School of Public Health, Capital Medical University, Beijing 100069, China.
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
J Diabetes Res. 2020 Jan 4;2020:2969105. doi: 10.1155/2020/2969105. eCollection 2020.
Sleep duration is associated with type 2 diabetes (T2D). However, few T2D risk scores include sleep duration. We aimed to develop T2D scores containing sleep duration and to estimate the additive value of sleep duration.
We used data from 43,404 adults without T2D in the Beijing Health Management Cohort study. The participants were surveyed approximately every 2 years from 2007/2008 to 2014/2015. Sleep duration was calculated from the self-reported usual time of going to bed and waking up at baseline. Logistic regression was employed to construct the risk scores. Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to estimate the additional value of sleep duration.
After a median follow-up of 6.8 years, we recorded 2623 (6.04%) new cases of T2D. Shorter (both 6-8 h/night and <6 h/night) sleep durations were associated with an increased risk of T2D (odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.30-1.59; OR = 1.98, 95%CI = 1.63-2.41, respectively) compared with a sleep duration of >8 h/night in the adjusted model. Seven variables, including age, education, waist-hip ratio, body mass index, parental history of diabetes, fasting plasma glucose, and sleep duration, were selected to form the comprehensive score; the -index was 0.74 (95% CI: 0.71-0.76) for the test set. The IDI and NRI values for sleep duration were 0.017 (95% CI: 0.012-0.022) and 0.619 (95% CI: 0.518-0.695), respectively, suggesting good improvement in the predictive ability of the comprehensive nomogram. The decision curves showed that women and individuals older than 50 had more net benefit.
The performance of T2D risk scores developed in the study could be improved by containing the shorter estimated sleep duration, particularly in women and individuals older than 50.
睡眠时长与 2 型糖尿病（T2D）有关。然而，很少有 T2D 风险评分包含睡眠时长。我们旨在开发包含睡眠时长的 T2D 评分，并评估睡眠时长的附加价值。
我们使用了来自北京健康管理队列研究的 43404 名无 T2D 的成年人的数据。参与者从 2007/2008 年至 2014/2015 年大约每两年接受一次调查。睡眠时长根据基线时自我报告的通常入睡和起床时间计算。采用逻辑回归构建风险评分。采用综合判别改善（IDI）和净重新分类改善（NRI）来评估睡眠时长的附加价值。
中位随访 6.8 年后，我们记录了 2623 例（6.04%）新的 T2D 病例。较短的（均为 6-8 小时/晚和<6 小时/晚）睡眠时长与 T2D 风险增加相关（调整模型中的比值比（OR）分别为 1.43（95%置信区间（CI）为 1.30-1.59）和 1.98（95%CI 为 1.63-2.41））相比，睡眠时间>8 小时/晚。七个变量，包括年龄、教育程度、腰臀比、体重指数、父母糖尿病史、空腹血糖和睡眠时长，被选入形成综合评分；测试集中的 -指数为 0.74（95%CI：0.71-0.76）。睡眠时长的 IDI 和 NRI 值分别为 0.017（95%CI：0.012-0.022）和 0.619（95%CI：0.518-0.695），表明综合预测模型的预测能力得到了很好的改善。决策曲线表明，女性和 50 岁以上的个体有更多的净收益。
通过包含较短的估计睡眠时长，特别是在女性和 50 岁以上的个体中，可以改善研究中开发的 T2D 风险评分的性能。
