Korean J Fam Pract 2019; 9(1): 89-95  https://doi.org/10.21215/kjfp.2019.9.1.89
A Retrospective Study of the Relationship between Sleep Duration, Carbohydrate Intake and the Atherosclerotic Cardiovascular Disease Risk in Korean, Based on the 2013-2015 Korean National Health and Nutrition Examination Survey
Young Hwan Han, Hyun Jin Kim, Rae Ho Chung*, Won Suk Baek
Department of Family Medicine, Daegu Veterans Hospital, Daegu, Korea
Rae Ho Chung, Tel: +82-53-630-7000, Fax: +82-53-630-7849, E-mail: urierl@hanmail.net, ORCID: http://orcid.org/0000-0001-7629-9449
Received: July 12, 2018; Revised: September 27, 2018; Accepted: October 17, 2018; Published online: February 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Atherosclerotic cardiovascular disease (ASCVD) is known to be related to various factors. The aim of this study was to evaluate the association between the risk of ASCVD and sleep duration or carbohydrate intake using the Pooled Cohort Risk Assessment equations, which estimate a patient’s 10-year primary risk.
Methods: A total of 7,781 adults were selected from the 6th Korean National Health and Nutrition Examination Survey, with no missing data as the inclusion criteria for analysis. The 10-year estimated risk of ASCVD risk was calculated using the Pooled Cohort Risk Assessment Equations. The χ2 test was used to analyze the difference in the rates of ASCVD high-risk groups due to sleep duration and carbohydrate intake. Multiple logistic regression analysis was performed to verify the effects of sleep duration and carbohydrate intake on ASCVD risk.
Results: Shorter sleep duration (≤5 hours) was 1.166-times more likely in the ASCVD high-risk group than was optimal sleep duration (6–8 hours) (odds ratio [OR], 1.166; P<0.05). Excessive sleep duration (≥9 hours) was also 1.504-times more likely in the ASCVD high-risk group than was optimal sleep duration (OR, 1.504; P<0.001). Excessive carbohydrate intake (>65%) was 1.185-times more likely in the ASCVD high-risk group than was recommended carbohydrate intake (55%–65%) (OR, 1.185; P>0.05).
Conclusion: Inappropriate sleep duration and excessive carbohydrate intake increase the risk of ASCVD.
Keywords: Sleep; Dietary Carbohydrates; Cardiovascular Disease
References
  1. Korean Statistical Information Service. The number of death and mortality by cause of death in 2016 [Internet]. Daejeon: Statistics Korea; 2017. [cited 2018 Jun 1].
  2. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364: 937-52.
    CrossRef
  3. Appel LJ, Sacks FM, Carey VJ, Obarzanek E, Swain JF, Miller ER 3rd, et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA 2005; 294: 2455-64.
    Pubmed CrossRef
  4. Wolk R, Gami AS, Garcia-Touchard A, Somers VK. Sleep and cardiovascular disease. Curr Probl Cardiol 2005; 30: 625-62.
    Pubmed CrossRef
  5. Menotti A, Puddu PE, Lanti M. Comparison of the Framingham risk functionbased coronary chart with risk function from an Italian population study. Eur Heart J 2000; 21: 365-70.
    Pubmed CrossRef
  6. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129(25 Suppl 2): S1-45.
    Pubmed CrossRef
  7. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157-63.
    CrossRef
  8. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans 2015. [Internet]. Sejong: Ministry of Health and Welfare. The Korean Nutrition Society; 2015 [cited 2018 Jun 1].
  9. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, at el. Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force Recommendation Statement. JAMA 2016; 316: 1997-2007.
    Pubmed CrossRef
  10. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et al. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension 2006; 47: 833-9.
    Pubmed CrossRef
  11. Mesarwi O, Polak J, Jun J, Polotsky VY. Sleep disorders and the development of insulin resistance and obesity. Endocrinol Metab Clin North Am 2013;42: 617-34.
    Pubmed KoreaMed CrossRef
  12. Kim JY, Yadav D, Ahn SV, Koh SB, Park JT, Yoon J, at el. A prospective study of total sleep duration and incident metabolic syndrome: the ARIRANG study. Sleep Med 2015; 16: 1511-5.
    Pubmed CrossRef
  13. Yeo Y, Ma SH, Park SK, Chang SH, Shin HR, Kang D, et al. A prospective cohort study on the relationship of sleep duration with all-cause and diseasespecific mortality in the Korean Multi-center Cancer Cohort study. J Prev Med Public Health 2013; 46: 271-81.
    Pubmed KoreaMed CrossRef
  14. Kim CW, Chang Y, Zhao D, Cainzos-Achirica M, Ryu S, Jung HS, et al. Sleep duration, sleep quality, and markers of subclinical arterial disease in healthy men and women. Arterioscler Thromb Vasc Biol 2015; 35: 2238-45.
    Pubmed CrossRef
  15. Tasali E, Leproult R, Spiegel K. Reduced sleep duration or quality: relationships with insulin resistance and type 2 diabetes. Prog Cardiovasc Dis 2009;51: 381-91.
    Pubmed CrossRef
  16. Vgontzas AN, Zoumakis E, Bixler EO, Lin HM, Follett H, Kales A, et al. Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. J Clin Endocrinol Metab 2004; 89: 2119-26.
    Pubmed CrossRef
  17. Rosmond R, Dallman MF, Björntorp P. Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. J Clin Endocrinol Metab 1998; 83: 1853-9.
    CrossRef
  18. Calvin AD, Covassin N, Kremers WK, Adachi T, Macedo P, Albuquerque FN, et al. Experimental sleep restriction causes endothelial dysfunction in healthy humans. J Am Heart Assoc 2014; 3: e001143.
    Pubmed KoreaMed CrossRef
  19. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143-421.
    Pubmed CrossRef
  20. Bravata DM, Sanders L, Huang J, Krumholz HM, Olkin I, Gardner CD, et al. Efficacy and safety of low-carbohydrate diets: a systematic review. JAMA 2003; 289: 1837-50.
    Pubmed CrossRef
  21. Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 2017; 390: 2050-62.
    CrossRef
  22. Choi Y, Chang Y, Ryu S, Cho J, Kim MK, Ahn Y, et al. Relation of dietary glycemic index and glycemic load to coronary artery calcium in asymptomatic Korean adults. Am J Cardiol 2015; 116: 520-6.
    Pubmed CrossRef
  23. Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129(25 Suppl 2):S49-73.
    Pubmed CrossRef
  24. Jung KJ, Jang Y, Oh DJ, Oh BH, Lee SH, Park SW, et al. The ACC/AHA 2013 pooled cohort equations compared to a Korean Risk Prediction Model for atherosclerotic cardiovascular disease. Atherosclerosis 2015; 242: 367-75.
    Pubmed CrossRef


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