Study On The Association Of Dietary Patterns And Antibiotic Exposure With Sleep Rhythm Disturbance In Newlyweds

ObjectivesWe aimed to identify the characteristics of dietary patterns and the prevalence of sleep rhythm disturbance in newlyweds,to investigate the impact of dietary patterns and internal antibiotic exposure on sleep rhythm disturbance;meanwhile,we analyzed the association of dietary patterns with antibiotic exposure and further illuminated the role of antibiotic exposure in the relationship between dietary patterns and sleep rhythm disturbance in newlyweds.MethodsFrom August 2019 to August 2020,we employed a stratified random sampling method and recruited newlyweds from the Reproductive Health of Childbearing Couples-Anhui Cohort.We utilized self-developed structured questionnaires to investigate the demographic characteristics and sleep information of newlyweds.The food frequency questionnaire was applied to assess the intake status of common foods.Then,physical measurements were conducted on the newlyweds.Finally,1349 dyadic newlyweds were included for data analysis.We used factor analysis to identify the dietary patterns of newlyweds.A liquid chromatography-triple quadrupole tandem mass spectrometer was applied to determine concentrations of 40 antibiotics and two corresponding metabolites in the urine of newlyweds,with their concentrations adjusted by urine-specific gravity.Long sleep duration（LSD）（≥9 h）,social jetlag（social jetlag）（≥1 h）,or excessive daytime sleepiness（EDS）were employed to measure sleep rhythm disturbance.We selected P₉₀,P₉₅,and the maximum value to characterize the distribution of antibiotic concentrations.Multiple linear regression models were used to analyze the linear relationships between dietary patterns,internal antibiotic concentrations and sleep rhythm disturbance in newlyweds.Binary logistic regression models were performed to investigate the associations of dietary patterns and antibiotic exposure with the risk of sleep rhythm disturbance.Restricted cubic spline models were established to delineate the dose-response relationships of dietary patterns and antibiotic concentrations with the sleep rhythm disturbance risk.We also adopted moderating effect models to examine the effect of antibiotic exposure on relationships between dietary patterns and sleep rhythm disturbance among newlyweds.ResultsThe prevalence of LSD,SJL≥1h,and EDS was separately 29.5%,21.7%,and32.3%in the total population.The overall detection rate of antibiotics was 99.0%,in which the detection rates of sulfonamides（94.5%）,quinolones（86.2%）,β-lactams（80.4%）,veterinary antibiotics（VA）（97.6%）and preferred veterinary antibiotics（94.9%）were relatively high in newlyweds.Factor analysis showed that husbands had three dietary patterns,which were meat fried,vegetable and grain,and dairy and nut dietary patterns.There were also 3 dietary patterns identified for wives:vegetarian-based,meat-based,and beverage fried dietary patterns.The dairy and nut dietary pattern was positively correlated with average sleep duration（β=0.063,95%CI:0.017～0.110）and could increase the LSD risk（OR=1.25,95%CI:1.10～1.43）in husbands.Among wives,the vegetarian-based dietary pattern raised the LSD risk（OR=1.21,95%CI:1.07～1.37）but was inversely with SJL（β=-0.034,95%CI:-0.054～-0.013）and could reduce the risk of SJL≥1h（OR=0.86,95%CI:0.76～0.99）.Among husbands,the second tertile（T）group of the meat fried dietary pattern increased the exposure risk of florfenicol（OR=1.49,95%CI:1.13～1.98）,and chloramphenicols（OR=1.57,95%CI:1.18～2.08）;the vegetable and grain dietary pattern elevated the exposure risk of trimethoprim（T3:OR=1.37,95%CI:1.02～1.86）,and lincomycin（T3:OR=1.41,95%CI:1.06～1.87）in husbands.In wives,the meat-based pattern was significantly associated with the increased exposure risk of oxytetracycline（T2:OR=1.74,95%CI:1.21～2.51）,and florfenicol（T3:OR=1.35,95%CI:1.03～1.77）;the beverage fried pattern increased the exposure risk of tetracyclines（T3:OR=1.48,95%CI:1.09～2.01）;however,the vegetarian-based pattern reduced the exposure risk of VA（T2:OR=0.40,95%CI:0.18～0.88）in wives.The low concentration group（OR=1.41,95%CI:1.03～1.92）and high concentration group（OR=1.40,95%CI:1.02～1.93）of sulfameter were related to raised LSD risk in husbands.The concentration of lincomycin（OR=1.30,95%CI:1.02～1.66）was associated with an increased risk of SJL≥1 h in husbands.The concentration of sulfadiazine（OR=1.20,95%CI:1.02～1.41）and the number of antibiotic exposure（OR=1.03,95%CI:1.00～1.05）increased the EDS risk in husbands.Among wives,the concentration of preferred as human antibiotics（OR=1.31,95%CI:1.06～1.61）increased the LSD risk.Higher concentration of cefaclor（OR=1.43,95%CI:1.05～1.95）was linked with an increased risk of SJL≥1 h in wives.Exposure to sulfadiazine（OR=1.31,95%CI:1.01～1.70）was connected with the increased EDS risk,whereas azithromycin（OR=0.50,95%CI:0.32～0.81）decreased the risk of EDS in wives.Moderating effect models showed that amoxicillin,pefloxacin,ofloxacin and quinolones antibiotics modulated the relationships between dietary patterns and sleep rhythm disturbance in husbands.Enrofloxacin,trimethoprim,florfenicol,and VA were also found to have moderation effects on associations between dietary patterns and sleep rhythm disturbance in wives;the proportions of moderating effects ranged from 0.4%～1.04%.Conclusions（1）The dairy and nut dietary pattern increased the LSD risk in husbands.The vegetarian-based dietary pattern decreased SJL≥1 h risk but significantly raised the LSD risk in wives.（2）Among husbands,the meat fried dietary pattern increased the exposure risk of florfenicol and chloramphenicols;the vegetable and grain dietary pattern raised the exposure risk of trimethoprim,and lincomycin.Among wives,the meat-based dietary pattern enhanced the exposure risk of oxytetracycline,and florfenicol;the beverage fried dietary pattern elevated the exposure risk of tetracyclines;however,the vegetarian-based dietary pattern reduced VA exposure risk in wives;（3）The internal antibiotic exposures could predominately facilitate sleep rhythm disturbance risk in newlyweds.（4）A few antibiotics could modulate associations between dietary patterns and sleep rhythm disturbance in newlyweds.