Abstract: Background　The risk of chronic diseases in female population increases after menopause.Sleep disorders are common health risk factors for middle-aged and elderly women，and are also a hot research topic about the etiology of diabetes in recent years.Objective　To evaluate the correlation between sleep characteristics and diabetes prevalence among middle-aged and elderly（≥40 years） women in Guiyang.Methods　From June to October 2017，with the support of Guiyang Health and Family Planning Commission，a household survey was conducted by School of Public Health，Guizhou Medical University among four districts and counties（Yunyan，Wudang，Baiyun and Xiuwen） in Guiyang City selected with stratified multistage sampling.Information on age，years of education，marriage status，nationality，tobacco smoking prevalence，alcohol consumption prevalence，exercise frequency，eating pattern，reproductive history，menopause，hypertension prevalence，BMI，central obesity，prevalence and duration of daytime napping，sleep duration and sleep quality at night，and so on in participants was collected，and was compared between those with diabetes and those without.The multivariate logistic regression model was used to analyze and explore the related factors of diabetes.Results　A total of 2 758 cases were included for analysis，among whom 150（5.4%） had a self-reported diagnosis of diabetes.Those with diabetes had greater mean age，and higher proportions of being unmarried，Han nationality，exercise frequency ≥ 1 d/week，regular eating pattern，menopause，hypertension，overweight or obesity，central obesity，daytime napping，poor sleep quality at night than those without（P<0.05）.Multivariate Logistic regression analysis showed that hypertension 〔OR=3.626，95%CI（2.463，5.337），P<0.001〕，central obesity 〔OR=1.782，95%CI（1.111，2.858），P=0.017〕，daytime napping〔OR=1.727，95%CI（1.161，2.569），P=0.007〕 and poor sleep quality at night 〔OR=1.682，95%CI（1.140，2.482），P=0.009〕were factors associated with diabetes in women over 40 years old.Daytime napping behavior 〔OR=1.888，95%CI（1.038，3.435），P=0.037〕 and poor night sleep quality〔OR=1.993，95%CI（1.115，3.563），P=0.020〕were correlated with diabetes among non-hypertension participants.Daytime napping 〔OR=1.588，95%CI（1.033，2.442），P=0.035〕 was also associated with diabetes in central obesity group.In addition，overweight / obesity and poor sleep quality at night〔OR=1.759，95%CI（1.098，2.820），P=0.019〕，central obesity and daytime napping 〔OR=1.186，95%CI（1.254，2.628），P=0.002〕were correlated with diabetes.Conclusion　Sleep disorders（poor night sleep quality and long daytime napping）may be risk factors for diabetes among women aged 40 and over.Hypertension and obesity may strengthen the association between sleep disorders and diabetes.Individualized differences such as sleep disorders，obesity and hypertension should be all taken into account in the improvement of diabetes prevention and treatment strategies.

Key words: Sleep, Diabetes mellitus, Obesity, Hypertension, Femininity, Middle-aged and elderly female

摘要： 背景　女性进入更年期后，慢性病发病风险上升，而睡眠障碍是中老年女性常见的健康危险因素之一，也是近年糖尿病病因学研究的热点之一。目的　调查贵阳市中老年（40岁及以上）女性人群睡眠特征及糖尿病现患情况，并分析二者的相关性。方法　2017年6—10月，在贵阳市卫生和计划生育委员会的支持下，贵州医科大学公共卫生学院采用分层、多级抽样的方法选择贵阳市云岩区、乌当区、白云区、修文县四个区县进行入户调查，收集其年龄、受教育年限、婚姻状况、民族、吸烟状况、饮酒状况、运动频率、三餐规律饮食情况、生育史、绝经状况、高血压患病、体质量情况、中心性肥胖、午睡、午睡时间、夜间睡眠时间、夜间睡眠质量等情况，并比较糖尿病患者与非糖尿病人群之间的差异。采用多因素Logistic回归分析探讨糖尿病的相关因素。结果　共纳入2 758例40岁及以上中老年女性进行分析。其中，自我报告被诊断为糖尿病患者150例，自我报告患病率为5.4%。糖尿病患者年龄相对较大，且非在婚、汉族、运动频率≥1 d/周、三餐规律饮食、已绝经、高血压患病、超重或肥胖、中心性肥胖、午睡、夜间睡眠质量差所占比例高于非糖尿病人群（P<0.05）。多因素Logistic回归分析结果显示，高血压〔OR=3.626，95%CI（2.463，5.337），P<0.001〕、中心性肥胖〔OR=1.782，95%CI（1.111，2.858），P=0.017〕、午睡情况〔OR=1.727，95%CI（1.161，2.569），P=0.007〕、夜间睡眠质量差〔OR=1.682，95%CI（1.140，2.482），P=0.009〕是40岁以上中老年女性糖尿病患病的相关因素。非高血压患者午睡〔OR=1.888，95%CI（1.038，3.435），P=0.037〕、夜间睡眠质量差〔OR=1.993，95%CI（1.115，3.563），P=0.020〕与糖尿病患病相关，而中心性肥胖者的午睡情况〔OR=1.588，95%CI（1.033，2.442），P=0.035〕也与糖尿病患病相关。超重或肥胖与夜间睡眠质量差〔OR=1.759，95%CI（1.098，2.820），P=0.019〕、中心性肥胖与午睡〔OR=1.186，95%CI（1.254，2.628），P=0.002〕两项交互项均与糖尿病患病相关。结论　40岁及以上女性人群夜间睡眠质量差、午睡行为可能是其糖尿病患病的危险因素，而高血压、肥胖可能在睡眠特征与糖尿病的关联中发挥修饰作用，糖尿病防制策略的完善应注意综合考虑睡眠障碍、肥胖、高血压因素。

关键词: 睡眠, 糖尿病, 肥胖, 高血压, 女性, 中老年