Short Duration of Sleep Is Associated with Elevated High-Sensitivity C-Reactive Protein Level in Taiwanese Adults: A Cross-Sectional Study

Abstract

Background: Elevated plasma levels of high-sensitivity C-reactive protein (hs-CRP) have been associated with increased adverse health outcomes. The aim of this study was to investigate the association of sleep duration with risk of elevated hs-CRP levels in Taiwanese adults. Methods: We examined the association between sleep duration and hs-CRP in 353 healthy adults recruited from the physical examination center at a regional hospital in southern Taiwan. Elevated hs-CRP was defi ned as a plasma level ≥ 0.20 mg/dL. Short sleep duration was defi ned as ≤ 5.5 h per day. Multiple logistic regression analysis was used to assess the association of short duration of sleep with elevated hs-CRP levels. Results: In this study, short duration of sleep (odds ratio [OR] = 2.20; 95% confi dence interval [CI]: 1.11-4.30), aged 70 years or older (OR = 4.58; 95% CI: 1.70-12.66), menopause (OR = 2.81; 95% CI: 1.52-5.3), higher heart rate (OR = 1.38; 95% CI: 1.10-1.75), higher body mass index (OR = 1.20; 95% CI: 1.09-1.34), higher white blood cell count (OR = 1.38; 95% CI: 1.14-1.66), and higher uric acid level (OR = 1.31; 95% CI: 1.06-1.63) were signifi cantly associated with an increased risk of elevated hs-CRP levels. Conclusions: In this study of healthy Taiwanese adults, short duration of sleep was signifi cantly associated with elevated hs-CRP levels. Activation of pro-infl ammatory pathways might represent a mechanism by which short sleep duration affects health. Keywords: sleep duration, C-reactive protein, high-sensitivity CRP, hs-CRP Citation: Chiang JK. Short duration of sleep is associated with elevated high-sensitivity C-reactive protein level in Taiwanese adults: a cross-sectional study. J Clin Sleep Med 2014;10(7):743-749.http://dx.doi.org/10.5664/jcsm.3862 S C I E N T I F I C I N V E S T I G A T I O N SC -reactive protein is secreted by the liver in response to acute infl ammation and infection.1 The high-sensitivity C-reactive protein (hs-CRP) assay has low detection limits, and good performance for apparently healthy subjects.2 Elevated hs-CRP levels have been associated with infl ammation, aging, cancer, adverse outcomes of angina pectoris, coronary artery disease, adverse outcomes of chronic obstructive pulmonary disease, stroke, and increased risk of mortality. [3][4][5][6][7][8][9][10] In addition, elevated hs-CRP has been shown to be a stronger predictor of cardiovascular disease than low-density lipoprotein cholesterol.11 A recent study of more than 4,000 subjects followed for six years revealed that elevated hs-CRP was associated with type 2 diabetes. 12Another study with a follow-up of 11 years also demonstrated the same association of hs-CRP with diabetes.13 As expected, patients with lower glycosylated hemoglobin (A1C) levels were found to have signifi cantly lower hs-CRP levels.14 In recent years it has been shown that sleep duration might affect health in a number of ways, such as its associations with insulin resistance, diabetes, hyperleptinemia, heart disease, and mortality.15-17 Specifi cally, sho...

U-Shaped Association between Sleep Duration, C-Reactive Protein, and Uric Acid in Korean Women

“…To date, there have been inconsistent results about the relationship between sleep duration and serum hsCRP. Several previous studies have shown that a shorter sleep duration was associated with higher levels of CRP [20,21]. The longitudinal Whitehall II study [21] on London-based office employees aged 35-55 years showed that shorter sleep duration (≤ 5 h) and decreased sleep duration was significantly associated with higher levels of CRP.…”

“…Although previous studies have investigated the association between sleep duration, hsCRP, and SUA, the results were inconsistent [20][21][22][23][24]. Some studies found that short sleep duration was associated with elevated CRP [20,21]. Richardson et al [22] showed that short sleep duration was significantly associated with elevated CRP only in men not in women.…”

Association between sleep duration and cardiac structure in youths at risk for metabolic syndrome

“…Nevertheless, recent studies have shown several novel CVD risk factors, such as adipokine leptin9, adiponectin10, and inflammatory marker high-sensitivity C-reactive protein (hs-CRP)11, being linked to short sleep duration. On the other hand, these cardio-metabolic factors have also been found to contribute to cardiac abnormalities, even in the youth, with early changes of cardiac geometry and function121314.…”

Environmental factors and life style having an impact on pathogenesis and etiology of Diabetes Mellitus

“…Lack of sleep is also associated with various metabolic disorders, as it enhances sympathetic activity, boosts catecholamine levels, and inhibits pancreatic function, thereby reducing insulin secretion. Current studies have shown that increased levels of inflammatory factors and mediators in patients with sleep disorders, including tumor necrosis factor-a, IL-6, IL-8, high-sensitivity C-reactive protein, transcription factors, and adhesion factors, may affect human health through low-grade inflammation pathways (51,52). Increased levels of inflammatory factors are involved in the promotion of insulin resistance by sleep disorders (53).…”