中医正骨2025，Vol.37Issue(9)：51-57,7.
中国中老年人夜间睡眠时长与髋部骨折风险的关系研究
A study of association between nocturnal sleep duration and risk of hip fracture in middle-aged and older Chi-nese adults
摘要
Abstract
Objective:To investigate the association between nocturnal sleep duration and the risk of hip fracture(HF)in middle-aged and older Chinese adults.Methods:Information about socio-demographic characteristics(age,gender,education level,marital status,and ur-ban-rural distribution),lifestyle factors(smoking,alcohol consumption,physical exercises,and sleep conditions),and health status(history of HF,history of falls within the past year)of the study participants was extracted from the 2018 China Health and Retirement Longitudinal Study(CHARLS)database.The included participants were categorized into ≤ 5 hours group(reference group),＞5 to＜6 hours group,6 to＜7 hours group,7 to＜8 hours group,and ≥8 hours group based on their reported nocturnal sleep duration.Concurrently,they were di-vided into an HF group and a non-HF group based on the presence or absence of HF.The differences in demographic characteristics among participants were compared using the Chi-square tests for single factor analysis,based on which the association between nocturnal sleep du-ration and HF risk was examined by progressively analyzing three models:a crude model unadjusted for any covariates(Model 1),a model adjusted for socio-demographic characteristics(Model 2),and a fully adjusted model that further incorporated lifestyle factors and health status(Model 3)which constructed by employing multivariate binary logistic regression approach.After that,a stratified analysis was conduc-ted by age groups(＜60 years,60-75 years,＞75 years)to explore this association within different age strata.Results:①Grouping.Nine-teen thousand two hundred and twenty-seven participants were included in the final analysis,with 6 237 ones in the ≤5 hours group,4 198 ones in the＞5 to＜6 hours group,3 276 ones in the 6 to＜7 hours group,333 ones in the 7 to＜8 hours group,and 5 183 ones in the ≥8 hours group,among which,219 participants were in the HF group and 19 008 ones in the non-HF group.②Demographic characteristics of the participants.Significant differences were found in age,gender,nap duration,physical exercises,education level,marital status,history of falls within the past year,urban-rural distribution,smoking status,and alcohol consumption among the 5 groups(x2=304.785,P=0.000;x2=208.055,P=0.000;x2=184.420,P=0.000;x2=14.026,P=0.007;x2=421.059,P=0.000;x2=198.142,P=0.000;x2=150.137,P=0.000;x2=196.246,P=0.000;x2=93.868,P=0.000;x2=95.261,P=0.000).Significant differences were also observed between HF group and non-HF group in age,nocturnal sleep duration,education level,marital status,urban-rural distribution,and history of falls within the past year(x2=23.668,P=0.000;x2=30.106,P=0.000;x2=44.297,P=0.000;x2=16.735,P=0.001;x2=9.969,P=0.019;x2=217.009,P=0.000),but not in gender,smoking status,alcohol consumption,nap duration,and physical exercises.③Asso-ciation between nocturnal sleep duration and HF risk.Multivariate binary logistic regression analysis revealed that,in Model 1,the＞5 to＜6 hours group,6 to＜7 hours group,and ≥8 hours group showcased a significantly lower risk of HF compared to the ≤5 hours group(B=-0.799,P=0.000,OR=0.449,95％(0.304,0.665);B=-0.654,P=0.002,OR=0.524,95％(0.349,0.787);B=-0.654,P=0.000,OR=0.519,95％(0.368,0.733));in Model 2,the＞5 to＜6 hours group,6 to＜7 hours group,and ≥8 hours group still exhibi-ted a significantly reduced risk of HF relative to the≤5 hours group(B=-0.635,P=0.001,OR=0.525,95％(0.353,0.781);B=-0.462,P=0.026,OR=0.626,95％(0.415,0.946);B=-0.654,P=0.000,OR=0.523,95％(0.370,0.741));in Model 3,the＞5 to＜6 hours group and ≥ 8 hours group maintained a significantly lower risk of HF compared to the≤5 hours group(B=-0.568,P=0.006,OR=0.567,95％(0.380,0.844);B=-0.516,P=0.005,OR=0.597,95％(0.420,0.848)).The stratified analy-sis by age groups revealed that,in participants aged less than 60 years,only the＞5 to＜6 hours group in Model 1 showed a significantly lower risk of HF compared to the≤ 5 hours group(B=-0.892,P=0.016,OR=0.410,95％(0.198,0.849));in the ones aged 60-75 years,both the＞5 to＜6 hours group and ≥8 hours group in all three Models exhibited a significantly reduced risk of HF relative to the ≤5 hours group(Model 1:B=-0.799,P=0.006,OR=0.451,95％CI(0.254,0.799);B=-0.916,P=0.001,OR=0.401,95％CI(0.232,0.692).Model2:B=-0.755,P=0.011,OR=0.474,95％CI(0.266,0.845);B=-0.916,P=0.001,OR=0.399,95％CI(0.230,0.690).Model 3:B=-0.673,P=0.021,OR=0.508,95％CI(0.284,0.906);B=-0.799,P=0.004,OR=0.447,95％CI(0.257,0.778));whereas in the ones aged over 75 years,no significant association was observed between nocturnal sleep duration and HF risk across all three models.Conclusion:In the middle-aged and older Chinese population,a nocturnal sleep duration of ≤5 hours may be an independent risk factor for HF,while,a nocturnal sleep duration of＞5 to＜6 hours and≥8 hours may be the independent pro-tective factors against HF,with this association being most robust in the individuals aged 60-75 years.关键词
髋骨折/睡眠/中年人/老年人/风险/回归分析Key words
hip fractures/sleep/middle aged/aged/risk/regression analysis引用本文复制引用
王其澜,朱宇喆,王金果,蒋怡,胡雪琴..中国中老年人夜间睡眠时长与髋部骨折风险的关系研究[J].中医正骨,2025,37(9):51-57,7.基金项目
国家自然科学基金项目(82274679) （82274679）
浙江省中医药科技计划项目(2023ZF100) （2023ZF100）
