Association of sleep time with diabetes mellitus and impaired glucose tolerance
Association of sleep time with diabetes mellitus and impaired glucose tolerance
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DOI：
10.1001/archinte.165.8.863
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发表时间：
2005-04-25
影响因子：
--
通讯作者：
Nieto, FJ
中科院分区：
文献类型：
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作者：
Gottlieb, DJ;Punjabi, NM;Nieto, FJ
背景：实验性睡眠限制可导致糖耐量受损(IGT)；然而，对习惯性睡眠限制对代谢的影响知之甚少。我们在睡眠心脏健康研究的参与者中评估了通常睡眠时间与糖尿病(DM)和糖耐量低减(IGT)的横截面关系。睡眠心脏健康研究是一项基于社区的前瞻性研究，旨在研究睡眠呼吸紊乱对心血管的影响。常规睡眠时间采用标准化问卷调查。糖尿病的定义为空腹血糖水平在126 mg/dL或以上(>；=7.0mmoVL)或空腹血糖水平在200 mg/dL或以上(>；=11.1mmoVL)。糖耐量受损被定义为攻击后2小时血糖水平达到或超过140 mg/dL(=7.8mmoVL)且低于200 mg/dL。在调整了年龄、性别、种族、身体习惯和呼吸暂停低通气指数后，用分类Logistic回归分析了睡眠时间与糖尿病和糖耐量减低的关系。结果：受试者的平均睡眠时间为每晚7小时，27.1%的受试者每晚睡眠时间不超过6小时。与每晚睡眠7-8小时的受试者相比，睡眠不超过5小时和每晚6小时的受试者调整后的DM的优势比分别为2.51(95%可信区间，1.57-4.02)和1.66(95%可信区间，1.15-2.39)。调整后IGT的优势比分别为1.33(95%可信区间，0.83-2.15)和1.58(95%可信区间，1.15-2.18)。每晚睡眠9小时或以上的受试者患糖尿病和糖耐量低减的优势比也增加。当有失眠症状的受试者被排除在外时，这些关联仍然存在。结论：睡眠时间为6小时或更少或9小时或更长与糖尿病和IGT的患病率增加有关。由于这种影响在没有失眠的受试者中存在，自愿的睡眠限制可能会导致糖尿病带来的巨大公共健康负担。
Background: Experimental sleep restriction causes impaired glucose tolerance (IGT); however, little is known about the metabolic effects of habitual sleep restriction. We assessed the cross-sectional relation of usual sleep time to diabetes mellitus (DM) and IGT among participants in the Sleep Heart Health Study, a community-based prospective study of the cardiovascular consequences of sleep-disordered breathing.Methods: Participants were 722 men and 764 women, aged 53 to 93 years. Usual sleep time was obtained by standardized questionnaire. Diabetes mellitus was defined as a serum glucose level of 126 mg/dL or more ( >= 7.0 mmoVL) fasting or 200 mg/dL or more ( >= 11. 1 mmoVL) 2 hours following standard oral glucose challenge or medication use for DM. Impaired glucose tolerance was defined as a 2-hour postchallenge glucose level of 140 mg/dL or more ( >= 7.8 mmoVL) and less than 200 mg/dL. The relation of sleep time to DM and IGT was examined using categorical logistic regression with adjustment for age, sex, race, body habitus, and apnea-hypopnea index.Results: The median sleep time was 7 hours per night, with 27.1% of subjects sleeping 6 hours or less per night. Compared with those sleeping 7 to 8 hours per night, subjects sleeping 5 hours or less and 6 hours per night had adjusted odds ratios for DM of 2.51 (95% confidence interval, 1.57-4.02) and 1.66 (95% confidence interval, 1.15-2.39), respectively. Adjusted odds ratios for IGT were 1.33 (95% confidence interval, 0.83-2.15) and 1.58 (95% confidence interval, 1.15-2.18), respectively. Subjects sleeping 9 hours or more per night also had increased odds ratios for DM and IGT. These associations persisted when subjects with insomnia symptoms were excluded.Conclusions: A sleep duration of 6 hours or less or 9 hours or more is associated with increased prevalence of DM and IGT. Because this effect was present in subjects without insomnia, voluntary sleep restriction may contribute to the large public health burden of DM.