Division of Endocrinology and Metabolism, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ann N Y Acad Sci. 2014 Apr;1311:151-73. doi: 10.1111/nyas.12355. Epub 2014 Mar 14.
Sleep disturbances, including sleep insufficiency and sleep fragmentation, have been linked to abnormal glucose metabolism and increased diabetes risk. Well-controlled laboratory studies have provided insights regarding the underlying mechanisms. Several large prospective studies suggest that these sleep disturbances are associated with an increased risk of incident diabetes. Obstructive sleep apnea, which combines sleep fragmentation and hypoxemia, is a major risk factor for insulin resistance and possibly diabetes. Whether glycemic control in type 2 diabetes patients can be improved by treating sleep apnea remains controversial. Recently, sleep disturbances during pregnancy and their relationship to gestational diabetes and hyperglycemia have received considerable attention owing to potential adverse effects on maternal and fetal health. Additionally, evidence from animal models has identified disruption of the circadian system as a putative risk factor for adverse metabolic outcomes. The purpose of this review is to provide an update on the current state of knowledge linking sleep disturbances, circadian dysfunction, and glucose metabolism. Experimental, prospective, and interventional studies are discussed.
睡眠障碍，包括睡眠不足和睡眠碎片化，与异常葡萄糖代谢和糖尿病风险增加有关。经过精心控制的实验室研究提供了有关潜在机制的深入了解。几项大型前瞻性研究表明，这些睡眠障碍与糖尿病发病风险增加有关。阻塞性睡眠呼吸暂停，它结合了睡眠碎片化和低氧血症，是胰岛素抵抗和可能的糖尿病的主要危险因素。治疗睡眠呼吸暂停是否可以改善 2 型糖尿病患者的血糖控制仍然存在争议。最近，由于对母婴健康的潜在不利影响，妊娠期间的睡眠障碍及其与妊娠期糖尿病和高血糖的关系引起了相当大的关注。此外，来自动物模型的证据表明，昼夜节律系统的破坏是不良代谢结果的一个潜在危险因素。本综述的目的是提供最新的知识链接睡眠障碍、昼夜节律功能障碍和葡萄糖代谢的现状。讨论了实验、前瞻性和干预性研究。
