护理人员睡眠状况与非酒精性脂肪性肝病的关系
Associations between sleep and non-alcoholic fatty liver disease in nurses
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摘要:
背景 睡眠持续时间和睡眠质量与非酒精性脂肪性肝病（NAFLD）的相关性存在不一致性，尚无统一定论。护理人员是睡眠障碍和非酒精性脂肪肝高发人群。
目的 探讨护理人员睡眠持续时间和睡眠质量与NAFLD的相关性。
方法 以辽宁省某三级甲等医院2019年春季参加职工健康体检的2 671名护理人员为调查对象，根据《2018年非酒精性脂肪性肝病防治指南》将确诊为NAFLD的护士作为病例组，以未患NAFLD的护理人员为对照组，采用一般资料调查表、匹兹堡睡眠质量指数量表（PSQI）调查护士群体的基本状况和睡眠情况，并根据PSQI总分将睡眠质量分成"好、较好、一般、很差"4组；睡眠持续时间按"≥ 7 h、6 h~、5 h~、< 5 h"分为4组。采用SPSS 24.0软件对数据进行统计分析，二元logistic回归分析护理人员睡眠持续时间和睡眠质量与NAFLD的关联。
结果 实际完成调查2 584名护理人员，有效率96.74%。检出NAFLD病例435例（病例组），患病率16.8%；余2 149例正常者为对照组。17.7%的护理人员睡眠质量一般或很差，33.9%和17.7%的护理人员睡眠持续时间仅为6~6.9 h和 < 6 h。单因素分析发现，护理人员不同睡眠质量间NAFLD的患病率差异无统计学意义（
P =0.058）；睡眠持续时间不同的护理人员，NAFLD患病率差异存在统计学意义（P < 0.001）。调整了年龄、性别、职称、科室、夜班频次、收缩压、舒张压、体重指数、空腹血糖、甘油三酯、高密度脂蛋白、低密度脂蛋白、总胆固醇之后，护理人员睡眠持续时间 < 6 h与NAFLD相关：5~5.9 h组OR 及其95%CI 为1.562（1.081~2.259），P =0.018； < 5h组为2.075（1.161~3.709），P =0.014。结论 睡眠持续时间 < 6h的护理人员NAFLD患病率更高。
Abstract:Background Studies have found inconsistent correlations of sleep duration and sleep quality with non-alcoholic fatty liver disease (NAFLD), and there is no conclusion on this issue yet. Nurses are an occupational group with high incidences of sleep disorders and NAFLD.
Objective This study examines the associations of sleep duration and quality with NAFLD in nurses.
Methods A total of 2 671 nursing staff who participated in occupational physical examination in the spring of 2019 from a tertiary level-A hospital in Liaoning Province were selected as study subjects. According to the
Guidelines for the Prevention and Treatment of Nonalcoholic Fatty Liver Diseases 2018 , the nurses diagnosed with NAFLD were classified as case group, and those not as control group. A general information questionnaire and the Pittsburgh Sleep Quality Index Scale (PSQI) were used to investigate the basic information and sleep status of the participants. They were subgrouped according to the total PSQI score (very good, fairly good, fairly bad, and very bad) and sleep duration (≥ 7 h, 6-6.9 h, 5-5.9 h, and < 5 h). Statistical analysis was conducted using SPSS 24.0 software, and the associations of sleep duration and sleep quality with NAFLD in selected nurses were evaluated by binary logistic regression analysis.Results A total of 2 584 nursing staff completed the questionnaires, with a valid return rate of 96.74%. There were 435 NAFLD cases (case group, 16.8%) and 2 149 healthy ones (control group); 17.7% of the nurses showed fairly bad and very bad sleep quality; 33.9% and 17.7% of the nurses slept 6-6.9 h and < 6 h respectively. The univariate analysis results found that there was no significant difference in the prevalence of NAFLD among the nurses with different sleep qualities (
P =0.058), but the prevalence was different among the nurses with different sleep durations (P < 0.001). After adjusting for age, gender, job title, department, frequency of night shifts, systolic blood pressure, diastolic blood pressure, body mass index, fasting blood glucose, triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol, sleep duration < 6 h was significantly associated with NAFLD (5-5.9 h sleep duration group,OR =1.562, 95%CI :1.081-2.259,P =0.018; < 5 h sleep duration group,OR =2.075, 95%CI :1.161-3.709,P =0.014).Conclusion The nurses sleeping < 6 h a day have a higher prevalence of NAFLD than those sleeping more.
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