A Systematic Review on Sleep Duration and Dyslipidemia in Adolescents: Understanding Inconsistencies

Abreu, Gabriela de Azevedo; Barufaldi, Laura Augusta; Bloch, Kátia Vergetti; Szklo, Moysés

doi:10.5935/abc.20150121

Cited by 13 publications

(15 citation statements)

References 30 publications

(73 reference statements)

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“…There is a lack of consistent evidence regarding the influence of sleep duration on lipid levels. While some studies show an association of unfavourable lipid levels with increased night time sleep duration other studies show the contrary [72,73]. Though our study did not show association of sleep duration with any of the lipids in the gender stratified analysis, there was a negative association of sleep duration with LDL-C levels in the combined analysis.…”

Section: Discussioncontrasting

confidence: 96%

The burden of dyslipidaemia and factors associated with lipid levels among adults in rural northern Ghana: An AWI-Gen sub-study

et al. 2018

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Dyslipidaemia is a primary risk factor for cardiometabolic disease, causing over 17 million deaths globally in 2015. However, the burden of dyslipidaemia and factors associated with lipid levels remain unknown in many rural African populations. Therefore, this study evaluated the association of socio-demographic, anthropometric and behavioural factors with lipid levels in rural Ghana. The prevalence of hypercholesterolaemia, hypertriglyceridaemia and elevated LDL-C in the total population of 1839 (846 men and 993 women) was 4.02%, 2.12%, and 5.55% respectively and did not differ between genders. The prevalence of low HDL-C levels was 60.30% and differed (p = 0.005) between men (56.86%) and women (63.24%). Subcutaneous abdominal fat was associated with TC (β = 0.067, p = 0.015) and TG (β = 0.137, p<0.001) among women and LDL-C (β = 0.139, p = 0.006) and TC (β = 0.071, p = 0.048) among men. Body mass index was associated with TC (β = 0.010, p = 0.043) among men while waist circumference was associated with LDL-C (β = 0.116, p<0.001) and TG (β = 0.094, p<0.001) among women. Hip circumference was negatively associated (β = -0.053, p = 0.043) while visceral fat was positively associated with TG (β = 0.033, p = 0.022) among women. Socioeconomic status, education, being unmarried and employment were associated with HDL-C (β = 0.081, p = 0.004), LDL-C (β = 0.095, p = 0.004) and TG (β = 0.095, p = 0.001) all among women, and TC (β = 0.070, p = 0.010) among men, respectively. Nankana women had lower TC (β = -0.069, p = 0.001), and men lower TG levels (β = -0.084, p = 0.008) than the other ethnic groups. Tobacco smoking (β = 0.066, p = 0.024) and alcohol intake (β = 0.084, p = 0.001) were associated with HDL-C levels among men and women respectively. Further studies are required to investigate whether high prevalence of low HDL-C levels in this population presents with any adverse cardiovascular disease outcomes. Associations of education, employment and adiposity with lipid levels suggest that future societal advances and increases in the prevalence of obesity may lead to associated adverse health consequences. Monitoring and interventions are required to limit these effects.

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Section: Discussioncontrasting

confidence: 96%

The burden of dyslipidaemia and factors associated with lipid levels among adults in rural northern Ghana: An AWI-Gen sub-study

et al. 2018

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“…Similar to adults, poor self-reported sleep quality in youth has been associated with components of the metabolic syndrome, including dyslipidemia, higher blood pressure, and markers of insulin resistance ( 35 – 39 ). Alterations in leptin, ghrelin, and cortisol levels and increased sympathetic nervous system activity are thought to contribute to an atherogenic lipid profile ( 40 ). Qian et al proposed that sleep fragmentation alters lipid metabolism via its effect on elevated cortisol levels, increased systemic inflammation, increased food intake, and obesity ( 41 ).…”

Section: Sleep Glucose Metabolism and Cardiometabolic Riskmentioning

confidence: 99%

Poor Sleep and Obesity: Concurrent Epidemics in Adolescent Youth

Gohil

Hannon

2018

Front. Endocrinol.

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Poor sleep and obesity are both extraordinarily common in the US adolescent population and often occur simultaneously. This review explores the links between obesity and sleep, outlining what is known about the relationships between sleep characteristics, obesity, and cardiometabolic risk factors in youth. Sleep duration is less than optimal in teens, and decreases as age increases. This is detrimental to overall well-being and is associated with obesity in children, adolescents, and young adults. Accordingly, inadequate sleep duration is associated with poor diet quality, decreased insulin sensitivity, hyperglycemia, and prevalent cardiometabolic risk factors. Evidence suggests that poor sleep quality and altered circadian timing characterized by a preferred later sleep onset, known as “adolescent chronotype,” contributes to shortened sleep duration. Obstructive sleep apnea (OSA) occurs more frequently among youth with obesity, and is associated with autonomic nervous system activity promoting higher blood pressure, increased markers of cardiovascular disease risk, and insulin resistance. While there is a clear association between OSA and type 2 diabetes in adults, whether or not this association is prevalent in youth is unclear at this time. Interventions to improve both sleep duration and quality, and obesity in adolescents are scarce and more evidence is needed to determine if such interventions can improve obesity-related health outcomes.

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“…Furthermore, these were mainly based on cross-sectional evidence—hence unable to establish a temporal relationship between exposure and outcome—and did not evaluate sleep quality as a potential exposure of interest. 15 16 In recent years, new prospective studies that include measures on sleep and blood lipids have emerged. Nadeem et al 17 performed a meta-analysis of 64 observational studies involving 18 116 patients on obstructive sleep apnoea (OSA) and the blood lipid profile.…”

Section: Introductionmentioning

confidence: 99%

Association of sleep duration and quality with blood lipids: a systematic review and meta-analysis of prospective studies

Kruisbrink

Robertson

et al. 2017

BMJ Open

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ObjectivesTo assess the longitudinal evidence of the relationships between sleep disturbances (of quantity and quality) and dyslipidaemia in the general population and to quantify such relationships.SettingSystematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.MethodsWe performed a systematic search of PubMed and Embase (up to 9 September 2017), complemented with manual searches, of prospective population studies describing the association between sleep duration and quality and the incidence of dyslipidaemias. Relative risks (95% CIs) were extracted and pooled using a random effects model. Subgroup analyses by lipid type were performed. Heterogeneity and publication bias were also assessed. Quality was assessed with Downs and Black score.ParticipantsStudies were included if they were prospective, had measured sleep quantity and/or quality at baseline and either incident cases of dyslipidaemia or changes in blood lipid fractions assessed prospectively.Primary outcome measuresIncidence of dyslipidaemia and changes in lipid fractions. Dyslipidaemia was defined as a high total cholesterol, triglycerides, low-density lipoprotein cholesterol or low high-density lipoprotein cholesterol compared with the reference group.ResultsThirteen studies were identified (eight using sleep duration, four sleep quality and one both). There was heterogeneity in the sleep quality aspects and types of lipids assessed. Classification of sleep duration (per hour/groups) also varied widely. In the pooled analysis of sleep duration (6 studies, 16 cohort samples; 30 033 participants; follow-up 2.6–10 years), short sleep was associated with a risk of 1.01 (95% CI 0.93 to 1.10) of developing dyslipidaemia, with moderate heterogeneity (I2=56%, P=0.003) and publication bias (P=0.035). Long sleep was associated with a risk of 0.98 (95% CI 0.87 to 1.10) for dyslipidaemia, with heterogeneity (I2=63%, P<0.001) and no significant publication bias (P=0.248).ConclusionThe present analysis was unable to find supportive evidence of a significant relationship between sleep duration and the development of dyslipidaemia. However, heterogeneity and small number of studies limit the interpretation.PROSPERO registration numberCRD42016045242.

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A Systematic Review on Sleep Duration and Dyslipidemia in Adolescents: Understanding Inconsistencies

Cited by 13 publications

References 30 publications

The burden of dyslipidaemia and factors associated with lipid levels among adults in rural northern Ghana: An AWI-Gen sub-study

The burden of dyslipidaemia and factors associated with lipid levels among adults in rural northern Ghana: An AWI-Gen sub-study

Poor Sleep and Obesity: Concurrent Epidemics in Adolescent Youth

Association of sleep duration and quality with blood lipids: a systematic review and meta-analysis of prospective studies

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