School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Prev Med. 2019 Feb;119:24-30. doi: 10.1016/j.ypmed.2018.11.019. Epub 2018 Nov 30.
Inadequate sleep could contribute to type 2 diabetes, but observational studies are inconsistent and open to biases, particularly from confounding. We used Mendelian randomization (MR) to obtain an unconfounded estimate of the effect of sleep duration on diabetes, fasting glucose (FG) and hemoglobin A1c (HbA1c), and an observation study to assess differences by sex. Using MR, we assessed the effects of genetically instrumented sleep on diabetes, based on 68 single nucleotide polymorphisms (SNPs), applied to the DIAbetes Genetics Replication and meta-analysis case (n = 26,676)-control (n = 132,532) study and on FG and HbA1c, based on 55 SNPs, applied to the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC) study of FG (n = 122,743) and HbA1c (n = 123,665). In the population-representative Hong Kong Chinese "Children of 1997" birth cohort we assessed whether associations of sleep duration at ~17.5 years with FG and HbA1c differed by sex. Using inverse variance weighting with multiplicative random effects, sleep duration was not associated with diabetes (odds ratio (OR) 0.85 per hour of sleep, 95% confidence interval (CI) 0.64 to 1.13), FG (-0.032 mmol/l per hour of sleep, 95% CI -0.126 to 0.063) or HbA1c (-0.022% per hour of sleep, 95% CI -0.069 to 0.024). In "Children of 1997", the associations of sleep duration with FG differed by sex (p for interaction 0.05) but not with HbA1c. Overall sleep duration does not appear to be related to diabetes, FG or HbA1c, but the possibility of sex differences merits investigation.
睡眠不足可能导致 2 型糖尿病，但观察性研究结果并不一致，而且容易受到混杂因素的影响。我们使用孟德尔随机化（MR）方法，获得了睡眠时间对糖尿病、空腹血糖（FG）和糖化血红蛋白（HbA1c）影响的无偏估计值，并进行了一项观察性研究来评估性别差异。我们基于 68 个单核苷酸多态性（SNP），应用于 DIAbetes Genetics Replication and meta-analysis case（n=26676）-control（n=132532）研究，评估了遗传工具睡眠对糖尿病的影响；基于 55 个 SNP，应用于 Meta-Analyses of Glucose and Insulin-related traits Consortium（MAGIC）研究的 FG（n=122743）和 HbA1c（n=123665）研究，评估了 FG 和 HbA1c 的影响。在具有代表性的香港中文“1997 年儿童”出生队列中，我们评估了睡眠时长在 17.5 岁左右与 FG 和 HbA1c 的关联是否存在性别差异。我们采用逆方差加权和乘法随机效应，结果显示，睡眠时长与糖尿病（睡眠时间每增加 1 小时，比值比（OR）为 0.85，95%置信区间（CI）为 0.64 至 1.13）、FG（睡眠时间每增加 1 小时，减少 0.032mmol/L，95%CI 为-0.126 至 0.063）或 HbA1c（睡眠时间每增加 1 小时，减少 0.022%，95%CI 为-0.069 至 0.024）均无关联。在“1997 年儿童”中，睡眠时长与 FG 的关联存在性别差异（交互作用检验 P 值为 0.05），但与 HbA1c 无关。总的来说，睡眠时长似乎与糖尿病、FG 或 HbA1c 无关，但性别差异的可能性值得进一步研究。
