Sleep Duration and Cardiometabolic-Kidney-Metabolic Syndrome: The Role of Depressive Symptoms in a Longitudinal Study.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-08-22 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S537555

Yilin Pan, Jingru Bi, Long Feng, Xiaoyun Li

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Abstract

Background: Sleep disturbances are increasingly recognized as modifiable risk factors for metabolic and cardiovascular diseases. However, the relationship between sleep duration patterns and Cardiometabolic-Kidney-Metabolic (CKM) syndrome remains underexplored, particularly regarding the mediating role of mental health factors. This study investigates the longitudinal association between sleep duration and CKM risk, examining whether depressive symptoms mediate this relationship.

Methods: We analyzed data from 6462 participants (aged ≥45 years) from the China Health and Retirement Longitudinal Study. Sleep duration was self-reported and categorized as short (<7 hours), optimal (7-9 hours), or long (>9 hours), with 2-year sleep trajectories also defined. CKM syndrome was classified per American Heart Association guidelines, and depressive symptoms were assessed via the 10-item Center for Epidemiologic Studies Depression Scale. Associations were examined using multivariable logistic regression, restricted cubic splines, and causal mediation analysis.

Results: Baseline short sleep duration was independently associated with increased CKM risk (adjusted OR = 1.148; 95% CI: 1.014-1.299). Persistently abnormal sleep over two years further elevated this risk (OR = 1.259; 95% CI: 1.077-1.471). We observed a significant non-linear dose-response relationship between sleep duration and CKM risk (P = 0.031). Causal mediation analysis showed that depressive symptoms partially mediated this association (ACME = -0.002; P < 0.001). Subgroup analyses revealed stronger associations among women, individuals with lower education, and urban residents.

Conclusion: Both short and persistently abnormal sleep independently increase CKM syndrome risk, with depressive symptoms acting as a key mediator. These findings highlight the importance of integrated interventions targeting sleep optimization and mental health management, particularly for high-risk demographic subgroups. Sleep assessment should be incorporated into CKM risk stratification and prevention strategies.

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睡眠时间与心-肾-代谢综合征：抑郁症状在一项纵向研究中的作用

背景：睡眠障碍越来越被认为是代谢和心血管疾病的可改变危险因素。然而，睡眠持续时间模式与心-肾-代谢（CKM）综合征之间的关系仍未得到充分探讨，特别是关于心理健康因素的中介作用。本研究调查了睡眠时间与CKM风险之间的纵向关联，考察抑郁症状是否介导了这种关系。方法：我们分析了来自中国健康与退休纵向研究的6462名参与者（年龄≥45岁）的数据。睡眠时间是自我报告的，并被归类为短（9小时），并定义了2年的睡眠轨迹。根据美国心脏协会指南对CKM综合征进行分类，并通过10项流行病学研究中心抑郁量表对抑郁症状进行评估。使用多变量逻辑回归、受限三次样条和因果中介分析来检验相关性。结果：基线短睡眠时间与CKM风险增加独立相关（调整后OR = 1.148; 95% CI: 1.014-1.299）。持续不正常的睡眠超过两年进一步增加了这种风险（OR = 1.259; 95% CI: 1.077-1.471）。我们观察到睡眠时间与CKM风险之间存在显著的非线性剂量-反应关系（P = 0.031）。因果中介分析显示，抑郁症状部分介导了这种关联（ACME = -0.002; P < 0.001）。亚组分析显示，女性、受教育程度较低的个体和城市居民之间的关联更强。结论：短时间和持续的睡眠异常均独立增加CKM综合征的风险，其中抑郁症状是关键的中介因素。这些发现强调了针对睡眠优化和心理健康管理的综合干预的重要性，特别是对高危人群。睡眠评估应纳入CKM风险分层和预防策略。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.