Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY.
Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY.
Diabetes Care. 2024 Jan 1;47(1):117-125. doi: 10.2337/dc23-1156.
Insufficient sleep is associated with type 2 diabetes, yet the causal impact of chronic insufficient sleep on glucose metabolism in women is unknown. We investigated whether prolonged mild sleep restriction (SR), resembling real-world short sleep, impairs glucose metabolism in women.
Women (aged 20-75 years) without cardiometabolic diseases and with actigraphy-confirmed habitual total sleep time (TST) of 7-9 h/night were recruited to participate in this randomized, crossover study with two 6-week phases: maintenance of adequate sleep (AS) and 1.5 h/night SR. Outcomes included plasma glucose and insulin levels, HOMA of insulin resistance (HOMA-IR) values based on fasting blood samples, as well as total area under the curve for glucose and insulin, the Matsuda index, and the disposition index from an oral glucose tolerance test.
Our sample included 38 women (n = 11 postmenopausal women). Values are reported with ±SEM. Linear models adjusted for baseline outcome values demonstrated that TST was reduced by 1.34 ± 0.04 h/night with SR versus AS (P < 0.0001). Fasting insulin (β = 6.8 ± 2.8 pmol/L; P = 0.016) and HOMA-IR (β = 0.30 ± 0.12; P = 0.016) values were increased with SR versus AS, with effects on HOMA-IR more pronounced in postmenopausal women compared with premenopausal women (β = 0.45 ± 0.25 vs. β = 0.27 ± 0.13, respectively; P for interaction = 0.042). Change in adiposity did not mediate the effects of SR on glucose metabolism or change results in the full sample when included as a covariate.
Curtailing sleep duration to 6.2 h/night, reflecting the median sleep duration of U.S. adults with short sleep, for 6 weeks impairs insulin sensitivity, independent of adiposity. Findings highlight insufficient sleep as a modifiable risk factor for insulin resistance in women to be targeted in diabetes prevention efforts.
睡眠不足与 2 型糖尿病有关，但慢性睡眠不足对女性葡萄糖代谢的因果影响尚不清楚。我们研究了长期轻度睡眠限制（SR）是否会损害女性的葡萄糖代谢，这种 SR 类似于现实世界中的短睡眠。
本研究纳入了无心血管代谢疾病且多导睡眠图证实习惯性总睡眠时间（TST）为 7-9 小时/夜的女性志愿者，参与这项随机、交叉研究，共两个 6 周阶段：充足睡眠（AS）维持和每晚 1.5 小时的睡眠限制（SR）。结果包括空腹血糖和胰岛素水平、基于空腹血样的胰岛素抵抗的 HOMA（HOMA-IR）值，以及口服葡萄糖耐量试验的葡萄糖和胰岛素总曲线下面积、Matsuda 指数和处置指数。
我们的样本包括 38 名女性（11 名绝经后女性）。结果以 ±SEM 表示。调整基线结果值的线性模型表明，与 AS 相比，SR 时 TST 减少了 1.34 ± 0.04 小时/夜（P < 0.0001）。与 AS 相比，SR 时空腹胰岛素（β = 6.8 ± 2.8 pmol/L；P = 0.016）和 HOMA-IR（β = 0.30 ± 0.12；P = 0.016）值升高，绝经后女性的 HOMA-IR 升高更明显（β = 0.45 ± 0.25 与 β = 0.27 ± 0.13，分别；P 交互 = 0.042）。当作为协变量纳入时，SR 对葡萄糖代谢的影响或在全样本中的结果并没有因脂肪量的变化而改变。
将睡眠时间缩短至 6.2 小时/夜，反映了美国成年人睡眠不足的中位数，持续 6 周会损害胰岛素敏感性，与肥胖无关。这些发现强调了睡眠不足是女性胰岛素抵抗的一个可改变的危险因素，应该成为糖尿病预防工作的目标。
