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Association between sleep duration and asthma in different weight statuses (CHNS 2009–2015)

  • Epidemiology • Original Article
  • Published:
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Abstract

Purpose

Inadequate sleep duration affects asthma and weight. The associations among sleep duration, asthma, and different weight statuses in the Chinese population need to be further determined.

Methods

The study included 32,776 Chinese adults from the China Health and Nutrition Survey during 2009–2015. Self-reported sleep duration was classified into three groups: ≤ 6 h (short), 7 to 8 h (optimal), and ≥ 9 h (long). Age, sex, smoking, drinking alcohol, and residence location were adjusted as potential confounding factors in a generalized estimating equations model.

Results

The prevalence of asthma in the Chinese population was approximately 1.17% (383/32,776). Asthmatics were associated with shorter sleep duration and higher indices of central obesity (mean waist circumference, waist to height ratio, and conicity index) than the population without asthma. After adjusting for potential confounding factors, odds ratios (ORs) indicated positive associations between sleep duration and asthma (short vs optimal, adjusted OR = 1.74, 95%CI 1.33, 2.26; and long vs optimal, adjusted OR = 1.51, 95%CI 1.18, 1.93). When stratified by weight status, the participants with central obesity showed highest prevalence of asthma among the three sleep duration groups. With the adjustment of confounding factors, underweight and obesity grouped by waist to height ratio and conicity index remained associated with higher risk of asthma among short and long sleepers than in optimal sleepers.

Conclusions

Short and long sleepers with central obesity and underweight status were associated with significantly higher prevalence of asthma than optimal sleepers in Chinese adults.

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Data availability

The data underlying this study were obtained from the China Health and Nutrition Survey (ID: hxq910813). All relevant data are within the paper and its Supporting Information files.

References

  1. Global Initiative for Asthma. Global strategy for asthma management and prevention; 2018. Available from: https://ginasthma.org/2018-gina-report-global-strategy-for-asthma-management-and-prevention. Accessed 16 Oct 2018

  2. Anne D, Matthew P (2015) A common pathway to obesity and allergic asthma. Am J Respir Crit Care Med 191(7):721–730

    Article  Google Scholar 

  3. Holguin F, Bleecker ER, Busse WW, Calhoun WJ, Castro M, Erzurum SC, Fitzpatrick AM, Gaston B, Israel E, Jarjour NN, Moore WC, Peters SP, Yonas M, Teague WG, Wenzel SE (2011) Obesity and asthma: an association modified by age of asthma onset. J Allergy Clin Immunol 127(6):1486–1492

    Article  Google Scholar 

  4. Dixon AE, Pratley RE, Forgione PM et al (2011) (2011). Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation. J Allergy Clin Immunol 128(3):508–515

    Article  Google Scholar 

  5. Kavanagh J, Jackson DJ, Kent BD (2018) Sleep and asthma. Curr Opin Pulm Med 24(6):569–573

    Article  Google Scholar 

  6. Esteban CA, Everhart RS, Kopel SJ et al (2017) Allergic sensitization and objective measures of sleep in urban school-aged children with asthma. Ann Allergy Asthma Immunol 119(3):238–245

    Article  Google Scholar 

  7. Afshin A, Forouzanfar MH, Reitsma MB et al (2017) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377(1):13–27

    Article  Google Scholar 

  8. Daniels SR, Khoury PR, Morrison JA (1997) The utility of body mass index as a measure of body fatness in children and adolescents: differences by race and gender. Pediatrics. 99(6):804–807

    Article  CAS  Google Scholar 

  9. Ness-Abramof R, Apovian CM (2008) Waist circumference measurement in clinical practice. Nutr Clin Pract 23(4):397–404

    Article  Google Scholar 

  10. Ma J, Xiao L, Knowles SB (2010) Obesity, insulin resistance and the prevalence of atopy and asthma in US adults. Allergy. 65(11):1455–1463

    Article  CAS  Google Scholar 

  11. Beuther DA, Sutherland ER (2007) Overweight, obesity, and incident asthma. Am J Respir Crit Care Med 175(7):661–666

    Article  Google Scholar 

  12. Musaad SMA, Patterson T, Ericksen M et al (2009) Comparison of anthropometric measures of obesity in childhood allergic asthma: central obesity is most relevant. J Allergy Clin Immunol 123(6):1321–1327.e12

    Article  Google Scholar 

  13. Xu S, Gilliland FD, Conti DV (2019) Elucidation of causal direction between asthma and obesity: a bi-directional Mendelian randomization study. Int J Epidemiol 48(3):899–907

    Article  Google Scholar 

  14. Jiang D, Wang L, Bai C et al (2019) Association between abdominal obesity and asthma: a meta-analysis. Allergy, Asthma Clin Immunol 15:16

    Article  Google Scholar 

  15. Deng X, Ma J, Yuan Y, Zhang Z, Niu W (2019) Association between overweight or obesity and the risk for childhood asthma and wheeze: an updated meta-analysis on 18 articles and 73 252 children. Pediatr Obes 14(9):e12532

    Article  Google Scholar 

  16. Tobaldini E, Fiorelli EM, Solbiati M, Costantino G, Nobili L, Montano N (2019) Short sleep duration and cardiometabolic risk: from pathophysiology to clinical evidence. Nat Rev Cardiol 16(4):213–224

    Article  Google Scholar 

  17. Tan X, Chapman CD, Cedernaes J (2018) Association between long sleep duration and increased risk of obesity and type 2 diabetes: a review of possible mechanisms. Sleep Med Rev 40:127–134

    Article  Google Scholar 

  18. Liu TZ, Xu C, Rota M, Cai H, Zhang C, Shi MJ, Yuan RX, Weng H, Meng XY, Kwong JS, Sun X (2017) Sleep duration and risk of all-cause mortality: a flexible, non-linear, meta-regression of 40 prospective cohort studies. Sleep Med Rev 32:28–36

    Article  Google Scholar 

  19. Teodorescu MCM, Polomis DA, Gangnon RE, Consens FB, Chervin RD, Teodorescu MC (2013) Sleep duration, asthma and obesity. J Asthma 50(9):945–953

    Article  CAS  Google Scholar 

  20. Fedele DA, Janicke DM, Lim CS, Abu-Hasan M (2014) An examination of comorbid asthma and obesity: assessing differences in physical activity, sleep duration, health-related quality of life and parental distress. J Asthma 51(3):275–281

    Article  Google Scholar 

  21. Bakour C, O’Rourke K, Schwartz S, Wang W, Sappenfield W, Couluris M (2017) Sleep duration, obesity, and asthma, in Florida adolescents: analysis of data from the Florida Youth Risk Behavior Survey (2009-2013). Sleep Breath 21(4):1039–1045

    Article  Google Scholar 

  22. Ashwell M, Gunn P, Gibson S (2012) Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 13(3):275–286

    Article  CAS  Google Scholar 

  23. Tchernof A, Després J (2013) Pathophysiology of human visceral obesity: an update. Physiol Rev 93(1):359–404

    Article  CAS  Google Scholar 

  24. Popkin BM, Du S, Zhai F et al (2010) Cohort profile: the China health and nutrition survey – monitoring and understanding socioeconomic and health change in China, 1989–2011. Int J Epidemiol 39(6):1435–1440

    Article  Google Scholar 

  25. World Health Organization (2011) Waist circumference and waist-hip ratio: report of a WHO expert consultation. WHO Press, Geneva

    Google Scholar 

  26. Li J, Zhu L, Wei Y et al (2020) Association between adiposity measures and COPD risk in Chinese adults. Eur Respir J. https://doi.org/10.1183/13993003.01899-2019

  27. Chen X, Liu Y, Sun X, Yin Z, Li H, Deng K, Cheng C, Liu L, Luo X, Zhang R, Liu F, Zhou Q, Wang C, Li L, Zhang L, Wang B, Zhao Y, Zhou J, Han C, Zhang H, Yang X, Pang C, Yin L, Feng T, Zhao J, Zhang M, Hu D (2018) Comparison of body mass index, waist circumference, conicity index, and waist-to-height ratio for predicting incidence of hypertension: the rural Chinese cohort study. J Hum Hypertens 32(3):228–235

    Article  Google Scholar 

  28. Lin J, Wang W, Chen P et al (2018) Prevalence and risk factors of asthma in mainland China: the CARE study. Respir Med 137(1):48–54

    Article  Google Scholar 

  29. Huang K, Yang T, Xu J, Yang L, Zhao J, Zhang X, Bai C, Kang J, Ran P, Shen H, Wen F, Chen Y, Sun T, Shan G, Lin Y, Xu G, Wu S, Wang C, Wang R, Shi Z, Xu Y, Ye X, Song Y, Wang Q, Zhou Y, Li W, Ding L, Wan C, Yao W, Guo Y, Xiao F, Lu Y, Peng X, Zhang B, Xiao D, Wang Z, Chen Z, Bu X, Zhang H, Zhang X, An L, Zhang S, Zhu J, Cao Z, Zhan Q, Yang Y, Liang L, Tong X, Dai H, Cao B, Wu T, Chung KF, He J, Wang C, China Pulmonary Health (CPH) Study Group (2019) Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet. 394(10196):407–418

    Article  Google Scholar 

  30. Cai GH, Theorell-Haglöw J, Janson C et al (2018) Insomnia symptoms and sleep duration and their combined effects in relation to associations with obesity and central obesity. Sleep Med 46(1):81–87

    Article  Google Scholar 

  31. Beuther DA (2010) Recent insight into obesity and asthma. Curr Opin Pulm Med 16(1):64–70

    Article  Google Scholar 

  32. Arteaga-Solis E, Zee T, Emala CW, Vinson C, Wess J, Karsenty G (2013) Inhibition of leptin regulation of parasympathetic signaling as a cause of extreme body weight-associated asthma. Cell Metab 17(1):35–48

    Article  CAS  Google Scholar 

  33. Nizri E, Fey-Tur-Sinai M, Lory O et al (2009) Activation of the cholinergic anti-inflammatory system by nicotine attenuates neuroinflammation via suppression of Th1 and Th17 responses. J Immunol 183(10):6681–6688

    Article  CAS  Google Scholar 

  34. Chong L, Liu L, Zhu L et al (2019) Expression levels of predominant adipokines and activations of STAT3, STAT6 in an experimental mice model of obese asthma. Iran J Allergy Asthma Immunol 18(1):62–71

    PubMed  Google Scholar 

  35. Fu J, Wang Y, Li G, Han L, Li Y, Li L, Feng D, Wu Y, Xiao X, Li M, Grant SFA, Li M, Gao S (2019) Childhood sleep duration modifies the polygenic risk for obesity in youth through leptin pathway: the Beijing child and adolescent metabolic syndrome cohort study. Int J Obes 43(8):1556–1567

    Article  CAS  Google Scholar 

  36. McKibbin CL, Archuleta C, Grant I (2006) Poor sleep is associated with higher plasma proinflammatory cytokine interleukin-6 and procoagulant marker fibrin D-dimer in older caregivers of people with Alzheimer’s disease. J Am Geriatr Soc 54(3):431–437

    Article  Google Scholar 

  37. Chen XJ, Zhang YH, Wang DH et al (2015) Effects of body mass index and serum inflammatory cytokines on asthma control in children with asthma. Chin J Contemp Pediatr 17(7):698–701

    CAS  Google Scholar 

  38. Zhang LL, Liu CT (2015) Activin A is associated with asthma in underweight and overweight patients. Genet Mol Res 14(1):440–452

    Article  Google Scholar 

Download references

Funding

This work was supported by the National Key Research and Development Program of China (project number: 2016YFC1304403).

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Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road No. 99, Wuhan, 430060, China

    Zhigang Hu & Ke Hu

  2. Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People’s Republic of China

    Zhigang Hu, Xinyu Song, Yushu Ruan & Fanjun Zeng

  3. Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China

    Zhigang Hu, Xinyu Song, Yushu Ruan & Fanjun Zeng

Authors
  1. Zhigang Hu
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  2. Xinyu Song
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  3. Ke Hu
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  5. Fanjun Zeng
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Contributions

Z. H. and K. H. designed the project and supervised research; Y.R. and F.Z. performed the research; Y.T., Z.H., and W.L. analyzed the data; X.S. provided significant intellectual input; Z.H. wrote the manuscript; all authors contributed to the editing of the manuscript.

Corresponding author

Correspondence to Ke Hu.

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The authors declare that they have no conflicts of interest.

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This study was deemed exempt for review by the Institutional Review Board at China, Three Gorges University.

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Hu, Z., Song, X., Hu, K. et al. Association between sleep duration and asthma in different weight statuses (CHNS 2009–2015). Sleep Breath 25, 493–502 (2021). https://doi.org/10.1007/s11325-020-02081-6

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  • DOI: https://doi.org/10.1007/s11325-020-02081-6

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