Assessing the Causal Role of Sleep Traits on Glycated Hemoglobin: A Mendelian Randomization Study.
Assessing the Causal Role of Sleep Traits on Glycated Hemoglobin: A Mendelian Randomization Study.
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探讨睡眠特征对糖化血红蛋白（HbA 1c）的影响。这项研究对多变量回归（MVR）和单样本（1 SMR）和双样本孟德尔随机化（2SMR）的证据进行了三角分析，包括对五种自我报告的睡眠特征（即，失眠症状[难以启动或维持睡眠]、睡眠持续时间、日间嗜睡、午睡和时钟类型）对HbA 1c的影响（SD单位）来自英国生物样本库的欧洲血统成人（用于MVR和1 SMR分析）（n = 336，999;平均[SD]年龄57 [8]岁; 54%女性）和葡萄糖和胰岛素相关性状联合会（MAGIC）荟萃分析的全基因组关联研究（用于2SMR分析）（n = 46，368; 53 [11]岁; 52%女性）。在MVR、1 SMR、2SMR及其敏感性分析中，我们发现失眠症状频率较高（通常vs.有时或很少/从不）与HbA 1c较高相关（MVR 0.05 SD单位[95% CI 0.04-0.06]; 1 SMR 0.52 [0.42-0.63]; 2SMR 0.24 [0.11-0.36]）。相关性仍然存在，但在排除糖尿病参与者后，点估计值有所减弱。对于其他睡眠特征，不同方法之间的一致性较低，其中一些但不是所有方法都提供了影响的证据。我们的研究结果表明，频繁的失眠症状会导致较高的HbA 1c水平，这意味着失眠在2型糖尿病中具有因果关系。这些发现可能对开发和评估改善睡眠习惯以降低高血糖和预防糖尿病的策略具有重要意义。
To examine the effects of sleep traits on glycated hemoglobin (HbA1c). This study triangulated evidence across multivariable regression (MVR) and one- (1SMR) and two-sample Mendelian randomization (2SMR) including sensitivity analyses on the effects of five self-reported sleep traits (i.e., insomnia symptoms [difficulty initiating or maintaining sleep], sleep duration, daytime sleepiness, napping, and chronotype) on HbA1c (in SD units) in adults of European ancestry from the UK Biobank (for MVR and 1SMR analyses) (n = 336,999; mean [SD] age 57 [8] years; 54% female) and in the genome-wide association studies from the Meta-Analyses of Glucose and Insulin-Related Traits Consortium (MAGIC) (for 2SMR analysis) (n = 46,368; 53 [11] years; 52% female). Across MVR, 1SMR, 2SMR, and their sensitivity analyses, we found a higher frequency of insomnia symptoms (usually vs. sometimes or rarely/never) was associated with higher HbA1c (MVR 0.05 SD units [95% CI 0.04–0.06]; 1SMR 0.52 [0.42–0.63]; 2SMR 0.24 [0.11–0.36]). Associations remained, but point estimates were somewhat attenuated after excluding participants with diabetes. For other sleep traits, there was less consistency across methods, with some but not all providing evidence of an effect. Our results suggest that frequent insomnia symptoms cause higher HbA1c levels and, by implication, that insomnia has a causal role in type 2 diabetes. These findings could have important implications for developing and evaluating strategies that improve sleep habits to reduce hyperglycemia and prevent diabetes.