Abstract: Background　Serum triglyceride to high-density lipoprotein cholesterol（TG/HDL-C） ratio is a systemic indicator of serum lipid levels. Poor sleep may be a risk factor of dyslipidemia. Exploring the association of sleep problems with TG/HDL-C ratio and identifying relevant risk groups，may help to reduce the risk of dyslipidemia via improve sleeping quality. Objective　To examine the sleep quality and its association with TG/HDL-C ratio in Beijing adults in 2017，providing scientific evidence for plasma lipid control via improving sleep quality. Methods　Data were gathered from the 2017 Beijing Non-communicable Disease and Associated Risk Factors Surveillance Program，involving adult permanent residents aged 18-79 years from 16 districts of Beijing selected by multistage stratified sampling and cluster sampling. Demographic information（age，gender，marital status，education level），diagnosis and treatment of chronic diseases（hypertension，diabetes，dyslipidemia），lifestyle（smoking，drinking，and so on），sleep duration and sleep problems〔snoring / suffocation，difficulty falling asleep，awakenings from sleep（≥2），early awakening，use of sleeping pills〕，anthropometric parameters（height，weight，waist circumference and blood pressure），and fasting lipid profile（TC，TG，HDL-C，LDL-C） in venous samples were analyzed. The t-test，Kruskal-Wallis H test，Mann-Whitney U test，chi-square test，and multivariate Logistic regression were used to examine the association of sleep and TG/HDL-C ratio. Results　A total of 13 240 cases were included，with an average age of （44.79±15.47） years and a self-reported average sleep duration of （7.47±1.30） hours/day，and a median TG/HDL-C ratio of 0.99（0.84）. The prevalence of self-reported sleep problems within 30 days was 49.02%（6 490/13 240）. Those who slept 9 hours per day had lowest TG/HDL-C ratio，with a median level of 0.95（0.82）. TG/HDL-C ratio differed significantly in women by the length of sleep（χ2=37.14，P<0.01）. TG/HDL-C ratio differed significantly between those with self-reported sleep problems and those without（P<0.01）. After adjusting for gender，age，marital status，living in urban or rural area，education level，current smoking，drinking within 30 days，insufficient physical activity，hypertension，diabetes，BMI and other potential confounding factors，multivariate Logistic regression analysis showed that at least one kind of sleep problems were associated with elevated TG/HDL-C ratio〔OR=1.05，95%CI（1.01，1.08）〕. Sleep problems were associated with elevated TG/HDL-C ratio in men〔OR=1.05，95%CI（1.01，1.09）〕，and in those aged 18-44〔OR=1.06，95%CI（1.01，1.10）〕. Conclusion　Sleep problems such as too long or too short sleep duration，snoring or suffocation might，difficulty in falling asleep and taking sleeping pills be related to high serum TG/HDL-C ratio among Beijing residents aged 18-79 years. Men and those under 45 years old should be encouraged to take measures to improve their sleep quality.

Key words: Sleep duration, Sleep problems, Triglyceride to HDL cholesterol ratio, Dyslipidemia, Beijing

摘要： 背景　血清三酰甘油（TG）与高密度脂蛋白胆固醇（HDL-C）的比值（TG/HDL-C）是系统性反映血脂水平的指标，不良的睡眠状况可能是血脂异常的危险因素，探索睡眠问题对TG/HDL-C的影响并识别危险人群，有助于有针对性地通过改善睡眠减少血脂异常的发生。目的　了解2017年北京市成年人睡眠问题现状及其与血清TG/HDL-C的关联，旨在为改善睡眠质量及控制血脂水平提供依据。方法　数据来源于2017年北京市成年人慢性病与危险因素监测，在北京市16区采用多阶段分层整群抽样方法抽取18~79岁常住居民，收集调查对象年龄、性别、婚姻状况、受教育程度等人口学信息，高血压、糖尿病、血脂异常等慢性病患病情况，吸烟、饮酒等生活行为方式，睡眠时长及打鼾/窒息、入睡困难、中间觉醒≥2次、早醒、服用安眠药等睡眠问题，测量身高、体质量、腰围、血压，抽取空腹静脉血进行血脂四项检测。采用t检验、非参数Kruskal-Wallis H检验、Mann-Whitney U检验、χ2检验、多因素Logistic回归分析睡眠与TG/HDL-C的关联。结果　13 240例调查对象平均年龄为（44.79±15.47）岁，平均睡眠时长为（7.47±1.30）h/d，中位TG/HDL-C为0.99（0.84），6 490例（49.02%）30 d内存在睡眠问题。睡眠处于9 h/d者TG/HDL-C水平最低，中位数为0.95（0.82），不同睡眠时长的女性人群TG/HDL-C比较，差异有统计学意义（χ2=37.14，P<0.01）。按是否存在睡眠问题进行分组，组间TG/HDL-C水平比较，差异有统计学意义（P<0.01）。在控制性别、年龄、婚姻状况、城乡、受教育程度、现在吸烟、30 d内饮酒、身体活动不足、高血压、糖尿病、BMI等协变量之后，多因素Logistic回归分析结果显示，存在≥1种睡眠问题是TG/HDL-C升高的影响因素〔OR（95%CI）=1.05（1.01，1.08）〕；相比于无睡眠问题的人群，男性或18~44岁人群存在≥1种睡眠问题是高TG/HDL-C的影响因素〔OR男（95%CI）=1.05（1.01，1.09）；OR18~44岁（95%CI）=1.06（1.01，1.10）〕。结论　北京市18~79岁成年人睡眠时长过长或过短，打鼾/窒息/入睡困难、服用安眠药等睡眠问题可能影响血清TG/HDL-C，男性及45岁以下人群作为高危人群应采取改善睡眠的措施。

关键词: 睡眠时长, 睡眠问题, TG/HDL-C, 血脂异常, 北京