The Impact of Sleep Duration and Dietary Patterns on the Risk of Metabolic Syndrome in Middle-Aged and Elderly Adults: A Decision Tree Analysis

Abstract The aim of this study was to investigate the relationship between sleep duration and dietary patterns and the prevalence of metabolic syndrome (MetS) in middle-aged and elderly adults in Bengbu city. This study, a cross-sectional analysis, utilized information from the “Community-based Cardiovascular and Health Promotion Study 2019” (COCHPS 2019), carried out in Bengbu, Anhui Province, China. The definition of MetS adhered to the criteria of Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults (2016 Revision). Dietary information was collected from 24-hour dietary records spanning three successive days. Principal component analysis (PCA) served to identify dominant dietary patterns. Logistic regression model was used to analyze the associations of sleep duration and dietary patterns with MetS, and decision tree model was used to analyze the influencing factors of MetS. The prevalence rate of MetS was 13.4% among the 9132 middle-aged and elderly adults over 45 years of age. Participants were divided into short ( 8 h/d) groups based on their daily sleep duration. Three dietary patterns were identified by PCA, namely fruit-milk pattern, tubers-meat pattern and vegetable-cereal pattern. After adjusting for covariates, logistic regression analysis showed that long sleep duration had statistically significant negative effects on MetS. Fruit-milk pattern and vegetable-cereal pattern were negatively associated with MetS, while tubers-meat pattern showed a positive correlation with MetS. The results of decision tree model analysis showed that vegetable-cereal pattern is the most important influencing factor for MetS, followed by marital status, tubers-meat pattern, fruit-milk pattern, exercise, sleep duration and gender. In addition, the decision tree model also screened out five types of high-risk groups of MetS. The results of our study indicate that normal sleep duration and consumption of either a fruit-milk or vegetable-cereal diet may lower the likelihood of Mets in middle-aged and elderly adults.