Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.
Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.
Diabetes Metab. 2022 Jan;48(1):101263. doi: 10.1016/j.diabet.2021.101263. Epub 2021 May 20.
To analyze the association of objective and subjective sleep measures with HbA1c and insulin sensitivity in the general population.
Using a cross-sectional design, data from 1028 participants in the ORISCAV-LUX-2 study from the general population in Luxembourg were analyzed. Objective sleep measures were assessed using accelerometers whereas subjective measures were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Sleep measures were defined as predictors, while HbA1c and quantitative insulin sensitivity check index (QUICKI) scores were considered outcomes. Linear and spline regression models were fitted by progressively adjusting for demographic and lifestyle variables in the total sample population as well as by stratified analyses using gender, obesity status, depressive symptoms and diabetes status.
In fully adjusted models, total and deep sleep durations were associated with lower HbA1c (mmol/mol) levels, whereas sleep coefficients of variation (%) and poor sleep efficiency, as measured by PSQI scores (units), were associated with higher HbA1c levels. In stratified models, such associations were observed mainly in men, and in subjects who had depressive symptoms, were overweight and no diabetes. In addition, total sleep, deep sleep, coefficients of variation and poor sleep efficiency as measured by PSQI revealed non-linear associations. Similarly, greater insulin sensitivity was associated with longer total sleep time and with PSQI-6 (use of sleep medication).
Associations were more frequently observed between sleep characteristics and glycaemic control with the use of objective sleep measures. Also, such associations varied within subgroups of the population. Our results highlight the relevance of measuring sleep patterns as key factors in the prevention of diabetes.
分析客观和主观睡眠指标与一般人群中 HbA1c 和胰岛素敏感性的关系。
使用横断面设计，分析来自卢森堡一般人群的 ORISCAV-LUX-2 研究中的 1028 名参与者的数据。使用加速度计评估客观睡眠指标，使用匹兹堡睡眠质量指数（PSQI）问卷评估主观睡眠指标。睡眠指标被定义为预测因子，而 HbA1c 和定量胰岛素敏感性检查指数（QUICKI）评分被认为是结果。在总样本人群中，通过逐步调整人口统计学和生活方式变量以及使用性别、肥胖状况、抑郁症状和糖尿病状况进行分层分析，拟合线性和样条回归模型。
在完全调整的模型中，总睡眠时间和深度睡眠时间与较低的 HbA1c（mmol/mol）水平相关，而 PSQI 评分（单位）测量的睡眠变异性（%）和睡眠效率差与较高的 HbA1c 水平相关。在分层模型中，这种关联主要在男性中观察到，并且在有抑郁症状、超重和没有糖尿病的人群中观察到。此外，总睡眠时间、深度睡眠时间、PSQI 测量的变异性和睡眠效率差显示出非线性关联。同样，胰岛素敏感性的增加与总睡眠时间的增加和 PSQI-6（使用睡眠药物）相关。
使用客观睡眠指标，睡眠特征与血糖控制之间的关联更为频繁。此外，这种关联在人群的亚组中有所不同。我们的研究结果强调了测量睡眠模式作为预防糖尿病的关键因素的重要性。
