Sleep Duration and Apolipoprotein B in Metabolically Healthy and Unhealthy Overweight/Obese Phenotypes: A Cross-Sectional Study in Chinese Adults

Citation

Ren, Huihui; Zhang, Lu; Liu, Zhelong; Zhou, Xinrong; & Yuan, Gang (2019). Sleep Duration and Apolipoprotein B in Metabolically Healthy and Unhealthy Overweight/Obese Phenotypes: A Cross-Sectional Study in Chinese Adults. BMJ Open, 9, e023817.

Abstract

Objectives Short sleep duration is independently associated with an increased risk of developing cardiovascular disease; however, the association has not yet been examined in obese populations. We assessed the associations between sleep duration, metabolic phenotype and apolipoprotein variables in a nationally representative Chinese population with overweight/obesity.Study design Cross-sectional study.Settings The study conducted in nine provinces of China that vary substantially in geography and economic development.Patients Data were obtained from 4149 adults with overweight/obesity aged 18 to 94 years from the 2009 China Health and Nutrition Survey. Sleep duration was categorised as ≤6, 7–8 or ≥9 hour. Phenotypes were determined based on body mass index and metabolic health status and categorised as metabolically healthy overweight/obesity (MHOO) and metabolically unhealthy overweight/obesity (MUOO).Main outcome measure The outcome variables were elevated apolipoproteins.Results Compared with MHOO phenotype, MUOO phenotypes were more likely to report shorter sleep duration (12.2%vs9%). In the MUOO group, the multivariate-adjusted OR (95% CI) for elevated apolipoprotein B (apoB) was 1.66 (1.23 to 2.23) for those with ≤6 hours of sleep and 1.12 (0.86 to 1.45) for those with ≥9 hours of sleep, using 7–8 hours of sleep as a reference. Similar results were obtained in the subgroup of subjects who were ≥45 or&lt;45 years old, but shorter sleep duration was more strongly associated with elevated apoB in those &lt;45 years (p interaction=0.023). However, no association was observed in the MHOO phenotype.Conclusions The high prevalence of short sleep duration and its strong association with elevated apoB in adults who are metabolically unhealthy overweight/obese suggest an increased risk of cardiovascular disease in this population. The differences in sleep sufficiency among obese phenotypes may account for the disparities in their cardiovascular outcomes.

URL

http://dx.doi.org/10.1136/bmjopen-2018-023817

Reference Type

Journal Article

Year Published

2019

Journal Title

BMJ Open

Author(s)

Ren, Huihui
Zhang, Lu
Liu, Zhelong
Zhou, Xinrong
Yuan, Gang