Sleep disturbance as a predictor of type 2 diabetes mellitus in men and women from the general population
Sleep disturbance as a predictor of type 2 diabetes mellitus in men and women from the general population
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DOI：
10.1007/s00125-004-1634-x
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发表时间：
2005-02-01
期刊：
影响因子：
8.2
通讯作者：
Loewel, H
中科院分区：
文献类型：
--
作者：
Meisinger, C;Heier, M;Loewel, H
目的/假设：在德国代表性人群样本中检查睡眠障碍与 2 型糖尿病发病之间的性别特异性关联。方法：该研究以 4,140 名男性和 4,129 名女性（年龄 25 - 74 岁）为基础，他们参加了 1984 年至 1995 年间三项 MONICA Augsburg 调查之一，并且基线时没有糖尿病。 1998 年使用后续调查问卷对 2 型糖尿病的发病病例进行了评估。根据 Cox 比例风险模型估计了性别特定风险比。结果：在平均 7.5 年的随访期内，总共登记了 119 例男性 2 型糖尿病病例和 69 例女性 2 型糖尿病病例。无论男女，维持睡眠困难都与较高的 2 型糖尿病风险相关。调整年龄、调查、高血压、血脂异常、父母糖尿病史、心绞痛病史、经常吸烟、体力活动、饮酒、体重指数和教育程度后，男性的风险比为 1.60 (95% CI: 1.05 - 2.45)，女性的风险比为 1.98 (95% CI: 1.20 - 3.29)。相比之下，在本研究中，对两性进行多变量调整后，入睡困难与患 2 型糖尿病的风险显着增加无关。结论/解释：一般人群中，维持睡眠困难与男性和女性患 2 型糖尿病的风险增加相关。尽管因果途径尚不完全清楚，但似乎胰岛素抵抗和慢性低度全身炎症都可能参与其中。
Aims/hypothesis: To examine gender specific associations between sleep disturbance and incident type 2 diabetes mellitus in a representative population sample in Germany. Methods: The study was based on 4,140 men and 4,129 women ( aged 25 - 74 years) who participated in one of the three MONICA Augsburg surveys between 1984 and 1995, and who were free of diabetes at baseline. Incident cases of type 2 diabetes were assessed using a follow-up questionnaire in 1998. Gender specific hazard ratios were estimated from Cox proportional hazard models. Results: A total of 119 cases of incident type 2 diabetes among men and 69 among women were registered during the mean follow- up period of 7.5 years. In both sexes, difficulty maintaining sleep was associated with a higher risk of type 2 diabetes. After adjustment for age, survey, hypertension, dyslipidemia, parental history of diabetes, history of angina pectoris, regular smoking, physical activity, alcohol intake, body mass index and education, the hazard ratio in men was 1.60 ( 95% CI: 1.05 - 2.45) and the hazard ratio in women was 1.98 ( 95% CI: 1.20 - 3.29). In contrast, difficulty initiating sleep was not associated with a significantly increased risk of developing type 2 diabetes mellitus after multivariable adjustment in both sexes in the present study. Conclusions/ interpretation: Difficulty maintaining sleep was associated with an increased risk of type 2 diabetes in men and women from the general population. Although, the causal pathway is not entirely clear, it seems that both insulin resistance and chronic low-grade systemic inflammation may be involved.