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Chronobiol Int. Author manuscript; available in PMC 2017 March 19. Published in final edited form as: Chronobiol Int. 2016 ; 33(5): 543–552. doi:10.3109/07420528.2016.1158721.
Relationship between sleep duration and arterial stiffness in a multi-ethnic population: The HELIUS study Kenneth Anujuoa, Karien Stronksa, Marieke B. Snijdera, Girardin Jean-Louisb,c, Bert-Jan van den Bornd, Ron J. Peterse, and Charles Agyemanga
Author Manuscript
aDepartment
of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands bDepartment of Medicine, Center for Healthful Behavior Change, New York University School of Medicine, New York, NY, USA cDepartment of Population Health, New York University School of Medicine, New York, NY, USA dDepartment of Internal and Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands eDepartment of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Abstract
Author Manuscript
We examined the relationship between sleep duration and arterial stiffness among a multi-ethnic cohort, and whether the associations differed among ethnic minority groups in the Netherlands. Data were derived from 10 994 participants (aged 18–71 years) of the Healthy Life in an Urban Setting (HELIUS) study. Self-reported sleep duration was categorized into: short (6.22 mmol/L, or high-density lipoprotein cholesterol (HDL-C) 4.14 mmol/L, or triglyceride (TG) >1.69 mmol/L (Eckel et al., 2010; Goldberg, 2015), or use of lipid-lowering medication.
Author Manuscript
Educational level was determined using participant’s highest level of education (either in the Netherlands or in the country of origin). Participants were categorized into those who have never been to school or had elementary schooling only (first category), those with lower vocational schooling or lower secondary schooling (second category), those with intermediate vocational schooling or intermediate/higher secondary education schooling (third category) and those with higher vocational schooling or university (fourth category). For the current analyses, the first two categories were combined because of small numbers. Marital status included married/registered/partnership, living together, unmarried/never married, divorced/separated or widowed. Alcohol intake in the past 12 months (yes/no) and smoking status (yes/no/ex-smoker) were obtained by questionnaire. Habitual physical activity was measured using the SQUASH questionnaire (Wendel-Vos et al., 2003). The SQUASH questions about multiple activities refer to a normal week in the past months. We categorized participants according to the Dutch guideline for physical activity by summing up the number of days per week for each moderate- and high-intensity activity lasting at least 30 min. A total of 5 days resulted in participants being categorized as achieving the Dutch norm for physical activity (Wendel-Vos et al., 2003).
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2.2.4. Ethnicity—Participant’s ethnicity was defined according to the country of birth of the participant as well as that of his/her parents and self-report. Specifically, a participant is considered as of non-Dutch ethnic origin if he/she fulfils either of the following criteria: (1) he or she was born abroad and has at least one parent born abroad (first generation); or (2) he or she was born in the Netherlands but both his/her parents born abroad (second generation) (Stronks et al., 2009). Of the Surinamese immigrants in the Netherlands, approximately 80% are of either African or South-Asian origin. Both subgroups were Chronobiol Int. Author manuscript; available in PMC 2017 March 19.
Anujuo et al.
Page 5
Author Manuscript
classified according to self-reported ethnic origin. Participants were considered as of Dutch origin if the person and both parents were born in the Netherlands. 2.3. Data analysis
Author Manuscript
Baseline data were expressed as percentages, means or median with interquartile range and reported stratified for ethnicity. The association between sleep duration and arterial stiffness was analysed by linear regression adjustment for potential confounders. We used healthy sleep (i.e. 7–8 h/night) as a reference category in the regression model. Independent factors were selected in the regression model based on the factors known to influence arterial stiffness and sleep duration relationship (Tsai et al., 2014; Wolff et al., 2008; Yoshioka et al 2011). The influence of potential confounders was determined by the change in regression coefficient before and after inclusion in the regression models. We stratified the analysis by gender because of interaction between sleep duration and gender (p = 0.000). There was no significant interaction between sleep duration and antihypertensive agents in all the ethnic groups. All analyses were performed using STATA 11.0 (Stata Corp., College Station, TX). A p-value of
Chronobiol Int. Author manuscript; available in PMC 2017 March 19. Published in final edited form as: Chronobiol Int. 2016 ; 33(5): 543–552. doi:10.3109/07420528.2016.1158721.
Relationship between sleep duration and arterial stiffness in a multi-ethnic population: The HELIUS study Kenneth Anujuoa, Karien Stronksa, Marieke B. Snijdera, Girardin Jean-Louisb,c, Bert-Jan van den Bornd, Ron J. Peterse, and Charles Agyemanga
Author Manuscript
aDepartment
of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands bDepartment of Medicine, Center for Healthful Behavior Change, New York University School of Medicine, New York, NY, USA cDepartment of Population Health, New York University School of Medicine, New York, NY, USA dDepartment of Internal and Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands eDepartment of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Abstract
Author Manuscript
We examined the relationship between sleep duration and arterial stiffness among a multi-ethnic cohort, and whether the associations differed among ethnic minority groups in the Netherlands. Data were derived from 10 994 participants (aged 18–71 years) of the Healthy Life in an Urban Setting (HELIUS) study. Self-reported sleep duration was categorized into: short (6.22 mmol/L, or high-density lipoprotein cholesterol (HDL-C) 4.14 mmol/L, or triglyceride (TG) >1.69 mmol/L (Eckel et al., 2010; Goldberg, 2015), or use of lipid-lowering medication.
Author Manuscript
Educational level was determined using participant’s highest level of education (either in the Netherlands or in the country of origin). Participants were categorized into those who have never been to school or had elementary schooling only (first category), those with lower vocational schooling or lower secondary schooling (second category), those with intermediate vocational schooling or intermediate/higher secondary education schooling (third category) and those with higher vocational schooling or university (fourth category). For the current analyses, the first two categories were combined because of small numbers. Marital status included married/registered/partnership, living together, unmarried/never married, divorced/separated or widowed. Alcohol intake in the past 12 months (yes/no) and smoking status (yes/no/ex-smoker) were obtained by questionnaire. Habitual physical activity was measured using the SQUASH questionnaire (Wendel-Vos et al., 2003). The SQUASH questions about multiple activities refer to a normal week in the past months. We categorized participants according to the Dutch guideline for physical activity by summing up the number of days per week for each moderate- and high-intensity activity lasting at least 30 min. A total of 5 days resulted in participants being categorized as achieving the Dutch norm for physical activity (Wendel-Vos et al., 2003).
Author Manuscript
2.2.4. Ethnicity—Participant’s ethnicity was defined according to the country of birth of the participant as well as that of his/her parents and self-report. Specifically, a participant is considered as of non-Dutch ethnic origin if he/she fulfils either of the following criteria: (1) he or she was born abroad and has at least one parent born abroad (first generation); or (2) he or she was born in the Netherlands but both his/her parents born abroad (second generation) (Stronks et al., 2009). Of the Surinamese immigrants in the Netherlands, approximately 80% are of either African or South-Asian origin. Both subgroups were Chronobiol Int. Author manuscript; available in PMC 2017 March 19.
Anujuo et al.
Page 5
Author Manuscript
classified according to self-reported ethnic origin. Participants were considered as of Dutch origin if the person and both parents were born in the Netherlands. 2.3. Data analysis
Author Manuscript
Baseline data were expressed as percentages, means or median with interquartile range and reported stratified for ethnicity. The association between sleep duration and arterial stiffness was analysed by linear regression adjustment for potential confounders. We used healthy sleep (i.e. 7–8 h/night) as a reference category in the regression model. Independent factors were selected in the regression model based on the factors known to influence arterial stiffness and sleep duration relationship (Tsai et al., 2014; Wolff et al., 2008; Yoshioka et al 2011). The influence of potential confounders was determined by the change in regression coefficient before and after inclusion in the regression models. We stratified the analysis by gender because of interaction between sleep duration and gender (p = 0.000). There was no significant interaction between sleep duration and antihypertensive agents in all the ethnic groups. All analyses were performed using STATA 11.0 (Stata Corp., College Station, TX). A p-value of
