title: Sex-Specific Difference in the Association Between Poor Sleep Quality and Abdominal Obesity in Rural Chinese: A Large Population-Based Study.
abstract: OBJECTIVE
  Existing studies on sleep quality and associated obesity are inconsistent, and few studies have prospectively evaluated the association between sleep quality and abdominal obesity among Chinese individuals. To fill this void, the current study aimed to assess the association between sleep quality and abdominal obesity in a rural Chinese population.
  
  
  METHODS
  A representative sample of 9,404 adults aged 20-93 years in northeastern China was selected between 2012 and 2013 by a multistage cluster and random sampling method. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), where a score of 6 or higher indicated sleep disorder. Abdominal obesity was measured by waist circumference (WC), with abdominal obesity defined as WC > 90 cm for men and WC > 80 cm for women.
  
  
  RESULTS
  Male participants with abdominal obesity had higher global PSQI scores in addition to higher subscores in almost all of the elements compared to normal values. The odds ratios of abdominal obesity among participants with sleep disorders were 1.64 (95% confidence interval [CI]: 1.39-1.95) and 1.14 (95% CI: 0.98-1.32) for males and females compared to the reference group. The risk in all sleep elements was significantly increased, with odds ratios ranging from 1.28 (95% CI: 1.08-1.51) to 5.81 (95% CI: 3.54-9.53) for males. The risk only in four elements was significantly increased, from 1.28 (95% CI: 1.12-1.47) to 2.27 (95% CI: 1.36-3.80) for females.
  
  
  CONCLUSIONS
  Poor sleep quality was associated with abdominal obesity in Chinese. Furthermore, effects in males were larger than those in females.
authors.affiliation: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Ru-Qing
authors.initials: RQ
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, College of Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri.
authors.forename: Zhengmin
authors.initials: Z
authors.lastname: Qian
authors.affiliation: Department of Statistics and Operations Research, Hong Kong Baptist University, Hong Kong, China.
authors.forename: Si-Quan
authors.initials: SQ
authors.lastname: Wang
authors.affiliation: School of Social Work, College of Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Vaughn
authors.affiliation: School of Nursing and Health Studies, Northern Illinois University, DeKalb, Illinois.
authors.forename: Sarah Dee
authors.initials: SD
authors.lastname: Geiger
authors.affiliation: Department of Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri.
authors.forename: Hong
authors.initials: H
authors.lastname: Xian
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, State University of New York, Albany, New York.
authors.forename: Shao
authors.initials: S
authors.lastname: Lin
authors.affiliation: Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
authors.forename: Gunther
authors.initials: G
authors.lastname: Paul
authors.affiliation: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Zeng
authors.affiliation: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Bo-Yi
authors.initials: BY
authors.lastname: Yang
authors.affiliation: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Li-Wen
authors.initials: LW
authors.lastname: Hu
authors.affiliation: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Shu-Li
authors.initials: SL
authors.lastname: Xu
authors.affiliation: Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Mo
authors.initials: M
authors.lastname: Yang
authors.affiliation: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: abdominal obesity; rural Chinese; sex difference; sleep quality