Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Internal Medicine, Fukuoka Dental College Medical and Dental Hospital, Fukuoka, Japan.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Metabolism. 2014 Apr;63(4):484-91. doi: 10.1016/j.metabol.2013.12.001. Epub 2013 Dec 7.
Sleep duration is suggested to be associated with adverse health outcomes. However, few studies are available on the impact of sleep duration on metabolic syndrome in patients with diabetes, who were at high risk for cardiovascular diseases (CVD). The objective of the present study was to examine the associations of sleep duration with metabolic syndrome and insulin resistance, a major pathophysiologic feature of metabolic syndrome, in patients with type 2 diabetes.
MATERIALS/METHODS: A total of 4402 Japanese patients with type 2 diabetes aged ≥20years were divided into 5 groups according to self-reported sleep duration: less than 5.5h, 5.5-6.4h, 6.5-7.4h, 7.5-8.4h, and more than 8.5h. The associations of sleep duration with metabolic syndrome and other cardiovascular risk factors were examined cross-sectionally.
The proportions of patients who had metabolic syndrome increased significantly in both patients with shorter and longer sleep duration compared with those with 6.5-7.4h of sleep (P for quadratic trend <0.001). This U-shaped association remained significant after adjustment for potential confounders, including total energy intake, current smoking, current drinking and depressive symptoms. Each component of metabolic syndrome also showed similar trends. Furthermore, sleep duration had a quadratic association with homeostasis model assessment of insulin resistance and high sensitivity C-reactive protein.
Sleep duration was shown to have a U-shaped relationship with metabolic syndrome and insulin resistance, independent of potential confounders, and therefore may be an important modifiable risk factor for CVD prevention in patients with type 2 diabetes.
睡眠时间与健康不良结局有关。然而，关于睡眠时间对糖尿病患者代谢综合征的影响的研究较少，而糖尿病患者患心血管疾病（CVD）的风险较高。本研究旨在探讨睡眠时间与代谢综合征及胰岛素抵抗（代谢综合征的主要病理生理特征）的关系。
材料/方法：共纳入 4402 名年龄≥20 岁的日本 2 型糖尿病患者，根据自我报告的睡眠时间分为 5 组：<5.5h、5.5-6.4h、6.5-7.4h、7.5-8.4h 和>8.5h。分析睡眠时间与代谢综合征及其他心血管危险因素的关系。
与 6.5-7.4h 睡眠时间的患者相比，睡眠时间较短和较长的患者发生代谢综合征的比例显著增加（趋势性 P<0.001）。调整总能量摄入、吸烟、饮酒和抑郁症状等潜在混杂因素后，这种 U 型关联仍然显著。代谢综合征的每个组成部分也表现出类似的趋势。此外，睡眠时间与稳态模型评估的胰岛素抵抗和高敏 C 反应蛋白呈二次关联。
睡眠时间与代谢综合征和胰岛素抵抗呈 U 型关系，与潜在混杂因素无关，因此可能是 2 型糖尿病患者预防 CVD 的一个重要可改变的危险因素。
