Yeung Deryck, Talukder Amlan, Shi Min, Umbach David M, Li Yuanyuan, Motsinger-Reif Alison, Hwang Janice J, Fan Zheng, Li Leping
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Division of Endocrinology and Metabolism and Department of Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Comput Biol Med. 2025 Jan;184:109484. doi: 10.1016/j.compbiomed.2024.109484. Epub 2024 Dec 1.
Sleep spindles may be implicated in sensing and regulation of peripheral glucose. Whether spindle density in patients with type 2 diabetes mellitus (T2DM) differs from that of healthy subjects is unknown.
Our retrospective analysis of polysomnography (PSG) studies identified 952 patients with T2DM and 952 sex-, age- and BMI-matched control subjects. We extracted spindles from PSG electroencephalograms and used rank-based statistical methods to test for differences between subjects with and without diabetes. We also explored potential modifiers of spindle density differences. We replicated our analysis on independent data from the Sleep Heart Health Study.
We found that patients with T2DM exhibited about half the spindle density during sleep as matched controls (P < 0.0001). The replication dataset showed similar trends. The patient-minus-control paired difference in spindle density for pairs where the patient had major complications were larger than corresponding paired differences in pairs where the patient lacked major complications, despite both patient groups having significantly lower spindle density compared to their respective control subjects. Patients with a prescription for a glucagon-like peptide 1 receptor agonist had significantly higher spindle density than those without one (P ≤ 0.03). Spindle density in patients with T2DM monotonically decreased as their highest recorded HbA1C level increased (P ≤ 0.003).
T2DM patients had significantly lower spindle density than control subjects; the size of that difference was correlated with markers of disease severity (complications and glycemic control). These findings expand our understanding of the relationships between sleep and glucose regulation.
睡眠纺锤波可能与外周葡萄糖的感知和调节有关。2型糖尿病（T2DM）患者的纺锤波密度是否与健康受试者不同尚不清楚。
我们对多导睡眠图（PSG）研究进行回顾性分析，确定了952例T2DM患者和952例性别、年龄和体重指数相匹配的对照受试者。我们从PSG脑电图中提取纺锤波，并使用基于秩次的统计方法来检验糖尿病患者和非糖尿病患者之间的差异。我们还探讨了纺锤波密度差异的潜在调节因素。我们在来自睡眠心脏健康研究的独立数据上重复了我们的分析。
我们发现，T2DM患者睡眠期间的纺锤波密度约为匹配对照的一半（P < 0.0001）。重复数据集显示出相似的趋势。在有主要并发症的患者对中，患者与对照的纺锤波密度配对差异大于无主要并发症的患者对中的相应配对差异，尽管两组患者的纺锤波密度均显著低于各自的对照受试者。使用胰高血糖素样肽1受体激动剂处方的患者的纺锤波密度显著高于未使用者（P≤0.03）。T2DM患者的纺锤波密度随着其记录的最高糖化血红蛋白水平的升高而单调下降（P≤0.003）。
T2DM患者的纺锤波密度显著低于对照受试者；这种差异的大小与疾病严重程度的标志物（并发症和血糖控制）相关。这些发现扩展了我们对睡眠与葡萄糖调节之间关系的理解。
