Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Diabetes Care. 2020 Jun;43(6):1219-1226. doi: 10.2337/dc19-2371. Epub 2020 Mar 24.
To identify sleep duration trajectories from early to middle adulthood and their associations with incident type 2 diabetes.
Using a group-based modeling approach, we identified sleep duration trajectories based on sleep duration in ages 20-25, 26-35, 36-45, and 46+ years, which were retrospectively assessed in 2009 among 60,068 women from the Nurses' Health Study II (median age 54.9 years) who were free of diabetes, cardiovascular disease, and cancer. We investigated the prospective associations between sleep duration trajectories and diabetes risk (2009-2017) using multivariable Cox proportional hazards models.
We documented 1,797 incident diabetes cases over a median follow-up of 7.8 years (442,437 person-years). Six sleep duration trajectories were identified: persistent 5-, 6-, 7-, or 8-h sleep duration and increased or decreased sleep duration. After multivariable adjustment for diabetes risk factors, compared with the persistent 7-h sleep duration group, the hazard ratio was 1.43 (95% CI 1.10, 1.84) for the 5-h group, 1.17 (1.04, 1.33) for the 6-h group, 0.96 (0.84, 1.10) for the 8-h group, 1.33 (1.09, 1.61) for the increased sleep duration group, and 1.32 (1.10, 1.59) for the decreased sleep duration group. Additional adjustment for time-updated comorbidities and BMI attenuated these associations, although a significantly higher risk remained in the decreased sleep duration group (1.24 [1.03, 1.50]).
Persistent short sleep duration or changes in sleep duration from early to middle adulthood were associated with higher risk of type 2 diabetes in later life. These associations were weaker after obesity and metabolic comorbidities were accounted for.
确定从青年到中年的睡眠时间轨迹及其与 2 型糖尿病发病的关系。
我们采用基于群组的建模方法，根据 2009 年护士健康研究 II 中 60068 名女性（中位年龄 54.9 岁）在 20-25、26-35、36-45 和 46+岁时的睡眠时间回顾性评估，确定睡眠时间轨迹。这些女性在研究开始时无糖尿病、心血管疾病和癌症。我们使用多变量 Cox 比例风险模型研究了睡眠时间轨迹与糖尿病风险（2009-2017 年）之间的前瞻性关联。
在中位随访 7.8 年（442437 人年）期间，我们记录了 1797 例新发糖尿病病例。确定了 6 种睡眠时间轨迹：持续 5、6、7 或 8 小时睡眠时间和睡眠时间增加或减少。在调整糖尿病危险因素后，与持续 7 小时睡眠时间组相比，5 小时睡眠时间组的风险比为 1.43（95%CI 1.10，1.84），6 小时睡眠时间组为 1.17（1.04，1.33），8 小时睡眠时间组为 0.96（0.84，1.10），睡眠时间增加组为 1.33（1.09，1.61），睡眠时间减少组为 1.32（1.10，1.59）。进一步调整时间更新的合并症和 BMI 后，这些关联减弱，但睡眠时间减少组的风险仍然显著升高（1.24[1.03，1.50]）。
从青年到中年持续的短睡眠时间或睡眠时间的变化与晚年 2 型糖尿病的风险增加有关。这些关联在考虑肥胖和代谢合并症后减弱。
