title: Contribution of Inflammation, Oxidative Stress, and Antioxidants to the Relationship between Sleep Duration and Cardiometabolic Health.
abstract: OBJECTIVE
  To explore the interrelationship and mediating effect of factors that are beneficial (i.e., antioxidants) and harmful (i.e., inflammation and oxidative stress) to the relationship between sleep and cardiometabolic health.
  
  
  METHODS
  Cross-sectional data from the 2005-2006 National Health and Nutrition Examination Survey.
  
  
  METHODS
  Nationally representative population sample from the US.
  
  
  METHODS
  Age ≥ 20 y with sleep data; final analytical sample of n = 2,079.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Metabolic syndrome was classified according to the Joint Interim Statement, and sleep duration was categorized as very short, short, adequate, and long sleepers (≤ 4, 5-6, 7-8, and ≥ 9 h per night, respectively). The indirect mediation effect was quantified as large (≥ 0.25), moderate (≥ 0.09), modest (≥ 0.01), and weak (< 0.01). In general, inflammation was above the current clinical reference range across all sleep duration categories, whereas oxidative stress was elevated among short and very short sleepers. Select sleep duration- cardiometabolic health relationships were mediated by C-reactive protein (CRP), γ-glutamyl transferase (GGT), carotenoids, uric acid, and vitamins C and D, and were moderated by sex. Specifically, moderate-to-large indirect mediation by GGT, carotenoids, uric acid, and vitamin D were found for sleep duration-waist circumference and -systolic blood pressure relationships, whereas vitamin C was a moderate mediator of the sleep duration-diastolic blood pressure relationship.
  
  
  CONCLUSIONS
  Several factors related to inflammation, oxidative stress, and antioxidant status were found to lie on the casual pathway of the sleep duration-cardiometabolic health relationship. Further longitudinal studies are needed to confirm our results.
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
authors.forename: Thirumagal
authors.initials: T
authors.lastname: Kanagasabai
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
authors.forename: Chris I
authors.initials: CI
authors.lastname: Ardern
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D001205:Ascorbic Acid / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D002320:Cardiovascular Physiological Phenomena; D002338:Carotenoids / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism*; D008875:Middle Aged; D009749:Nutrition Surveys; D018384:Oxidative Stress; D012727:Sex Characteristics; D012890:Sleep / Q000502:physiology*; D013997:Time Factors; D011503:Transglutaminases / Q000378:metabolism; D014481:United States / Q000453:epidemiology; D014527:Uric Acid / Q000378:metabolism; D014807:Vitamin D / Q000378:metabolism; D055105:Waist Circumference
chemical_list: D000975:Antioxidants; D014807:Vitamin D; D014527:Uric Acid; D002338:Carotenoids; D002097:C-Reactive Protein; D011503:Transglutaminases; D001205:Ascorbic Acid
keywords: antioxidants; cardiometabolic health; indirect mediation effect; inflammation and oxidative stress; sleep duration