Associação entre curta duração do sono e obesidade: uma revisão sistemática e meta-análise de estudos de coorte

Abstract

Introduction: Short sleep duration is associated with an increased risk of developing obesity. Systematic reviews have been carried out trying to confirm these findings, however, a review with greater methodological and systematic rigor is needed that includes only cohort studies with the aim of increasing the confidence of this evidence. Objective: This review aimed to conduct a systematic review of the literature, including cohort studies that assessed the association between sleep duration and development of obesity and, subsequently, to perform a meta-analysis. There was also an association between short sleep duration and secondary outcomes, such as type 2 diabetes mellitus, metabolic syndrome, risk of cardiovascular disease, systemic arterial hypertension, abdominal obesity, quality of life and mortality. Data sources: LILACs, Medline, Central and Embase, in addition to the gray literature by Opengrey were used to find articles without languages limits until July 2020 using Rayyan with “sleep deprivation” and “obesity” as mesh terms. Study selection: The PECO strategy (P: adults, E: short sleep duration, C: normal sleep duration, O: obesity) was used, excluding studies with pregnant, lactating or physically disabled participants. Data extraction: After reading in full-text the studies selected in Rayyan, according to inclusion and exclusion criteria, twenty-nine studies were included in the review, and data such as study design, sample size, location, follow-up period, age at baseline, exposure, outcome, statistical method and results were extracted. Statistics: The meta-analysis was performed using the Cochrane Review Manager 5.3 Software. Risk Ratio was calculated for dichotomous data and Odds Ratio for data from pooled analyses. The sensitivity analysis was performed by removing studies classified as low quality by NewCastle-Ottawa from the main analysis (two studies). The quality of the evidence was performed using the Grading of Recommendations Assessment, Development, and Evaluation. Results: The meta-analysis was carried out in 22 studies and showed a significant association between short sleep duration and the development of obesity (RR = 1.18, 95% CI, 1.15, 1.26), metabolic syndrome (RR: 1.54; 95%CI: 1.13, 2.11) and type 2 diabetes (RR: 1.13; 95%CI: 1.02, 1.25). In the analysis with pooled data, the association remained significant between short sleep duration and the development of obesity (OR = 1.26, 95%CI: 1.17, 1.36) and type 2 diabetes (OR: 1.25; 95%CI: 1.08, 1.45). Conclusion: Short sleep duration is associated with obesity, metabolic syndrome and type 2 diabetes.