王冠军 龚清海 李辉

[摘要] 目的 探討儿童睡眠时间、睡眠质量对外周血清Leptin、Ghrelin及血脂水平的影响。 方法 利用前瞻性研究设计，在2016、2018年对宁波市象山县某中学学生开展睡眠问卷调查和体检，分析364例12～13岁初中学生不同睡眠时长、不同睡眠质量的血清Leptin、Ghrelin及血脂水平前后2年的变化情况，利用协方差分析方法分析睡眠对血清Leptin、Ghrelin及血脂水平的影响。 结果 协方差分析结果发现，去除基线水平影响后，不同睡眠时间的TC、Leptin水平仍有统计学差异（P<0.05）、不同睡眠时间的TG、LDL-C水平差异也有边缘统计学意义（P=0.053;P=0.051），该结果表明，中学生睡眠时间不足可能会升高TC、LDL-C、TG水平而降低Leptin水平。 结论 中学生睡眠时间不足（<9 h）与2年后TC、LDL-C、TG水平升高、Leptin水平下降有关，睡眠不足可能通过改变摄食和代谢的有关激素Leptin水平进一步影响血脂水平。

[关键词] 睡眠;瘦素;胃饥饿素;血脂

[中图分类号] R766          [文献标识码] B          [文章编号] 1673-9701（2020）15-0170-04

Prospective study of the effect of sleep on serum leptin， ghrelin and blood lipid levels in children

WANG Guanjun1   GONG Qinghai2   LI Hui2   HOU Zhiwei3   LI Sixuan2

1.Department of Integrated Traditional Chinese and Western Medicine and Psychosomatic Medicine， Ningbo First Hospital， Ningbo   315010， China; 2.Institute of Chronic Non-Communicable Disease Control and Prevention， Ningbo Center for Disease Control and Prevention， Ningbo   315010， China; 3.Department of Health Surveillance， Xiangshan County Center for Disease Controland Prevention in Zhejiang Province， Xiangshan   315700， China

[Abstract] Objective To investigate the effect of children's sleep time and sleep quality on serum Leptin， Ghrelin and blood lipid levels in peripheral blood. Methods A prospective study design was used to conduct a sleep questionnaire survey and physical examination on a middle school student in Xiangshan County， Ningbo City in 2016 and 2018. The changes of serum Leptin， Ghrelin， and lipid levels before and 2 years after different sleep durations and sleep quality in 364 junior high school students aged 12-13 were analyzed. Covariance analysis was used to analyze the effect of sleep on serum Leptin， Ghrelin and blood lipid levels. Results The analysis of covariance found that after removing the influence of the baseline level， there were still statistical differences in TC and Leptin levels at different sleep times（P<0.05）. There were also statistical differences in TG and LDL-C levels at different sleep times（P=0.053; P=0.051）. The results showed that insufficient sleep time in middle school students may increase TC， LDL-C， TG levels and decrease Leptin levels. Conclusion The lack of sleep time of middle school students（<9 h） is related to the increase of TC， LDL-C， TG levels and the decrease of Leptin levels after 2 years. Lack of sleep may further affect blood lipid levels by changing the levels of the hormone leptin， which is related to food intake and metabolism.

[Key words] Sleep; Leptin; Ghrelin; Blood lipids

目前，我国儿童青少年超重与肥胖已成为重要的公共卫生问题，6～17岁儿童青少年超重率和肥胖率分别为9.6%和6.4%，比2002年上升了5.1和4.3个百分点，增长幅度均高于发达国家[1]。儿童青少年期超重肥胖不仅严重影响身心健康，还与成年期的许多慢性疾病如心血管疾病、代谢性疾病、恶性肿瘤等疾病的发生和死亡密切相关[2]。研究发现，睡眠不足可能通过改变摄食行为及减少能量消耗，并最终引起能量代谢失衡，导致超重与肥胖的发生，并可能与食欲相关激素如瘦素（Leptin）、生长激素释放肤（Ghrelin）的改变有关[3]，这种生理激素水平变化可能与血脂水平的变化有一定关系。儿童期是个体生长发育最为迅速，同时也是代谢和行为模式发展形成的关键期，是成人期疾病实现早期预防的窗口期和敏感期[4]。在当前儿童普遍存在睡眠不足的社会背景下，关注儿童期睡眠与体重增长和线性生长的相关性，评估儿童期睡眠不足对肥胖发生风险的预测效应，将有助于确定儿童期睡眠在人群肥胖预防控制领域的公共卫生意义。……