Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA.
J Clin Endocrinol Metab. 2023 Sep 18;108(10):e1044-e1055. doi: 10.1210/clinem/dgad229.
N3 sleep (i.e., slow-wave sleep), a marker of deep restorative sleep, is implicated in hormonal and blood pressure regulation and may impact cardiometabolic health.
We conducted cross-sectional and prospective analyses to test whether a higher proportion and longer duration of N3 sleep are associated with reduced type 2 diabetes risk.
A subsample of participants from the Multi-Ethnic Study of Atherosclerosis completed 1-night polysomnography at Exam 5 (2010-2013) and were prospectively followed until Exam 6 (2016-2018). We used modified Poisson regression to examine the cross-sectional associations of N3 proportion and duration with prevalent diabetes and Cox proportional hazards models to estimate risk of diabetes according to N3 measures.
In cross-sectional analyses (n = 2026, mean age: 69 years), diabetes prevalence was 28% (n = 572). Compared with the first quartile (Q1) of the N3 proportion (<2.0%), participants in Q4 (≥15.4%) were 29% (95% CI 0.58, 0.87) less likely to have prevalent diabetes (P trend = .0016). The association attenuated after adjustment for demographics, lifestyles, and sleep-related factors (P trend = .3322). In prospective analyses of 1251 participants and 129 incident cases over 6346 person-years of follow-up, a curvilinear relationship was observed between N3 proportion and incident diabetes risk. In the fully adjusted model, the hazard ratio (95% CI) of developing diabetes vs Q1 was 0.47 (0.26, 0.87) for Q2, 0.34 (0.15, 0.77) for Q3, and 0.32 (0.10, 0.97) for Q4 (P nonlinearity = .0213). The results were similar for N3 duration.
Higher N3 proportion and longer N3 duration were prospectively associated with lower type 2 diabetes risk in a nonlinear fashion among older American adults.
N3 睡眠（即慢波睡眠）是深度恢复性睡眠的标志物，与激素和血压调节有关，可能影响心脏代谢健康。
我们进行了横断面和前瞻性分析，以检验更高比例和更长时间的 N3 睡眠是否与降低 2 型糖尿病风险有关。
动脉粥样硬化多民族研究的参与者亚组在第五次检查（2010-2013 年）进行了 1 晚多导睡眠图检查，并前瞻性随访至第六次检查（2016-2018 年）。我们使用修正泊松回归来检验 N3 比例和持续时间与现患糖尿病的横断面关联，并用 Cox 比例风险模型根据 N3 指标来估计糖尿病的发病风险。
在横断面分析（n=2026，平均年龄：69 岁）中，糖尿病的患病率为 28%（n=572）。与 N3 比例的第一四分位数（Q1）（<2.0%）相比，Q4（≥15.4%）的参与者患现患糖尿病的可能性低 29%（95%CI0.58，0.87）（趋势 P 值=0.0016）。调整人口统计学、生活方式和与睡眠相关的因素后，关联减弱（趋势 P 值=0.3322）。在对 1251 名参与者和 129 例 6346 人年随访期间发生的事件进行的前瞻性分析中，观察到 N3 比例与新发糖尿病风险之间呈曲线关系。在完全调整的模型中，与 Q1 相比，Q2 的糖尿病发病风险比（95%CI）为 0.47（0.26，0.87），Q3 为 0.34（0.15，0.77），Q4 为 0.32（0.10，0.97）（非线性 P 值=0.0213）。N3 持续时间的结果相似。
在年龄较大的美国成年人中，N3 比例较高和 N3 持续时间较长与 2 型糖尿病风险呈非线性降低相关。
