Table 4.
Association of habitual sleep quality with risk of coronary heart disease overall (total), mediated by SMS (indirect) and independent of SMS (direct)a
| Total effect |
Direct effect |
Indirect effect |
% mediated | |
|---|---|---|---|---|
| OR (95% CI) | OR (95% CI) | OR (95% CI) | ||
| Model 1b | 1.36 (1.02, 1.81) | 1.28 (0.95, 1.73) | 1.06 (0.97, 1.15) | 20.2 |
| Model 2c | 1.18 (0.88, 1.58) | 1.14 (0.85, 1.52) | 1.03 (0.95, 1.11) | 21.3 |
The sleep-related metabolite score (SMS) included nine sleep-related metabolites (TAGs 45: 1 48: 1 50: 4, DAG 32: 1, PEs 36: 4 38: 5, PCs 30: 1 40: 6, N6-acetyl-L-lysine). Habitual sleep quality was evaluated as a binary variable (sleep-quality score ≥6 vs <6).
Model 1: adjusted for matching factors (age, race/ethnicity, hysterectomy status and enrolment window), BMI, smoking, dietary quality, physical activity, prevalent hypertension, current hormone therapy, aspirin use, statin use and other lipid-lowering medications.
Model 2: Model 1 + adjusted for total cholesterol, HDL cholesterol, total triglycerides, fasting glucose and C-reactive protein. As total triglycerides and fasting glucose were not measured on every participant, Model 3 were based on a subset of 1287 participants (629 cases and 658 controls).