Effects of Sleep Fragmentation on Glucose Metabolism in Normal Subjects
Effects of Sleep Fragmentation on Glucose Metabolism in Normal Subjects
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DOI：
10.1378/chest.09-0791
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发表时间：
2010-01-01
期刊：
影响因子：
9.6
通讯作者：
Punjabi, Naresh M.
中科院分区：
文献类型：
--
作者：
Stamatakis, Katherine A.;Punjabi, Naresh M.
背景：睡眠障碍越来越多地与胰岛素抵抗、糖耐量减低和2型糖尿病有关。目前尚不清楚睡眠相关疾病造成的代谢障碍是由睡眠质量差还是其他混杂因素造成的。这项研究的目的是检测实验性睡眠分段是否会改变葡萄糖代谢、肾上腺皮质功能和交感迷走神经平衡。方法：对11名健康、正常的志愿者进行为期两晚的听觉和机械刺激睡眠分段实验。主要结果包括胰岛素敏感性(S-I)、葡萄糖有效性(S-G)和胰岛素分泌，由静脉葡萄糖耐量试验确定。次要结果包括交感迷走神经平衡以及血清炎症标志物、脂肪因子和皮质醇水平。结果：经过两个晚上的睡眠中断，S-I从5.02(亩/L)(-1)分钟(-1)下降到3.76(单位/L)(P<；0.0001)。S-G也从2.73×10~(-2)分(-1)降至2.16×10~(-2)分(~(-1))(P<；0.01)。睡眠片断导致早晨皮质醇水平升高，交感迷走神经平衡向交感神经系统活动增加转变。全身炎症指标和血清脂肪因子随着睡眠碎片化而变化不大。结论：睡眠各阶段的碎片化与S和S的睡眠减少有关。交感神经系统和肾上腺皮质活动的增加可能会调节睡眠质量不佳的不利代谢影响。《胸腔》2010；137(1)：95-101
Background: Sleep disorders are increasingly associated with insulin resistance, glucose intolerance, and type 2 diabetes mellitus. Whether the metabolic toll imposed by sleep-related disorders is caused by poor-quality sleep or due to other confounding factors is not known. The objective of this study was to examine whether experimental sleep fragmentation across all sleep stages would alter glucose metabolism, adrenocortical function, and sympathovagal balance.Methods: Sleep was experimentally fragmented across all stages in 11 healthy, normal volunteers for two nights using auditory and mechanical stimuli. Primary outcomes included insulin sensitivity (S-I), glucose effectiveness (S-G), and insulin secretion, as determined by the intravenous glucose tolerance test. Secondary outcomes included measures of sympathovagal balance and serum levels of inflammatory markers, adipokines, and cortisol.Results: Following two, nights of sleep fragmentation, S-I decreased from 5.02 to 3.76 (mU/L)(-1)min(-1) (P < .0001). S-G, which is the ability of glucose to mobilize itself independent of an insulin response, also decreased from 2.73 X 10(-2) min(-1) to 2.16 X 10(-2) min(-1) (P < .01). Sleep fragmentation led to an increase in morning cortisol levels and a shift in sympathovagal balance toward an increase in sympathetic nervous system activity. Markers of systemic inflammation and serum adipokines were unchanged with sleep fragmentation.Conclusions: Fragmentation of sleep across all stages is associated with a decrease in S, and S,. Increases in sympathetic nervous system and adrenocortical activity likely mediate the adverse metabolic effects of poor sleep quality. CHEST 2010; 13 7(1):95-101