Wen Zhen, Ma Minglei, Zhang Dongxue, Xiu Lei, Jiang Tao
Department of Endocrinology, Beijing Shijitan Hospital Affiliated to Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, China.
Diabetes Ther. 2025 Sep 15. doi: 10.1007/s13300-025-01789-6.
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized primarily by insulin resistance and hyperglycemia, often leading to multiple complications. Sleep disturbances, including insomnia and sleep apnea, are prevalent in patients with T2DM and are associated with poorer glucose metabolism. Despite research examining the relationship between glucose metabolism, body composition, and sleep quality, the underlying mechanisms remain unclear, particularly within patients with T2DM.
This study involved 269 newly diagnosed patients with T2DM from January to June 2024. Data collected included demographic information, clinical variables, glycemic markers, and body composition analyses. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), categorizing participants into poor (PSQI-H) and good sleep quality (PSQI-L) groups. Univariate and multivariate regression analyses, along with mediation analysis, were performed using SPSS 26.0 and R software to explore associations between sleep quality, glycemic markers, and body composition.
Significant correlations were found between PSQI scores and glycemic markers such as HbA1c, HOMA-IR, and postprandial blood glucose levels, showing that poorer glucose control was correlated with worse sleep quality. Mediation analysis suggested that body composition, particularly the trunk-to-limb fat mass ratio, may act as a statistical mediator in the relationship between glucose metabolism and sleep quality.
Our findings highlight the complex relationship between glucose metabolism, body composition, and sleep quality in patients with T2DM. Targeting glucose regulation and body composition may be explored in future studies as potential approaches to improve sleep quality in individuals with T2DM.
Clinical ChiCTR1900022768.
2型糖尿病（T2DM）是一种慢性代谢紊乱疾病，主要特征为胰岛素抵抗和高血糖，常导致多种并发症。睡眠障碍，包括失眠和睡眠呼吸暂停，在T2DM患者中很常见，并且与较差的葡萄糖代谢相关。尽管有研究探讨了葡萄糖代谢、身体成分和睡眠质量之间的关系，但其潜在机制仍不清楚，尤其是在T2DM患者中。
本研究纳入了2024年1月至6月新诊断的269例T2DM患者。收集的数据包括人口统计学信息、临床变量、血糖标志物和身体成分分析。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量，将参与者分为睡眠质量差（PSQI-H）组和睡眠质量好（PSQI-L）组。使用SPSS 26.0和R软件进行单因素和多因素回归分析以及中介分析，以探讨睡眠质量、血糖标志物和身体成分之间的关联。
发现PSQI评分与糖化血红蛋白（HbA1c）、稳态模型评估胰岛素抵抗（HOMA-IR）和餐后血糖水平等血糖标志物之间存在显著相关性，表明血糖控制较差与睡眠质量较差相关。中介分析表明，身体成分，特别是躯干与四肢脂肪量之比，可能在葡萄糖代谢与睡眠质量之间的关系中起统计学中介作用。
我们的研究结果突出了T2DM患者葡萄糖代谢、身体成分和睡眠质量之间的复杂关系。未来的研究可以探索针对血糖调节和身体成分，作为改善T2DM患者睡眠质量的潜在方法。
Clinical ChiCTR1900022768。
