{"title":"睡眠特征和心-肾-代谢多重疾病的纵向进展：一项来自英国生物银行的前瞻性研究。","authors":"Yali Niu, Tianrun Wang, Xiaocan Jia, Chaojun Yang, Jingwen Fan, Chenyu Zhao, Nana Wang, Zhixing Fan, Xuezhong Shi","doi":"10.1016/j.sleh.2025.08.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cardio-renal-metabolic multimorbidity is defined as the coexistence of two or three cardio-renal-metabolic diseases, namely cardiovascular disease, type 2 diabetes mellitus, and chronic kidney disease. The association between sleep traits and cardio-renal-metabolic disease progression is often overlooked. Anxiety and depression may affect both sleep and cardio-renal-metabolic diseases, while their mediating role is unclear.</p><p><strong>Methods: </strong>We conducted a multistate analysis using data from 375,837 UK Biobank participants (42.16% men, mean age 55.77 years, 95.37% White) to investigate the associations between sleep traits and the longitudinal progression from healthy to first cardio-renal-metabolic disease, cardio-renal-metabolic multimorbidity, and death. Sleep traits, including sleep duration, ease of getting up in the morning, chronotype, napping during day, insomnia, and snoring, were self-reported at baseline, and an integrated sleep score was calculated, with higher scores indicating healthier sleep. Counterfactual mediation analysis assessed the role of anxiety and depression.</p><p><strong>Results: </strong>During a median follow-up of 13.68 years, 110,287 participants developed first cardio-renal-metabolic disease, 14,562 experienced cardio-renal-metabolic multimorbidity, and 2709 died. Healthy sleep traits were associated with a decreased risk of progressing from healthy to first cardio-renal-metabolic disease (HR=0.70, 95% CI: 0.67-0.72), healthy to death (HR=0.79, 95% CI: 0.70-0.88), and first cardio-renal-metabolic disease to cardio-renal-metabolic multimorbidity (HR=0.70, 95% CI: 0.64-0.76). Anxiety or depression mediated 16.48% of the first cardio-renal-metabolic disease risk, 14.48% of cardio-renal-metabolic multimorbidity risk, and 25.17% of mortality risk.</p><p><strong>Conclusions: </strong>Healthy sleep traits were associated with a protective effect in early- to mid-stage cardio-renal-metabolic disease development, with anxiety and depression acting as mediators. Adhering to healthy sleep traits and addressing anxiety and depression may help prevent cardio-renal-metabolic diseases and their progression.</p>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sleep traits and the longitudinal progression of cardio-renal-metabolic multimorbidity: A prospective study from UK-Biobank.\",\"authors\":\"Yali Niu, Tianrun Wang, Xiaocan Jia, Chaojun Yang, Jingwen Fan, Chenyu Zhao, Nana Wang, Zhixing Fan, Xuezhong Shi\",\"doi\":\"10.1016/j.sleh.2025.08.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cardio-renal-metabolic multimorbidity is defined as the coexistence of two or three cardio-renal-metabolic diseases, namely cardiovascular disease, type 2 diabetes mellitus, and chronic kidney disease. The association between sleep traits and cardio-renal-metabolic disease progression is often overlooked. Anxiety and depression may affect both sleep and cardio-renal-metabolic diseases, while their mediating role is unclear.</p><p><strong>Methods: </strong>We conducted a multistate analysis using data from 375,837 UK Biobank participants (42.16% men, mean age 55.77 years, 95.37% White) to investigate the associations between sleep traits and the longitudinal progression from healthy to first cardio-renal-metabolic disease, cardio-renal-metabolic multimorbidity, and death. Sleep traits, including sleep duration, ease of getting up in the morning, chronotype, napping during day, insomnia, and snoring, were self-reported at baseline, and an integrated sleep score was calculated, with higher scores indicating healthier sleep. Counterfactual mediation analysis assessed the role of anxiety and depression.</p><p><strong>Results: </strong>During a median follow-up of 13.68 years, 110,287 participants developed first cardio-renal-metabolic disease, 14,562 experienced cardio-renal-metabolic multimorbidity, and 2709 died. Healthy sleep traits were associated with a decreased risk of progressing from healthy to first cardio-renal-metabolic disease (HR=0.70, 95% CI: 0.67-0.72), healthy to death (HR=0.79, 95% CI: 0.70-0.88), and first cardio-renal-metabolic disease to cardio-renal-metabolic multimorbidity (HR=0.70, 95% CI: 0.64-0.76). Anxiety or depression mediated 16.48% of the first cardio-renal-metabolic disease risk, 14.48% of cardio-renal-metabolic multimorbidity risk, and 25.17% of mortality risk.</p><p><strong>Conclusions: </strong>Healthy sleep traits were associated with a protective effect in early- to mid-stage cardio-renal-metabolic disease development, with anxiety and depression acting as mediators. Adhering to healthy sleep traits and addressing anxiety and depression may help prevent cardio-renal-metabolic diseases and their progression.</p>\",\"PeriodicalId\":48545,\"journal\":{\"name\":\"Sleep Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.sleh.2025.08.001\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.sleh.2025.08.001","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Sleep traits and the longitudinal progression of cardio-renal-metabolic multimorbidity: A prospective study from UK-Biobank.
Background: Cardio-renal-metabolic multimorbidity is defined as the coexistence of two or three cardio-renal-metabolic diseases, namely cardiovascular disease, type 2 diabetes mellitus, and chronic kidney disease. The association between sleep traits and cardio-renal-metabolic disease progression is often overlooked. Anxiety and depression may affect both sleep and cardio-renal-metabolic diseases, while their mediating role is unclear.
Methods: We conducted a multistate analysis using data from 375,837 UK Biobank participants (42.16% men, mean age 55.77 years, 95.37% White) to investigate the associations between sleep traits and the longitudinal progression from healthy to first cardio-renal-metabolic disease, cardio-renal-metabolic multimorbidity, and death. Sleep traits, including sleep duration, ease of getting up in the morning, chronotype, napping during day, insomnia, and snoring, were self-reported at baseline, and an integrated sleep score was calculated, with higher scores indicating healthier sleep. Counterfactual mediation analysis assessed the role of anxiety and depression.
Results: During a median follow-up of 13.68 years, 110,287 participants developed first cardio-renal-metabolic disease, 14,562 experienced cardio-renal-metabolic multimorbidity, and 2709 died. Healthy sleep traits were associated with a decreased risk of progressing from healthy to first cardio-renal-metabolic disease (HR=0.70, 95% CI: 0.67-0.72), healthy to death (HR=0.79, 95% CI: 0.70-0.88), and first cardio-renal-metabolic disease to cardio-renal-metabolic multimorbidity (HR=0.70, 95% CI: 0.64-0.76). Anxiety or depression mediated 16.48% of the first cardio-renal-metabolic disease risk, 14.48% of cardio-renal-metabolic multimorbidity risk, and 25.17% of mortality risk.
Conclusions: Healthy sleep traits were associated with a protective effect in early- to mid-stage cardio-renal-metabolic disease development, with anxiety and depression acting as mediators. Adhering to healthy sleep traits and addressing anxiety and depression may help prevent cardio-renal-metabolic diseases and their progression.
期刊介绍：
Sleep Health Journal of the National Sleep Foundation is a multidisciplinary journal that explores sleep''s role in population health and elucidates the social science perspective on sleep and health. Aligned with the National Sleep Foundation''s global authoritative, evidence-based voice for sleep health, the journal serves as the foremost publication for manuscripts that advance the sleep health of all members of society.The scope of the journal extends across diverse sleep-related fields, including anthropology, education, health services research, human development, international health, law, mental health, nursing, nutrition, psychology, public health, public policy, fatigue management, transportation, social work, and sociology. The journal welcomes original research articles, review articles, brief reports, special articles, letters to the editor, editorials, and commentaries.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
