Sleep duration as a risk factor for diabetes incidence in a large US sample
Sleep duration as a risk factor for diabetes incidence in a large US sample
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DOI：
10.1093/sleep/30.12.1667
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发表时间：
2007-12-01
期刊：
影响因子：
5.6
通讯作者：
Malaspina, Dolores
中科院分区：
文献类型：
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作者：
Gangwisch, James E.;Heymsfield, Steven B.;Malaspina, Dolores
研究目的：在第一次全国健康与营养调查（NHANES I）的数据中，探讨睡眠时间与糖尿病发病率之间的关系，随访时间为8至10年。我们假设睡眠时间短与糖尿病有关，肥胖和高血压是这种关系的部分介导因素。由于长期睡眠不足引起的胰岛素抵抗导致胰腺负荷增加，随着时间的推移，会损害β细胞功能并导致2型糖尿病。长期睡眠导致糖尿病的机制尚不明确。设计：采用logistic回归模型对NHANES I进行多变量纵向分析。设置：概率样本（n = 8992）的非机构化的人口的美国在1982年和1992年之间。参与者：受试者之间的年龄32和86岁。测量和结果：在1982年至1992年期间，4.8%的样本（n = 430）由医生诊断，医院记录或死亡原因确定为糖尿病事件病例。睡眠时间≤ 5小时的受试者（比值比= 1.47，95%置信区间1.03-2.09）和睡眠时间≥ 9小时的受试者（比值比= 1.52，95%可信区间1.06-2.18）在控制协变量后的随访期内更有可能发生糖尿病。睡眠时间短可能是糖尿病的一个重要危险因素。长时间睡眠与糖尿病发病率之间的联系更可能是由于一些未测量的混杂因素，如睡眠质量差。
Study Objectives: To explore the relationship between sleep duration and diabetes incidence over an 8- to 10-year follow-up period in data from the First National Health and Nutrition Examination Survey (NHANES I). We hypothesized that prolonged short sleep duration is associated with diabetes and that obesity and hypertension act as partial mediators of this relationship. The increased load on the pancreas from insulin resistance induced by chronically short sleep durations can, over time, compromise beta-cell function and lead to type 2 diabetes. No plausible mechanism has been identified by which long sleep duration could lead to diabetes.Design: Multivariate longitudinal analyses of the NHANES I using logistic regression models.Setting: Probability sample (n = 8992) of the noninstitutionalized population of the United States between 1982 and 1992.Participants: Subjects between the ages of 32 and 86 years.Measurements and Results: Between 1982 and 1992, 4.8% of the sample (n = 430) were determined by physician diagnosis, hospital record, or cause of death to be incident cases of diabetes. Subjects with sleep durations of 5 or fewer hours (odds ratio = 1.47, 95% confidence interval 1.03-2.09) and subjects with sleep durations of 9 or more hours (odds ratio = 1.52, 95% confidence interval 1.06-2.18) were significantly more likely to have incident diabetes over the follow-up period after controlling for covariates.Conclusions: Short sleep duration could be a significant risk factor for diabetes. The association between long sleep duration and diabetes incidence is more likely to be due to some unmeasured confounder such as poor sleep quality.