| 摘要: | 研究背景：代謝症候群是代謝異常聚集的疾病，晝夜節律失衡與睡眠障礙是代謝症候群重要的致病因子。由於光害以及輪班工作之職業型態均會導致代謝症候群及晝夜節律異常。因此，輪班人員的睡眠品質、晨昏活動型態與罹患代謝症候群風險之相關性，值得我們深入探討。
研究目的：（一）分析睡眠品質、代謝症候群與晨昏活動型態的狀況，（二）評估睡眠品質與罹患代謝症候群之相關性，（三）探討晨昏活動型態與罹患代謝症候群之相關性，（四）探討頸圍及輪班型態對於罹患代謝症候群風險之相關性。
研究方法：本研究為以新竹某機械製造業公司為基礎之病例對照研究，病例組為78名代謝症候群患者，對照組為444名之健檢員工；每位研究個案以問卷收集基本人口學變項與匹茲堡睡眠品質指標量表(PSQI)及晨昏活動型態量表(MEQ)來收集其睡眠狀態的資料。
研究結果：採用邏輯斯迴歸分析影響睡眠之因子，其模式檢定度良好，概要百分比為63%。睡眠品質不佳之代謝症候群風險比值為1.58 (95%信賴區間:0.53-4.69)；女性相對於男性有較差的睡眠品質，OR值為2.16(95%信賴區間:1.47~3.18)；血糖異常相對於血糖正常者睡眠品質差之風險增加為1.67倍(95%信賴區間:1.06~2.64)；輪班相對於無輪班者睡眠品質差之風險性增加為1.64倍；貓頭鷹型相對於早鳥型睡眠品質差之風險增加為5.71倍(95%信賴區間:2.69~12.11)。另外針對代謝症候群風險分析顯示，年齡每增加一歲，罹患代謝症候群之風險增加為1.13倍(95%信賴區間:1.08~1.19)；頸圍粗大相對於頸圍正常者，罹患代謝症候群之風險性增加為5.85倍(95%信賴區間：2.88~11.89)；輪班相對非輪班者，罹患代謝症候群之風險性增加為1.64倍(95%信賴區:1.25~2.16)。
結論：睡眠品質會受個人晨昏活動型態與代謝症候群的影響。睡眠品質的預測因子有性別、輪班、晨昏活動型態、咖啡因攝取頻率與代謝症候群中的血糖、心跳數值。另代謝症候群會受頸圍異常與輪班型態的影響。代謝症候群的預測因子有年齡、頸圍及輪班型態。本研究所探討的睡眠品質與晨昏活動型態對於代謝症候群關聯性確實存在差異，皮質醇分泌的基因與遺傳學存在的相互連結與相關機轉則值得後續探討。
Background: Recent evidence has emerged to suggest that alterations in circadian systems and sleep play important roles in the pathogenesis of metabolic syndrome (MetS). Indeed, over exposure of artificial light and shiftwork will lead to circadian misalignment. Therefore, elucidation of the role of sleep quality and circadian rhythms of shift workers in metabolic diseases is worthy of further investigation.
Objectives: The study aims were to assess (i) to evaluate the combined effect of chronotype and sleep quality on the risk of MetS. (ii) to examine the association between sleep quality and the risk of MetS, (iii) to investigate the relationships between chronotype and the risk of MetS, (v) to examine the association between neck circumference and the risk of MetS in night-shift workers.
Methods: A total of 78 cases with MetS and 444 control subjects were recruited from the Machinery manufacturing company in the Hsinchu area. All participants responded to an on-site self-administered questionnaire with the assistance of interviewer to collect data on sociodemographic factors, lifestyle characteristics, and sleep quality by using the validated Chinese version of the Pittsburgh Sleep Quality Index (PSQI). Their chronotype were assessed by the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ).
Result: To assess the influence of different variables on sleep quality, stepwise Logistics regression analysis was used. The model correctly classified at least 63% of adults on each of the outcomes studied, and gender (OR=2.16,95% CI=1.47~3.18), caffeine ingestion (OR=1.64, 95%CI=1.02~2.64), blood sugar (OR=1.67, 95% CI=1.06~2.64), pulse (OR=1.02, 95% CI=1.00~1.04), and chronotype (OR=5.71, 95% CI=2.69~12.11) were significantly associated with sleep quality. Age (OR=1.13, 95% CI=1.08~1.19), neck circumference (OR= 5.85, 95% CI=2.88~11.89) and shift work (OR=1.64, 95% CI=1.25~2.16) were the predict factors for high risk of MetS.
Conclude: The female, evening type, hyperglycemia and high pulse rate in metabolic syndrome increased the risk of poor sleep quality. In addition, higher neck circumference and shift worker increased the risk of MetS. Further studies are needed to elucidate the mechanisms of gene and genetics in the pathogenesis of MetS. |
