Sleep duration, mediating biomarkers, and risk of microvascular complications among individuals with type 2 diabetes: A prospective cohort study

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes research and clinical practice Pub Date : 2025-02-08 DOI:10.1016/j.diabres.2025.112026

Xiaoge Niu , Hongwei Liu , Yanxi Wang , Yanfang Lu , Xiaojing Jiao , Yafeng Ren , Lei Yan , Shaokai Zhang , Huixia Cao , Fengmin Shao

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Abstract

Background

Associations between sleep duration and incident diabetic microvascular complications remain uncertain. The potential biological pathways underlying the association are unclear.

Methods

This prospective cohort study included 24,081 participants with type 2 diabetes from the UK Biobank. Habitual sleep duration was obtained via a baseline questionnaire. Associations of sleep duration with microvascular complications were analyzed using Cox regression models.

Results

The association of sleep duration with composite microvascular complications followed U-shaped patterns. Compared with sleeping for 7 hrs/day, the hazard ratios (95 % confidence intervals) of ≤ 5 and ≥ 10 hrs/day were 1.21 (1.09, 1.35) and 1.24 (1.09, 1.42) for the composite outcome, 1.20 (1.04, 1.38) and 1.30 (1.09, 1.54) for diabetic kidney disease, 1.61 (1.30, 2.00) and 1.35 (1.01, 1.79) for diabetic neuropathy, and 1.10 (0.93, 1.30) and 1.17 (0.95, 1.44) for diabetic retinopathy. Body mass index, gamma-glutamyl transferase, C-reactive protein, alkaline phosphatase, total cholesterol, and low-density lipoprotein cholesterol collectively explained 20.34 % of the association between sleep duration and composite microvascular complications.

Conclusions

Our study demonstrated that both short and long sleep durations were independently associated with increased risk of diabetic microvascular complications. The associations were partially mediated by metabolic biomarkers related to obesity, systemic inflammation, liver function, and lipid profile.

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2型糖尿病患者的睡眠时间、中介生物标志物和微血管并发症风险：前瞻性队列研究

背景：睡眠时间与糖尿病微血管并发症之间的关系尚不清楚。这种关联背后潜在的生物学途径尚不清楚。方法：这项前瞻性队列研究包括来自英国生物银行的24,081名2型糖尿病患者。通过基线问卷调查获得习惯性睡眠时间。采用Cox回归模型分析睡眠时间与微血管并发症的关系。结果：睡眠时间与复合微血管并发症呈u型相关。与每天睡眠7小时相比， ≤ 5和 ≥ 10小时/天的综合结局风险比（95 %可信区间）分别为1.21（1.09,1.35）和1.24(1.09,1.42)，糖尿病肾病风险比分别为1.20（1.04,1.38）和1.30(1.09,1.54)，糖尿病神经病变风险比分别为1.61（1.30,2.00）和1.35(1.01,1.79)，糖尿病视网膜病变风险比分别为1.10（0.93,1.30）和1.17（0.95,1.44）。体重指数、γ -谷氨酰转移酶、c反应蛋白、碱性磷酸酶、总胆固醇和低密度脂蛋白胆固醇共同解释了睡眠时间与复合微血管并发症之间20.34% %的关联。结论：我们的研究表明，短睡眠时间和长睡眠时间都与糖尿病微血管并发症的风险增加独立相关。与肥胖、全身性炎症、肝功能和血脂相关的代谢生物标志物部分介导了这种关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.