Mattos Ana Carolina Musser Tavares de, Campos Yuri Sofiati, Fiorini Vitória Oliveira, Sab Yasmin, Tavares Bruna Landeiro, Velarde Luis Guillermo Coca, Lima Giovanna Aparecida Balarini, Cruz Filho Rubens Antunes da
Departamento de Medicina Clínica, Universidade Federal Fluminense, Niterói, RJ, Brasil.
Arch Endocrinol Metab. 2020 Aug;64(4):412-417. doi: 10.20945/2359-3997000000228. Epub 2020 Apr 6.
Objective The consequences of sleep deprivation in type 1 diabetes (T1D) patients are poorly understood. Our aim was to determine how sleep disorders influence lipid profile and insulin sensitivity in T1D patients. Materials and methods This was a cross-sectional study at a public university hospital. Demographic information and medical histories were obtained during regular scheduled visit of T1D patients to the outpatient clinic. Insulin sensitivity was obtained using the estimated glucose disposal rate (eGDR) formula. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Berlin Questionnaire. Results The adult participants (n = 66, 62% women) had a median age of 28.0 years (interquartile range 21.8-33.0). Six patients (9%) had metabolic syndrome according to the International Diabetes Federation criteria. Thirty patients (46%) were considered poor sleepers according to the Pittsburgh Sleep Quality Index. The LDL-c and total cholesterol levels of poor sleepers were higher than those of good sleepers (103 v. 81; p = 0.003 and 178.0 v. 159.5 mg/dL; p = 0.009, respectively). Three patients (4%) were at high risk of obstructive sleep apnea syndrome (OSAS) according to the Berlin Questionnaire. The eGDR was lower in the group of patients with high probability of having OSAS (6.0 v. 9.1 mg.kg-1.min-1;p = .03). Conclusions Poor subjective quality of sleep and higher risk of OSAS were correlated with a worsened lipid profile and decreased insulin sensitivity, respectively. Therefore, T1D patients with sleep disturbances might have an increased cardiovascular risk in the future.
目的 1 型糖尿病（T1D）患者睡眠剥夺的后果目前尚不清楚。我们的目的是确定睡眠障碍如何影响 T1D 患者的血脂谱和胰岛素敏感性。材料和方法 这是一项在公立大学医院进行的横断面研究。在 T1D 患者定期门诊就诊期间获取人口统计学信息和病史。使用估计的葡萄糖处置率（eGDR）公式获得胰岛素敏感性。使用匹兹堡睡眠质量指数、爱泼华嗜睡量表和柏林问卷评估睡眠质量。结果 成年参与者（n = 66，62%为女性）的中位年龄为 28.0 岁（四分位间距 21.8 - 33.0）。根据国际糖尿病联合会标准，6 名患者（9%）患有代谢综合征。根据匹兹堡睡眠质量指数，30 名患者（46%）被认为睡眠质量差。睡眠质量差的患者的低密度脂蛋白胆固醇（LDL - c）和总胆固醇水平高于睡眠质量好的患者（分别为 103 对 81；p = 0.003 和 178.0 对 159.5 mg/dL；p = 0.009）。根据柏林问卷，3 名患者（4%）有阻塞性睡眠呼吸暂停综合征（OSAS）的高风险。OSAS 高可能性组患者的 eGDR 较低（6.0 对 9.1 mg·kg-1·min-1；p = 0.03）。结论 睡眠主观质量差和 OSAS 风险较高分别与血脂谱恶化和胰岛素敏感性降低相关。因此，有睡眠障碍的 T1D 患者未来心血管风险可能增加。
