Greater social jetlag associates with higher HbA1c in adults with type 2 diabetes: a cross sectional study
Greater social jetlag associates with higher HbA1c in adults with type 2 diabetes: a cross sectional study
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DOI：
10.1016/j.sleep.2019.07.023
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发表时间：
2020-02-01
期刊：
影响因子：
4.8
通讯作者：
Coogan, Andrew N.
中科院分区：
文献类型：
--
作者：
Kelly, Rachael M.;Finn, Jacinta;Coogan, Andrew N.
背景/目的：在2型糖尿病患者中，较晚的生理时钟型与较差的血糖控制相关。目前还不清楚这是否是一种直接关系，或者是否是个性因素或社会时差（[SJL]，即慢性昼夜节律失调，反映了生物钟的诱导阶段和社会决定的行为周期之间的差异）发挥作用。本研究的目的是确定2型糖尿病患者的生理时钟类型、SJL、个性因素和血糖控制之间的关系，独立于睡眠障碍和每日热量分配。总之，252名参加年度回顾门诊的2型糖尿病患者完成了问卷调查，包括评估时间型的慕尼黑时间型问卷和SJL，匹兹堡睡眠质量指数（PSQI），大五人格量表和流行病学研究中心抑郁量表。图表审查提供了关于糖尿病病程、血红蛋白A1 c（HbA 1c）、体重指数（BMI）和其他临床变量的信息。结果：分层线性回归分析显示，SJL是HbA 1c水平的显著预测因子，而非时间型或人格因素（β = 0.16，p < 0.05）。晚时型与HbA 1c水平之间存在显著相关性，但仅在SJL超过90 min的患者中存在相关性（r = 0.51，p = 0.002）。年龄越小，HbA 1c越高（r =-0.23，p < 0.001），这种效应部分是通过SJL介导的（Pm = 0.22.Conclusions：我们确定SJL是一个可能影响2型糖尿病血糖控制的新因素。需要进一步研究以确定旨在减少SJL的干预措施是否可能导致血糖控制的改善。(C)2019 Elsevier B. V.版权所有。
Background/Objectives: Later chronotype has been associated with poorer glycemic control in type 2 diabetes. It is unclear whether this is a direct relationship, or if personality factors or social jetlag ([SJL], ie, chronic circadian misalignment reflecting the discrepancy between the entrained phase of the circadian clock and socially-determined behavioural cycles) play a role. This study aimed to determine the relationships among chronotype, SJL, personality factors and glycemic control in type 2 diabetes, independently of sleep disturbances and daily caloric distribution.Methods: In sum, 252 type 2 diabetes patients attending an annual review outpatients' clinic completed questionnaires, including the Munich Chronotype Questionnaire to assess chronotype and SJL, the Pittsburgh Sleep Quality index (PSQI), the Big Five Personality Inventory and the Center for Epidemiologic Studies Depression Scale. Chart review provided information on diabetes duration, Hemoglobin A1c (HbA1c), body mass index (BMI) and other clinical variables. Caloric intake was assessed via 24-h dietary recall.Results: Hierarchical linear regression revealed that SJL, but not chronotype or personality factors, was a significant predictor of HbA1c levels beta = 0.16, p < 0.05). There was a significant relationship between later chronotype and HbA1c levels, but only in patients who had more than 90 min SJL (r = 0.51, p = 0.002). Younger age was associated with a higher HbA1c (r = -0.23, p < 0.001), and this effect was partially mediated through SJL (Pm = 0.22).Conclusions: We identify SJL as a novel factor that may impact on glycemic control in type 2 diabetes. Further study is needed to determine whether interventions aimed at reducing SJL may lead to improvements in glycemic control. (C) 2019 Elsevier B.V. All rights reserved.