Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, China.
School of Medicine, Southern University of Science and Technology, Shenzhen, China.
J Diabetes. 2023 Jun;15(6):496-507. doi: 10.1111/1753-0407.13387. Epub 2023 Apr 13.
Existing evidence concerning the relationship between daytime napping and type 2 diabetes (T2D) is inconsistent, and whether the effects of napping differ by body fat percentage (BFP) and C-reactive protein (CRP) is unclear. We aimed to investigate the association between daytime napping frequency and T2D risk and whether such an association was modified by BFP and CRP.
We included 435 342 participants free of diabetes from the UK Biobank. Participants were categorized as nonnappers, occasional nappers, and frequent nappers based on napping frequency, and BFP/CRP was divided into quartiles. Cox proportional hazards models were used.
During a median follow-up of 9.2 years, 17 592 T2D cases occurred. Higher frequency of daytime napping was significantly associated with an increased risk of T2D. Compared with nonnappers, the adjusted hazard ratios (HRs) for occasional nappers and habitual nappers were 1.28 (95% confidence interval [CI]: 1.24-1.32) and 1.49 (95% CI: 1.41-1.57), respectively. There was a significant additive and multiplicative interaction (relative excess risk due to interaction [RERI] = 0.490, 95% CI 0.307-0.673; p for multiplicative interaction <.001) between napping and BFP, whereby a higher hazard of T2D associated with more frequent napping was greatest among participants in the highest BFP quartile (HR = 4.45, 95% CI: 3.92-5.06). The results for CRP were similar (RERI = 0.266, 95% CI: 0.094-0.439; p for multiplicative interaction <.001).
Higher daytime napping frequency is associated with an increased T2D risk, and such relationships are modified by BFP and CRP. These findings underscore the importance of adiposity and inflammation control to mitigate diabetes risk.
关于日间小睡与 2 型糖尿病（T2D）之间的关系，现有证据并不一致，且小睡的影响是否因体脂百分比（BFP）和 C 反应蛋白（CRP）而有所不同尚不清楚。我们旨在研究日间小睡频率与 T2D 风险之间的关联，以及这种关联是否受 BFP 和 CRP 的影响。
我们纳入了来自英国生物库的 435342 名无糖尿病的参与者。根据小睡频率，参与者被分为非小睡者、偶发性小睡者和频繁小睡者，并将 BFP/CRP 分为四等份。采用 Cox 比例风险模型进行分析。
在中位随访 9.2 年期间，发生了 17592 例 T2D 病例。日间小睡频率较高与 T2D 风险增加显著相关。与非小睡者相比，偶发性小睡者和习惯性小睡者的调整后风险比（HR）分别为 1.28（95%置信区间[CI]：1.24-1.32）和 1.49（95%CI：1.41-1.57）。BFP 与小睡之间存在显著的相加和相乘交互作用（交互归因超额相对危险度[RERI]为 0.490，95%CI：0.307-0.673；p 相乘交互作用<0.001），即与更频繁小睡相关的 T2D 风险增加在 BFP 四分位最高的参与者中最大（HR=4.45，95%CI：3.92-5.06）。CRP 的结果相似（RERI=0.266，95%CI：0.094-0.439；p 相乘交互作用<0.001）。
更高的日间小睡频率与 T2D 风险增加相关，且这种关系受 BFP 和 CRP 的影响。这些发现强调了控制肥胖和炎症对降低糖尿病风险的重要性。
