Maimaitituerxun Rehanguli, Wang Hengxue, Chen Wenhang, Xiang Jingsha, Xie Yu, Xiao Fang, Wu Xin Yin, Chen Letao, Yang Jianzhou, Liu Aizhong, Ding Songning, Dai Wenjie
Department for Acute Infectious Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
BMC Public Health. 2025 Mar 22;25(1):1096. doi: 10.1186/s12889-025-22338-7.
Globally, the number of individuals with type 2 diabetes mellitus (T2DM) is increasing, and they are at a higher risk of developing mild cognitive impairment (MCI) than the general population. Sleep quality is thought to be a modifiable factor that may contribute to MCI, as previous studies have linked it to cognitive function in older adults. However, evidence concerning the association between sleep quality and MCI among patients with T2DM in China is limited. Therefore, this study aims to identify the association between sleep quality and MCI among patients with T2DM in China.
This cross-sectional study was conducted among patients with T2DM who were referred to the Endocrinology Department of Xiangya Hospital, Central South University. Data regarding sociodemographic characteristics, lifestyle factors, T2DM-related information, and biochemical indicators were collected. Sleep quality and MCI were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Mini-Mental State Examination (MMSE) scale, respectively. The association between sleep quality and MCI was analyzed using univariate and multivariate analyses.
This study included 1,001 patients with T2DM, with a mean age of 60.2 (standard deviation: 10.1) years. Pearson's correlation analysis showed that the total PSQI score was negatively associated with the MMSE score (r=-0.27, P < 0.05). Multivariate analyses based on four models consistently showed that those with higher total PSQI score (aOR = 1.09-1.11, P < 0.05), as well as higher scores on the subjective sleep quality (aOR = 1.32-1.46, P < 0.05), sleep latency (aOR = 1.25-1.32, P < 0.05), sleep duration (aOR = 1.30-1.32, P < 0.05), sleep efficiency (aOR = 1.36-1.41, P < 0.05), sleep disturbance (aOR = 1.66-1.86, P < 0.05), and daily dysfunction (aOR = 1.38-1.48, P < 0.05) were associated with higher rates of MCI.
Among Chinese patients with T2DM, poor overall sleep quality, subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, and daily dysfunction were associated with higher rates of MCI. Future studies are needed to examine whether sleep intervention could improve cognitive function in patients with T2DM. It is also suggested for clinicians working with T2DM patients to raise the awareness of cognitive impairment and sleep problems.
在全球范围内，2型糖尿病（T2DM）患者的数量正在增加，与普通人群相比，他们患轻度认知障碍（MCI）的风险更高。睡眠质量被认为是一个可调节的因素，可能与MCI有关，因为先前的研究已将其与老年人的认知功能联系起来。然而，在中国T2DM患者中，关于睡眠质量与MCI之间关联的证据有限。因此，本研究旨在确定中国T2DM患者中睡眠质量与MCI之间的关联。
本横断面研究在转诊至中南大学湘雅医院内分泌科的T2DM患者中进行。收集了有关社会人口学特征、生活方式因素、T2DM相关信息和生化指标的数据。分别使用匹兹堡睡眠质量指数（PSQI）和简易精神状态检查表（MMSE）量表评估睡眠质量和MCI。使用单因素和多因素分析来分析睡眠质量与MCI之间的关联。
本研究纳入了1001例T2DM患者，平均年龄为60.2（标准差：10.1）岁。Pearson相关分析表明，PSQI总分与MMSE评分呈负相关（r = -0.27，P < 0.05）。基于四个模型的多因素分析一致显示，PSQI总分较高者（调整后比值比[aOR] = 1.09 - 1.11，P < 0.05），以及主观睡眠质量（aOR = 1.32 - 1.46，P < 0.05）、入睡潜伏期（aOR = 1.25 - 1.32，P < 0.05）、睡眠时间（aOR = 1.30 - 1.32，P < 0.05）、睡眠效率（aOR = 1.36 - 1.41，P < 0.05）、睡眠障碍（aOR = 1.66 - 1.86，P < 0.05）和日常功能障碍（aOR = 1.38 - 1.48，P < 0.05）得分较高者与MCI发生率较高相关。
在中国T2DM患者中，总体睡眠质量差、主观睡眠质量、入睡潜伏期、睡眠时间、睡眠效率、睡眠障碍和日常功能障碍与MCI发生率较高相关。未来需要进行研究，以检验睡眠干预是否可以改善T2DM患者的认知功能，并建议诊治T2DM患者的临床医生提高对认知障碍和睡眠问题的认识。
