 6.7); 36% of the participants had hypertension and 7.2% had diabetes. The mean BMI of this population was 24.9 kg/m2 and 18.8% were generally obese. Over half (56.4%) of the participants were abdominally obese and 32.5% had high %BF. The average sleep duration reported was 7.3 h (SD = 1.3) for men and 7.5h (SD = 1.3) for women; men tended to show less sleep times than women (P < 0.001). Among men, 18.27% were obese, 58.9% were abdominally obese, and 40.21% had a high %BF. Among women, 19.21% were obese, 54.55% were abdominally obese, and 26.56% had a high %BF.
Table 1 shows the clinical characteristics of participants with different intervals of sleep duration by gender. Short sleepers and longer sleepers tended to be older than normal sleepers (P < 0.001). Among women, the prevalence of obesity, abdominal obesity, and high %BF was higher in long sleepers than in short and normal sleepers (P all < 0.01). Among men, the prevalence of abdominal obesity differed across sleep duration groups (P = 0.005).
Table 1. Descriptive Characteristics of Participants by Sex and Sleep Duration (n=7,094)a
The results of logistic regression analysis of the relationship between sleep duration and obesity, abdominal obesity, and high %BF in men and women are summarized in Table 2. The association between sleep duration and obesity was attenuated by adjusting for additional confounding factors. In women, longer sleepers (≥ 9 h) demonstrated a higher prevalence of obesity (OR = 1.30, 95% CI: 1.02-1.67) and higher %BF (OR = 1.43, 95% CI: 1.04-1.96) with all covariates adjusted but shorter sleepers (< 6 h) did not. In men, subjects who slept 8-9 and ≥ 9 h daily presented a reduced frequency of abdominal obesity, with ORs of 0.71 (95% CI: 0.53-0.95) and 0.79 (95% CI: 0.44-0.99) respectively.
Table 2. Odds Ratios among Groups of Sleep Duration and Obesity Classified by BMI, Waist Circumference, and Percent Body Fat from Ordinary Least-Squares (OLS) Regressiona
Model Men Women Obeseb Abdominal
ObesebHigh %BFb Obeseb Abdominal
ObesebHigh %BFb Model 1c < 6 h 0.90 (0.61, 1.33) 0.76 (0.56, 1.03) 0.99 (0.72, 1.35) 0.93 (0.65, 1.34) 0.95 (0.71, 1.26) 0.92 (0.66, 1.27) 6-7 h 0.99 (0.76, 1.30) 1.01 (0.81, 1.26) 1.02 (0.82, 1.27) 1.06 (0.81, 1.39) 1.15 (0.93, 1.42) 1.09 (0.86, 1.40) 7-8 h ref ref ref ref ref ref 8-9 h 0.91 (0.72, 1.15) 0.74 (0.62, 0.89)* 0.93 (0.77, 1.12) 1.00 (0.82, 1.24) 1.09 (0.93, 1.28) 1.01 (0.83, 1.22) ≥ 9 h 1.06 (0.77, 1.44) 0.81 (0.63, 1.04) 1.16 (0.90, 1.49) 1.47 (1.16, 1.87)* 1.44 (1.18, 1.76)* 1.76 (1.41, 2.19)* Model 2c < 6 h 0.93 (0.61, 1.40) 0.73 (0.45, 1.20) 1.09 (0.74, 1.61) 0.96 (0.66, 1.40) 1.13 (0.74, 1.72) 0.92 (0.58, 1.47) 6-7 h 0.98 (0.74, 1.31) 0.95 (0.67, 1.35) 1.05 (0.76, 1.33) 1.06 (0.80, 1.40) 0.93 (0.68, 1.27) 1.00 (0.71, 1.42) 7-8 h Ref Ref Ref Ref Ref Ref 8-9 h 0.98 (0.77, 1.25) 0.71 (0.53, 0.95)* 1.02 (0.80, 1.29) 0.97 (0.78, 1.20) 0.95 (0.76, 1.21) 0.88 (0.67, 1.16) ≥ 9 h 1.04 (0.75, 1.45) 0.79 (0.44, 0.99)* 1.18 (0.86, 1.63) 1.30 (1.02, 1.67)* 0.99 (0.73, 1.34) 1.43 (1.04, 1.96)* Note.a, Logistic regression was used to estimate the odds ratio between groups of sleep duration and obesity prevalence. Obesity was defined as a BMI ≥ 28 kg/m2or waist circumference ≥ 85 cm in men and ≥ 80 cm in women. High %BF was defined as %BF > 25% for men and > 35% for women. b, Obesity was defined as BMI ≥ 28 kg/m2or waist circumference ≥ 85 cm in men and ≥ 80 cm in women. High %BF was defined as %BF > 25% for men and > 35% for women. c, Model 1 was adjusted for age, and Model 2 was adjusted for age, education, occupation, marital status, smoking, alcohol consumption, sedentary behavior, hypertension, diabetes, dietary intake, and physical activity. BMI was adjusted in the abdominal obesity and high %BF regression model. *, P< 0.05. QR regression indicated that, in men, the negative association of sleep duration and WC could be observed in the median percentile of the WC distribution (Table 3). No striking association was found between any number of sleep hours and BMI and %BF in men.
Table 3. Association of Sleep Duration with percentiles of BMI, Waist Circumference, and Percent Body Fat Estimatde by Quantile Regression in Mena
Women who slept ≥ 9 h showed BMI values higher by about 0.54-0.59 kg/m2 in the 10th to 75th percentile of the BMI distribution compared with those who slept 7-8 h (Table 4). An association between long sleep hours and increased %BF was found only in the 50th percentile of the %BF distribution. However, the association of long sleep hours with WC disappeared after BMI and other cofounders adjusted.
Table 4. Association of Sleep Duration with Percentiles of BMI, Waist Circumference, and Percent Body Fat Estimatde by Quantile Regression in Womena
The association between sleep duration and obesity by gender was determined by age group, and we observed fairly similar association patterns between younger and older participants (Figure 1).
Figure 1. Adjusted odds ratio (OR) of obesity, abdominal obesity, and percent body fat (%BF) by age and sex from ordinary least-squaresreg ression. (A) OR of obesity by age and sex. (B) OR of abdominal obesity by age and sex. (C) OR of %BF by age and sex. Obesity was defined as BMI ≥ 28 kg/m2, abdominal obesity was defined as waist circumference ≥ 85 cm in men and ≥ 80 cm in women, and high %BF was defined as % BF > 25% for men and > 35% for women. The adjusted variables include age, education, occupation, marital status, smoking, alcohol consumption, sedentary behavior, hypertension, diabetes, dietary intake, and physical activity. BMI was adjusted in the abdominal obesity and high %BF regression model.
Gender-specific Association of Sleep Duration with Body Mass Index, Waist Circumference, and Body Fat in Chinese Adults
doi: 10.3967/bes2017.023
Gender-specific Association of Sleep Duration with Body Mass Index, Waist Circumference, and Body Fat in Chinese Adults
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Abstract:
Objective To examine the association between habitual sleep duration and obesity among Chinese adults. Methods The association of sleep duration and obesity was investigated among 7,094 community-dwelling Chinese adults. Sleep duration was self-reported. In this study, obesity was defined as follows: body mass index (BMI) ≥ 28 kg/m2, waist circumference (WC) ≥ 85 cm in men and ≥ 80 cm in women, and percent body fat (% BF) ≥ 25 in men and ≥ 35 in women. Logistic and quantile regressions were employed to examine relationships of interest. Results Overall, 6.42% of the participants reported short sleep durations (<6 h/d) while 14.71% reported long (≥ 9 h/d) sleep durations. Long sleepers (≥ 9 h/d) represented a greater frequency of women with obesity [odds ratio (OR): 1.30; 95% confidence interval (CI), 1.02-1.67] and high body fat (1.43, 1.04-1.96) than those who slept 7-8 h/d. An association between long sleep times and higher BMI estimations was found across the 10th-75th percentile of the BMI distribution. Among men, long sleepers (≥ 9 h/d) presented lower risks of developing abdominal obesity compared with individuals who slept 7-8 h/d (OR=0.79, 95% CI: 0.44-0.99). Conclusion Our study suggests that long sleep durations are associated with general obesity in Chinese women but reduced waist circumferences in men. Confirmatory studies are needed to determine the heterogeneous association of sleep time and obesity by gender. -
Key words:
- Sleep duration /
- Gender /
- Obesity /
- Quantile regression
注释:1) CONFLICT OF INTEREST: 2) AUTHOR'S CONTRIBUTIONS: -
Figure 1. Adjusted odds ratio (OR) of obesity, abdominal obesity, and percent body fat (%BF) by age and sex from ordinary least-squaresreg ression. (A) OR of obesity by age and sex. (B) OR of abdominal obesity by age and sex. (C) OR of %BF by age and sex. Obesity was defined as BMI ≥ 28 kg/m2, abdominal obesity was defined as waist circumference ≥ 85 cm in men and ≥ 80 cm in women, and high %BF was defined as % BF > 25% for men and > 35% for women. The adjusted variables include age, education, occupation, marital status, smoking, alcohol consumption, sedentary behavior, hypertension, diabetes, dietary intake, and physical activity. BMI was adjusted in the abdominal obesity and high %BF regression model.
Table 1. Descriptive Characteristics of Participants by Sex and Sleep Duration (n=7,094)a
Table 2. Odds Ratios among Groups of Sleep Duration and Obesity Classified by BMI, Waist Circumference, and Percent Body Fat from Ordinary Least-Squares (OLS) Regressiona
Model Men Women Obeseb Abdominal
ObesebHigh %BFb Obeseb Abdominal
ObesebHigh %BFb Model 1c < 6 h 0.90 (0.61, 1.33) 0.76 (0.56, 1.03) 0.99 (0.72, 1.35) 0.93 (0.65, 1.34) 0.95 (0.71, 1.26) 0.92 (0.66, 1.27) 6-7 h 0.99 (0.76, 1.30) 1.01 (0.81, 1.26) 1.02 (0.82, 1.27) 1.06 (0.81, 1.39) 1.15 (0.93, 1.42) 1.09 (0.86, 1.40) 7-8 h ref ref ref ref ref ref 8-9 h 0.91 (0.72, 1.15) 0.74 (0.62, 0.89)* 0.93 (0.77, 1.12) 1.00 (0.82, 1.24) 1.09 (0.93, 1.28) 1.01 (0.83, 1.22) ≥ 9 h 1.06 (0.77, 1.44) 0.81 (0.63, 1.04) 1.16 (0.90, 1.49) 1.47 (1.16, 1.87)* 1.44 (1.18, 1.76)* 1.76 (1.41, 2.19)* Model 2c < 6 h 0.93 (0.61, 1.40) 0.73 (0.45, 1.20) 1.09 (0.74, 1.61) 0.96 (0.66, 1.40) 1.13 (0.74, 1.72) 0.92 (0.58, 1.47) 6-7 h 0.98 (0.74, 1.31) 0.95 (0.67, 1.35) 1.05 (0.76, 1.33) 1.06 (0.80, 1.40) 0.93 (0.68, 1.27) 1.00 (0.71, 1.42) 7-8 h Ref Ref Ref Ref Ref Ref 8-9 h 0.98 (0.77, 1.25) 0.71 (0.53, 0.95)* 1.02 (0.80, 1.29) 0.97 (0.78, 1.20) 0.95 (0.76, 1.21) 0.88 (0.67, 1.16) ≥ 9 h 1.04 (0.75, 1.45) 0.79 (0.44, 0.99)* 1.18 (0.86, 1.63) 1.30 (1.02, 1.67)* 0.99 (0.73, 1.34) 1.43 (1.04, 1.96)* Note.a, Logistic regression was used to estimate the odds ratio between groups of sleep duration and obesity prevalence. Obesity was defined as a BMI ≥ 28 kg/m2or waist circumference ≥ 85 cm in men and ≥ 80 cm in women. High %BF was defined as %BF > 25% for men and > 35% for women. b, Obesity was defined as BMI ≥ 28 kg/m2or waist circumference ≥ 85 cm in men and ≥ 80 cm in women. High %BF was defined as %BF > 25% for men and > 35% for women. c, Model 1 was adjusted for age, and Model 2 was adjusted for age, education, occupation, marital status, smoking, alcohol consumption, sedentary behavior, hypertension, diabetes, dietary intake, and physical activity. BMI was adjusted in the abdominal obesity and high %BF regression model. *, P< 0.05. Table 3. Association of Sleep Duration with percentiles of BMI, Waist Circumference, and Percent Body Fat Estimatde by Quantile Regression in Mena
Table 4. Association of Sleep Duration with Percentiles of BMI, Waist Circumference, and Percent Body Fat Estimatde by Quantile Regression in Womena
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