食欲脂肪因子和胰岛素抵抗塑造了有心脏代谢风险的年轻人睡眠质量和心脏结构之间的联系：BCAMS研究

IF 3.7 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Cytokine Pub Date : 2025-07-18 DOI:10.1016/j.cyto.2025.156998

Mengyu He , Ling Zhong , Lanwen Han , Xinghao Yi , Ming Li , Shan Gao

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引用次数: 0

摘要

背景：睡眠质量差（PSQ）与心血管疾病有关，但在青少年中这种关系背后的关键中间变量尚不清楚。我们旨在探讨中国心脏代谢风险升高的青少年PSQ与不良心脏结构之间的关系，重点关注食欲脂肪因子和胰岛素抵抗的作用。方法采用来自北京儿童和青少年代谢综合征（BCAMS）研究队列的横断面数据（n = 559，平均年龄= 20.2岁）。参与者接受了超声心动图评估、睡眠质量问卷、口服葡萄糖耐量试验、血浆胰岛素水平和五种食欲脂肪因子。结果PSQ评分升高与左心室质量指数（LVMI）不良（PSQ评分每单位升高0.64 g/m2.7）、食欲脂肪因子改变（包括瘦素升高8.3%、视黄醇结合蛋白4 （RBP4）升高1.9%、高分子量脂联素（hmw -脂联素）降低3.2%）以及胰岛素敏感性受损相关，反映在空腹胰岛素水平升高6.6%、胰岛素抵抗稳态模型评估（HOMA-IR）升高6.7%。胰岛素敏感性指数（松田指数）（ISIMatsuda）降低4.9%，PSQ评分每增加1分(均p <；0.05)。在中介分析中，瘦素显著介导了28.5%的PSQ-LVMI关联(p <；0.001)，胰岛素相关指数解释了13.6% - 23.6% (p <；0.05);hmw -脂联素具有边际调节作用（8.1%,p = 0.077）。此外，相互作用分析显示，胰岛素抵抗放大了PSQ对LVMI的不利影响(HOMA-IR的相互作用= 0.04；0.029 (ISIMatsuda)， LVMI中psq相关的高升高在胰岛素抵抗较高的青少年中更为明显。结论spsq与具有心脏代谢风险的青年早期不良心脏重构相关，可能由瘦素升高和胰岛素抵抗驱动。针对睡眠质量、脂肪因子信号和胰岛素敏感性，可能为高危青少年早期心血管预防提供协同策略。

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Appetite adipokines and insulin resistance shape the link between sleep quality and cardiac structure in youths with cardiometabolic risk: the BCAMS study

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Appetite adipokines and insulin resistance shape the link between sleep quality and cardiac structure in youths with cardiometabolic risk: the BCAMS study

Background

Poor sleep quality (PSQ) is associated with cardiovascular disease, but the key intermediate variables underlying this relationship in youths remain unclear. We aimed to explore the relationship between PSQ and adverse cardiac structure in Chinese youths with elevated cardiometabolic risk, focusing on the roles of appetite adipokines and insulin resistance.

Methods

We utilized cross-sectional data from the Beijing Children and Adolescents Metabolic Syndrome (BCAMS) Study Cohort (n = 559, mean age = 20.2 years). Participants underwent echocardiographic assessments, a sleep quality questionnaire, an oral glucose tolerance test, and plasma levels of insulin and five appetite adipokines.

Results

Elevated PSQ scores were associated with adverse left ventricular mass index (LVMI) (0.64 g/m^2.7 per unit increase in PSQ score), altered appetite adipokines, including 8.3 % higher leptin, 1.9 % higher retinol-binding protein 4 (RBP4), and 3.2 % lower high-molecular-weight adiponectin (HMW-adiponectin), as well as impaired insulin sensitivity, reflected by 6.6 % higher fasting insulin levels, 6.7 % higher homeostasis model assessment of insulin resistance (HOMA-IR), and 4.9 % lower insulin sensitivity index (Matsuda Index) (ISI_Matsuda), per point increase in PSQ score (all p < 0.05). In mediation analyses, leptin significantly mediated 28.5 % of the PSQ–LVMI association (p < 0.001), and insulin-related indices explained 13.6 %–23.6 % (p < 0.05); HMW-adiponectin showed a marginal mediating effect (8.1 %, p = 0.077). Furthermore, interaction analysis revealed that insulin resistance amplified the adverse impact of PSQ on LVMI (p_interaction = 0.04 for HOMA-IR; 0.029 for ISI_Matsuda), with high PSQ-related elevations in LVMI more pronounced among youths with higher insulin resistance.

Conclusions

PSQ is associated with early adverse cardiac remodeling in youths with cardiometabolic risk, potentially driven by elevated leptin and insulin resistance. Targeting sleep quality, adipokine signaling, and insulin sensitivity, may offer synergistic strategies for early cardiovascular prevention in at-risk youths.

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来源期刊

Cytokine 医学-免疫学

CiteScore

7.60

自引率

2.60%

发文量

262

审稿时长

48 days

期刊介绍： The journal Cytokine has an open access mirror journal Cytokine: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. * Devoted exclusively to the study of the molecular biology, genetics, biochemistry, immunology, genome-wide association studies, pathobiology, diagnostic and clinical applications of all known interleukins, hematopoietic factors, growth factors, cytotoxins, interferons, new cytokines, and chemokines, Cytokine provides comprehensive coverage of cytokines and their mechanisms of actions, 12 times a year by publishing original high quality refereed scientific papers from prominent investigators in both the academic and industrial sectors. We will publish 3 major types of manuscripts: 1) Original manuscripts describing research results. 2) Basic and clinical reviews describing cytokine actions and regulation. 3) Short commentaries/perspectives on recently published aspects of cytokines, pathogenesis and clinical results.