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Papale O, Festino E, Di Rocco F, Foster C, Prestanti I, Serafini S, Izzicupo P, Cortis C, Fusco A. The Impact of a Multidimensional Physical Activity Intervention on Glycemic Control in Type 1 Diabetes: A Preliminary Study. J Funct Morphol Kinesiol 2025; 10:163. [PMID: 40407447 PMCID: PMC12101377 DOI: 10.3390/jfmk10020163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2025] [Revised: 04/17/2025] [Accepted: 05/06/2025] [Indexed: 05/26/2025] Open
Abstract
Objectives: Type 1 diabetes is characterized by hyperglycemic episodes influenced by diet, sleep quality, chronotype, and physical activity, among others. While aerobic exercise is known to improve glycemic control, its effect on blood glucose regulation remains underexplored. Thus, this case study aimed to evaluate the effects of a prolonged and differentiated indoor and outdoor exercise intervention on glycemic control in an individual with type 1 diabetes. Methods: The participant (age: 23 years; weight: 95 kg; height: 1.90 m; Body Mass Index: 26.3 kg/m2; waist to hip ratio: 0.98; basal metabolic rate: 2015 kcal; Heart Rate Maximum (HRmax): 197 beats·min-1) completed two outdoor (~3800 m) and two indoor sessions with self-selected speed, in the initial 2 min stage, at a 0% grade slope. The grade increased by 2% at each stage during the uphill phase until reaching volitional fatigue, followed by a 2% decrease at each stage during the downhill phase until returning to a 0% grade. Blood pressure was assessed before and after each session. Daily nutrition intake, insulin intake, and blood glucose were continuously monitored. Dietary adherence (PREvención con DIeta MEDiterránea), sleep quality (Pittsburgh Sleep Quality Index), chronotype (Morningness-Eveningness Questionnaire), and physical activity levels (International Physical Activity Questionnaire) were assessed before each session. The Physical Activity Enjoyment Scale was used to measure enjoyment after each session. Results: The sessions were completed in ~44 and ~39 min with the participant achieving 84% (outdoor) and 96% (indoor) of their theoretical HRmax. The intervention resulted in glycemic improvements, with time spent in hyperglycemia (>250 mg/dL) decreasing from 56.46% to 0%, while time in the normal range (70-180 mg/dL) increased to 63.96%. A 47% reduction in insulin units showed that insulin sensitivity also improved. Conclusions: Despite differences in intensity, indoor and outdoor activities yielded comparable benefits, with outdoor activities being perceived as more enjoyable (outdoor: 28.5 ± 0.7; indoor: 24.0 ± 5.6) and positively impacting glycemic control, thus supporting the need for tailored strategies in diabetes management.
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Affiliation(s)
- Olga Papale
- Department of Human Sciences, Society and Heath, University of Cassino and Lazio Meridionale, 03042 Cassino, Italy; (O.P.); (E.F.); (F.D.R.)
| | - Emanuel Festino
- Department of Human Sciences, Society and Heath, University of Cassino and Lazio Meridionale, 03042 Cassino, Italy; (O.P.); (E.F.); (F.D.R.)
| | - Francesca Di Rocco
- Department of Human Sciences, Society and Heath, University of Cassino and Lazio Meridionale, 03042 Cassino, Italy; (O.P.); (E.F.); (F.D.R.)
| | - Carl Foster
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA;
| | - Iris Prestanti
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.P.); (S.S.); (P.I.); (A.F.)
| | - Sofia Serafini
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.P.); (S.S.); (P.I.); (A.F.)
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.P.); (S.S.); (P.I.); (A.F.)
| | - Cristina Cortis
- Department of Human Sciences, Society and Heath, University of Cassino and Lazio Meridionale, 03042 Cassino, Italy; (O.P.); (E.F.); (F.D.R.)
| | - Andrea Fusco
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.P.); (S.S.); (P.I.); (A.F.)
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Dunietz GL, Shedden K, Lyu X, Chervin RD, Baylin A, O’Brien LM, Jansen EC, Wactawski-Wende J, Schisterman EF, Mumford SL. Patterns of Sleep Duration and Metabolic Biomarkers Across the Menstrual Cycle. J Clin Endocrinol Metab 2025; 110:e363-e371. [PMID: 38529946 PMCID: PMC11747681 DOI: 10.1210/clinem/dgae191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/04/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
CONTEXT Along the menstrual cycle, associations between inconsistent sleep duration and levels of metabolic biomarkers are uncertain and could involve fluctuations in estrogen concentrations. OBJECTIVE To examine associations between patterns of sleep duration and metabolic biomarkers across 2 menstrual cycles within a cohort of premenopausal women. METHODS The BioCycle Study was conducted in New York between 2005 and 2007, enrolling 259 premenopausal women over 2 menstrual cycles. This microlongitudinal cohort study involved intensive data collection including daily sleep diaries and biomarker assessments of leptin, insulin, and glucose at 16 key points timed to menstrual cycle phases. We considered dynamic sleep duration as hours slept 1 night or as mean hours slept during the 2 nights before each biomarker assessment. Variability in habitual sleep duration (ie, reported daily sleep duration) was summarized across both menstrual cycles. Variation in habitual sleep duration was computed using L-moments, a robust version of dispersion, skewness, and kurtosis. To examine associations between patterns of sleep duration and metabolic biomarkers, we fitted a series of linear mixed models with random intercepts and inverse probability weighting. These models were adjusted for potential demographic, lifestyle, health confounders, and menstrual cycle phase. RESULTS Sleep duration 1 night or 2 nights before clinic visits were not associated with metabolic biomarker measures. However, overall variability (dispersion) in habitual sleep duration was associated with lower mean insulin Homeostatic Model Assessment for Insulin Resistance levels, but not glucose. Moreover, extremely short or long bouts of sleep duration were associated with higher mean levels of leptin, insulin, and Homeostatic Model Assessment for Insulin Resistance. CONCLUSION These data suggest that variation in habitual sleep duration along the menstrual cycle may be associated with metabolic function.
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Affiliation(s)
- Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kerby Shedden
- Department of Statistics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Xiru Lyu
- Department of Statistics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ronald D Chervin
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Louise M O’Brien
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Erica C Jansen
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Enrique F Schisterman
- Department of Biostatistics, Epidemiology and Informatics and Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sunni L Mumford
- Department of Biostatistics, Epidemiology and Informatics and Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Imaizumi H, Takahashi A, Takahata Y, Anzai Y, Kogure A, Sakuma C, Abe N, Sugaya T, Fujita M, Hayashi M, Abe K, Ohira H. Association between Sleep Duration and a New Onset of Nonalcoholic Fatty Liver Disease. Intern Med 2024; 63:3277-3282. [PMID: 38658342 PMCID: PMC11729180 DOI: 10.2169/internalmedicine.3119-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/10/2024] [Indexed: 04/26/2024] Open
Abstract
Objective A short sleep duration is associated with non-alcoholic fatty liver disease (NAFLD). However, the causal relationship between a short sleep duration and the onset of NAFLD remains unknown because of the lack of any longitudinal studies. Therefore, we evaluated the association between sleep duration and the onset of NAFLD. Methods We evaluated health checkup data for 1,862 NAFLD-free Japanese adults aged 33-86 years at baseline and followed those individuals for a median of 41 months. Hepatic steatosis was examined using ultrasonography (US). The Cox proportional hazards model was used to evaluate the association between sleep duration and NAFLD onset. Results Among the 1,862 participants, 483 (25.9%) developed NAFLD. The proportion of women who developed NAFLD was the highest in the group with a sleep duration of <6 hours and lowest in the group with a sleep duration of 7 to <8 hours. The multivariable-adjusted hazard ratio (95% confidence interval) for the onset of NAFLD in women with a sleep duration <6 hours compared with those with a sleep duration of 7 to <8 hours was 1.55 (1.09-2.20; p=0.02). Conclusion In women, a short sleep duration was independently associated with the onset of NAFLD, thus suggesting that an adequate sleep duration can be a promising preventive factor for the onset of NAFLD in women.
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Affiliation(s)
- Hiromichi Imaizumi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
- Department of Gastroenterology, Watari Hospital, Japan
| | - Yosuke Takahata
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Yukio Anzai
- Department of Gastroenterology, Watari Hospital, Japan
| | - Atsuko Kogure
- Department of Gastroenterology, Fujita General Hospital, Japan
| | - Chiharu Sakuma
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Naoto Abe
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Tatsuro Sugaya
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Masashi Fujita
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Manabu Hayashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Kazumichi Abe
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
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Duan Y, Fu H, Gao J, Wang S, Chen C, Zhao Y, Jiang S, Wang C. Associations of prediabetes and sleep duration, and inflammation as a mediator in the China Health and Retirement Longitudinal Study. Sleep Health 2024; 10:470-477. [PMID: 38749824 DOI: 10.1016/j.sleh.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/21/2024] [Accepted: 01/31/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE The objective of this study was to examine the relationship between sleep duration and prediabetes, as well as to evaluate the influence of inflammation in mediating this association. METHODS A total of 4632 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included in this study, comprising both baseline and 4-year follow-up data. The prospective relationship between sleep duration and the risk of prediabetes was examined using logistic regression models. We used multinomial logistic regression to evaluate the impact of prediabetes on sleep duration changes over follow-up, assessing the role of C-reactive protein in the association using mediation analysis. RESULTS Participants with short sleep duration (<5 hours) had a higher risk of prediabetes (odds ratios=1.381 [95% CI: 1.028-1.857]) compared to those with normal sleep durations (7-8 hours). However, excessive sleep durations (≥9 hours) did not show a statistically significant association with prediabetes risk. Moreover, individuals at least 60years old who experienced short sleep durations exhibited a higher risk of prediabetes. Individuals with prediabetes were more likely to have shorter sleep duration than excessive sleep duration (relative risk ratios=1.280 [95% CI: 1.059-1.547]). The mediation analysis revealed a mediating effect of C-reactive protein on the association between prediabetes and reduced sleep duration. CONCLUSIONS Short sleep duration was identified as a risk factor for the incidence of prediabetes. Conversely, prediabetes was found to contribute to shorter sleep duration rather than excessive sleep duration. Moreover, elevated levels of C-reactive protein may serve as a potential underlying mechanism that links prediabetes with shorter sleep.
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Affiliation(s)
- Yanran Duan
- Hospital Management Departments, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Health Policy Research Center, Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Hang Fu
- Hospital Management Departments, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Health Policy Research Center, Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Jinghong Gao
- Hospital Management Departments, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Health Policy Research Center, Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Sufan Wang
- Hospital Management Departments, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Health Policy Research Center, Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Changying Chen
- Hospital Management Departments, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Health Policy Research Center, Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Yaojun Zhao
- Operation Management Department, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuai Jiang
- Hospital Management Departments, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Health Policy Research Center, Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Chengzeng Wang
- Hospital Management Departments, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Health Policy Research Center, Institute for Hospital Management of Henan Province, Zhengzhou, China.
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Association of Poor Quality of Sleep with Vision-Threatening Diabetic Retinopathy: A Matched Case-Control Study. Ophthalmol Ther 2023; 12:1141-1153. [PMID: 36745315 PMCID: PMC10011256 DOI: 10.1007/s40123-023-00663-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/20/2023] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Vision-threatening diabetic retinopathy, a long-term microvascular complication of diabetes in the eye, is a major cause of blindness worldwide. Sleep is regulated by a special area of the brain, and poor quality of sleep has been implicated in long-term diabetic complications, including diabetic retinopathy. The study was aimed at exploring whether poor sleep quality is associated with the likelihood of developing vision-threatening diabetic retinopathy. METHODS A matched case-control study was conducted from 6 May 2022 to 6 September 2022. The study was based on patients with diabetes (both type 1 and type 2), attending a retina clinic of the referral center. Patients with confirmed vision-threatening diabetic retinopathy were defined as cases and matched with control study subjects. Rating of sleep quality was done by Pittsburgh Sleep Quality Index assessment tool. Conditional logistic regression model was applied to assess the effect of overall poor sleep quality on vision-threatening diabetic retinopathy. RESULTS The study recruited a total of 126 (63 duration-matched pairs) patients with diabetes. The overall quality of sleep was poor among 71.90% of patients in the case groups, significantly higher compared with those of the control groups (28.10%) (p < 0.00). The mean quality of sleep for cases [mean (M) = 7.10, standard deviation (SD) = 4.30] was higher than the control group (M = 3.60, SD = 2.70). The magnitude of the difference [M difference = 3.50, 95% confidence interval (CI): 2.25-4.75] was significant. Poor sleep quality predicted the chance of developing vision-threatening diabetic retinopathy in a diabetic cohort. CONCLUSIONS This study revealed a significant association between the overall poor quality of sleep and vision-threatening diabetic retinopathy. Co-management of sleep disruption and vision-threatening diabetic retinopathy, and better sleep advisory are warranted.
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He J, Hong C, Zhang L, Li C, Wang Y, Fan Y, Guo P, Zhang B, Qi X, Chen S, Niu YJ, Liu F, Zhang R, Li Q, Ma S, Zhang M, Zhang M. Associations between night-time sleep duration and fasting glucose and ratio of triglyceride to high-density lipoprotein cholesterol among adults free of type 2 diabetes or without diagnosed type 2 diabetes: a multicentre, cross-sectional study in China. BMJ Open 2022; 12:e062239. [PMID: 35906046 PMCID: PMC9345048 DOI: 10.1136/bmjopen-2022-062239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES We aimed to assess the associations between night-time sleep duration and fasting glucose (FG), triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and body mass index (BMI) among adults free of type 2 diabetes (T2D) or without diagnosed T2D. DESIGN Cross-sectional study. SETTING Medical examination centres at six hospitals in Beijing-Tianjin-Hebei region, China. PARTICIPANTS Participants were recruited via multistage, stratified cluster sampling. We included adults free of T2D or without diagnosed T2D who attended for physical examination and completed the validated questionnaire. 32 497 participants were included in the study, of whom 52.50% were men. PRIMARY AND SECONDARY OUTCOME MEASURES FG, TG, HDL-C, height and weight were measured. RESULTS Overall, 12.80% and 9.67% reported night sleep duration <7 hours and ≥9 hours, respectively; 6.91% had elevated FG and 3.57% had undiagnosed T2D. Sleep duration had an independent, U-shaped associated with FG (β1 (linear term)=-0.111, p=0.047; β2 (quadratic term)=0.008, p=0.026) with 6.9 hours of sleep associated with the lowest FG and a negative association with BMI (β=-0.154, p<0.001). BMI mediated a U-shaped association of sleep duration with TG/HDL-C (β1=-0.040, p=0.017; β2=0.003, p=0.023). CONCLUSIONS Both short and long night-time sleep was associated with elevated FG, and short sleep duration was associated with increased BMI. BMI mediated a U-shaped association between sleep duration and TG/HDL-C.
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Affiliation(s)
- Jiangshan He
- School of Medicine, Nankai University, Tianjin, China
| | - Chenglin Hong
- Department of Social Welfare, University of California, Los Angeles, California, USA
| | - Li Zhang
- Tianjin First Central Hospital, Tianjin, China
| | - Chunjun Li
- Tianjin People's Hospital Tianjin Union Medical Center, Tianjin, China
| | - Yuxue Wang
- School of Medicine, Nankai University, Tianjin, China
| | - Yaqi Fan
- School of Medicine, Nankai University, Tianjin, China
| | - Pei Guo
- School of Medicine, Nankai University, Tianjin, China
| | - Binbin Zhang
- School of Medicine, Nankai University, Tianjin, China
| | - Xin Qi
- Tianjin People's Hospital Tianjin Union Medical Center, Tianjin, China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing, China
| | - Yu-Jie Niu
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang City, Hebei, China
| | - Feng Liu
- Beijing Physical Examination Center, Beijing, China
| | - Rong Zhang
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang City, Hebei, China
| | - Qiang Li
- Beijing Physical Examination Center, Beijing, China
| | - Shitao Ma
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang City, Hebei, China
| | - Mianzhi Zhang
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Minying Zhang
- School of Medicine, Nankai University, Tianjin, China
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Johnson JM, Durrant SJ, Law GR, Santiago J, Scott EM, Curtis F. The effect of slow-wave sleep and rapid eye-movement sleep interventions on glycaemic control: a systematic review and meta-analysis of randomised controlled trials. Sleep Med 2022; 92:50-58. [DOI: 10.1016/j.sleep.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/04/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
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Xu S, Turakhia S, Miller M, Johnston D, Maddalozzo J, Thompson D, Trosman I, Grandner M, Sheldon SH, Ahluwalia V, Bhushan B. Association of obstructive sleep apnea and total sleep time with health-related quality of life in children undergoing a routine polysomnography: a PROMIS approach. J Clin Sleep Med 2022; 18:801-808. [PMID: 34669574 PMCID: PMC8883074 DOI: 10.5664/jcsm.9726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) negatively impacts health-related quality of life (HR-QoL) in adults, but few pediatric studies have explored this relationship or the relationships between HR-QoL domains. METHODS Patients aged 8-17 years visiting the sleep laboratory from July 2019 to January 2020 for overnight polysomnography participated in the study. Controls seen for problems other than sleep disturbance were recruited from Department of Pediatrics outpatient clinics. HR-QoL was assessed by Patient-Reported Outcome Measure Information System (PROMIS) profile questionnaires, version 2.0. Statistical analysis was conducted using R 3.6.0 (R Foundation for Statistical Computing, Vienna, Austria). RESULTS One hundred twenty-two patients were included in the final analysis. Sixty-four patients were males (52.4%). Twenty-nine (23.8%) had mild OSA, 8 (6.6%) had moderate OSA, 17 (13.9%) had severe OSA, 46 (37.7%) were without OSA, and 22 (18.0%) were controls. Patients referred for polysomnography had lower physical function mobility compared with controls (P = .03). Increased OSA severity was linearly associated with a decrease in physical function mobility (P = .008). Correlation analysis revealed that physical function mobility was positively associated with total sleep time (P = .02) and negatively associated with apnea-hypopnea index (P = .01). Age was positively associated with fatigue (P = .02) and negatively associated with deep sleep (P < .001). Regression analysis revealed that physical function mobility was positively associated with total sleep time (P = .02) and negatively associated with apnea-hypopnea index (P = .04) after controlling for age, sex, and number of arousals. CONCLUSIONS OSA and total sleep time were associated with problems with physical function mobility after adjusting for age, sex, and number of arousals. CITATION Xu S, Turakhia S, Miller M, et al. Association of obstructive sleep apnea and total sleep time with health-related quality of life in children undergoing a routine polysomnography: a PROMIS approach. J Clin Sleep Med. 2022;18(3):801-808.
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Affiliation(s)
- Sarah Xu
- Otolaryngology Head and Neck Surgery, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | | | - Michael Miller
- Stanley Manne Research Institute, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Douglas Johnston
- Otolaryngology Head and Neck Surgery, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois,Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - John Maddalozzo
- Otolaryngology Head and Neck Surgery, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois,Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Dana Thompson
- Otolaryngology Head and Neck Surgery, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois,Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Irina Trosman
- Pulmonary and Sleep Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Michael Grandner
- Department of Psychiatry, The University of Arizona College of Medicine, Tucson, Arizona
| | - Stephen H. Sheldon
- Pulmonary and Sleep Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Vikas Ahluwalia
- Otolaryngology Head and Neck Surgery, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Bharat Bhushan
- Otolaryngology Head and Neck Surgery, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois,Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois,Address correspondence to: Bharat Bhushan, PhD, CCSH, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Northwestern University, 225 East Chicago Avenue, Box #25, Chicago, IL 60611-2605; Tel: (312) 227-6793; Fax: (312) 227-9414;
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Behravesh M, Fernandez-Tajes J, Estampador AC, Varga TV, Gunnarsson ÓS, Strevens H, Timpka S, Franks PW. A prospective study of the relationships between movement and glycemic control during day and night in pregnancy. Sci Rep 2021; 11:23911. [PMID: 34903782 PMCID: PMC8668873 DOI: 10.1038/s41598-021-03257-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022] Open
Abstract
Both disturbed sleep and lack of exercise can disrupt metabolism in pregnancy. Accelerometery was used to objectively assess movement during waking (physical activity) and movement during sleeping (sleep disturbance) periods and evaluated relationships with continuous blood glucose variation during pregnancy. Data was analysed prospectively. 15-women without pre-existing diabetes mellitus wore continuous glucose monitors and triaxial accelerometers from February through June 2018 in Sweden. The relationships between physical activity and sleep disturbance with blood glucose rate of change were assessed. An interaction term was fitted to determine difference in the relationship between movement and glucose variation, conditional on waking/sleeping. Total movement was inversely related to glucose rate of change (p < 0.001, 95% CI (− 0.037, − 0.026)). Stratified analyses showed total physical activity was inversely related to glucose rate of change (p < 0.001, 95% CI (− 0.040, − 0.028)), whereas sleep disturbance was not related to glucose rate of change (p = 0.07, 95% CI (< − 0.001, 0.013)). The interaction term was positively related to glucose rate of change (p < 0.001, 95% CI (0.029, 0.047)). This study provides temporal evidence of a relationship between total movement and glycemic control in pregnancy, which is conditional on time of day. Movement is beneficially related with glycemic control while awake, but not during sleep.
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Affiliation(s)
- Masoud Behravesh
- Genetic & Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35 214 28, Malmö, Sweden
| | - Juan Fernandez-Tajes
- Genetic & Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35 214 28, Malmö, Sweden
| | - Angela C Estampador
- Genetic & Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35 214 28, Malmö, Sweden
| | - Tibor V Varga
- Genetic & Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35 214 28, Malmö, Sweden.,Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ómar S Gunnarsson
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö and Lund, Sweden.,Perinatal and Cardiovascular Epidemiology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Helena Strevens
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö and Lund, Sweden
| | - Simon Timpka
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö and Lund, Sweden.,Perinatal and Cardiovascular Epidemiology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Paul W Franks
- Genetic & Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35 214 28, Malmö, Sweden. .,Harvard TH Chan School of Public Health, Boston, MA, USA.
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10
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Aguayo GA, Pastore J, Backes A, Stranges S, Witte DR, Diederich NJ, Alkerwi A, Huiart L, Ruiz-Castell M, Malisoux L, Fagherazzi G. Objective and subjective sleep measures are associated with HbA1c and insulin sensitivity in the general population: Findings from the ORISCAV-LUX-2 study. DIABETES & METABOLISM 2021; 48:101263. [PMID: 34023494 DOI: 10.1016/j.diabet.2021.101263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/20/2021] [Accepted: 04/29/2021] [Indexed: 11/25/2022]
Abstract
AIM To analyze the association of objective and subjective sleep measures with HbA1c and insulin sensitivity in the general population. METHODS Using a cross-sectional design, data from 1028 participants in the ORISCAV-LUX-2 study from the general population in Luxembourg were analyzed. Objective sleep measures were assessed using accelerometers whereas subjective measures were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Sleep measures were defined as predictors, while HbA1c and quantitative insulin sensitivity check index (QUICKI) scores were considered outcomes. Linear and spline regression models were fitted by progressively adjusting for demographic and lifestyle variables in the total sample population as well as by stratified analyses using gender, obesity status, depressive symptoms and diabetes status. RESULTS In fully adjusted models, total and deep sleep durations were associated with lower HbA1c (mmol/mol) levels, whereas sleep coefficients of variation (%) and poor sleep efficiency, as measured by PSQI scores (units), were associated with higher HbA1c levels. In stratified models, such associations were observed mainly in men, and in subjects who had depressive symptoms, were overweight and no diabetes. In addition, total sleep, deep sleep, coefficients of variation and poor sleep efficiency as measured by PSQI revealed non-linear associations. Similarly, greater insulin sensitivity was associated with longer total sleep time and with PSQI-6 (use of sleep medication). CONCLUSION Associations were more frequently observed between sleep characteristics and glycaemic control with the use of objective sleep measures. Also, such associations varied within subgroups of the population. Our results highlight the relevance of measuring sleep patterns as key factors in the prevention of diabetes.
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Affiliation(s)
- Gloria A Aguayo
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.
| | - Jessica Pastore
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anne Backes
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Saverio Stranges
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg; Department of Epidemiology and Biostatistics and Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Daniel R Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus, Denmark
| | - Nico J Diederich
- Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
| | | | - Laetitia Huiart
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Maria Ruiz-Castell
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Laurent Malisoux
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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11
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Zhang H, Zhu Y, Hao M, Wang J, Wang Z, Chu X, Bao Z, Jiang X, Shi G, Wang X. The Modified Healthy Ageing Index Is Associated with Mortality and Disability: The Rugao Longevity and Ageing Study. Gerontology 2021; 67:572-580. [PMID: 34000721 DOI: 10.1159/000513931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/20/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The Healthy Ageing Index (HAI) has been shown not only to have wider applicability and predictive ability but also to adequately predict mortality in Western populations. There is still a lack of studies validating the applicability of the HAI in China. OBJECTIVE To evaluate the applicability of the HAI and validate whether the HAI is suitable for monitoring ageing in the elderly population in China. METHODS Data were obtained from the Rugao Longevity and Ageing Study. The modified HAI was constructed based on systolic blood pressure, chronic pulmonary diseases, cognitive function, fasting glucose, and kidney function. It was calculated in 1719 individuals aged 70-84 years at baseline. The adverse outcomes were mortality and disability. Demographic, physiologic, and clinical data were collected. Cox proportional hazards and logistic regression models were used to analyze the relationship between the modified HAI and adverse outcomes. RESULTS A total of 1,719 older adults were analyzed in our study. A total of 793 (46.13%) males were recruited. The mean age was 75.69 ± 3.93 years. At the 5-year follow-up, there were 266 deaths and 275 individuals with disabilities. In the multivariable models, the modified HAI was associated with mortality (hazard ratio = 1.11, 95% confidence interval [CI]: 1.03-1.20) and disability (odds ratio = 1.11, 95% CI: 1.05-1.18). In the sensitivity analyses, similar associations remained after imputing missing data using multiple imputation and excluding participants with major cardiovascular disease at baseline. CONCLUSION The modified HAI was a robust and independent predictor of adverse outcomes. It is a valid and feasible tool for monitoring ageing in older adults.
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Affiliation(s)
- Hui Zhang
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China
| | | | - Meng Hao
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China
| | - Jiucun Wang
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China
| | | | | | - Zhijun Bao
- Shanghai Key Laboratory of Clinical Geriatric Medicine and Huadong Hospital Clinical Research Center for Geriatric Medicine, Fudan University, Shanghai, China
| | - Xiaoyan Jiang
- Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai, China
| | | | - Xiaofeng Wang
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine and Huadong Hospital Clinical Research Center for Geriatric Medicine, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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12
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Zhang HZ, Zhang P, Chang GQ, Xiang QY, Cao H, Zhou JY, Dong ZM, Qiao C, Xu CR, Qin Y, Lou PA. Effectiveness of cognitive behavior therapy for sleep disturbance and glycemic control in persons with type 2 diabetes mellitus: A community-based randomized controlled trial in China. World J Diabetes 2021; 12:292-305. [PMID: 33758648 PMCID: PMC7958479 DOI: 10.4239/wjd.v12.i3.292] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/09/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Poor sleep quality is a common clinical feature in patients with type 2 diabetes mellitus (T2DM), and often negatively related with glycemic control. Cognitive behavioral therapy (CBT) may improve sleep quality and reduce blood sugar levels in patients with T2DM. However, it is not entirely clear whether CBT delivered by general practitioners is effective for poor sleep quality in T2DM patients in community settings.
AIM To test the effect of CBT delivered by general practitioners in improving sleep quality and reducing glycemic levels in patients with T2DM in community.
METHODS A cluster randomized controlled trial was conducted from September 2018 to October 2019 in communities of China. Overall 1033 persons with T2DM and poor sleep quality received CBT plus usual care or usual care. Glycosylated hemoglobin A1c (HbAlc) and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were assessed. Repeated measures analysis of variance and generalized linear mixed effects models were used to estimate the intervention effects on hemoglobin A1c and sleep quality.
RESULTS The CBT group had 0.64, 0.50, and 0.9 lower PSQI scores than the control group at 2 mo, 6 mo, and 12 mo, respectively. The CBT group showed 0.17 and 0.43 lower HbAlc values than the control group at 6 mo and 12 mo. The intervention on mean ΔHbAlc values was significant at 12 mo (t = 3.68, P < 0.01) and that mean ΔPSQI scores were closely related to ΔHbAlc values (t = 7.02, P < 0.01). Intention-to-treat analysis for primary and secondary outcomes showed identical results with completed samples. No adverse events were reported.
CONCLUSION CBT delivered by general practitioners, as an effective and practical method, could reduce glycemic levels and improve sleep quality for patients with T2DM in community.
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Affiliation(s)
- Huai-Zhong Zhang
- Department of Psychiatry, Xuzhou Third People’s Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Pan Zhang
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, Jiangsu Province, China
| | - Gui-Qiu Chang
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, Jiangsu Province, China
| | - Quan-Yong Xiang
- Department of Control and Prevention of Chronic Non-communicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
| | - Huan Cao
- Department of Psychiatry, Xuzhou Third People’s Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Jin-Yi Zhou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
| | - Zong-Mei Dong
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, Jiangsu Province, China
| | - Cheng Qiao
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, Jiangsu Province, China
| | - Chun-Rong Xu
- Department of Psychiatry, Xuzhou Third People’s Hospital, Xuzhou 221000, Jiangsu Province, China
| | - Yu Qin
- Department of Control and Prevention of Chronic Non-communicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
| | - Pei-An Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, Jiangsu Province, China
- Department of Epidemiology and Health Statistics, Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
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13
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Bogdanet D, O’Shea P, Lyons C, Shafat A, Dunne F. The Oral Glucose Tolerance Test-Is It Time for a Change?-A Literature Review with an Emphasis on Pregnancy. J Clin Med 2020; 9:E3451. [PMID: 33121014 PMCID: PMC7693369 DOI: 10.3390/jcm9113451] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/29/2020] [Accepted: 10/22/2020] [Indexed: 02/06/2023] Open
Abstract
Globally, gestational diabetes (GDM) is increasing at an alarming rate. This increase is linked to the rise in obesity rates among women of reproductive age. GDM poses a major global health problem due to the related micro- and macro-vascular complications of subsequent Type 2 diabetes and the impact on the future health of generations through the long-term impact of GDM on both mothers and their infants. Therefore, correctly identifying subjects as having GDM is of utmost importance. The oral glucose tolerance test (OGTT) has been the mainstay for diagnosing gestational diabetes for decades. However, this test is deeply flawed. In this review, we explore a history of the OGTT, its reproducibility and the many factors that can impact its results with an emphasis on pregnancy.
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Affiliation(s)
- Delia Bogdanet
- Department of Medicine, School of Medicine, National University of Ireland Galway, H91TK33 Galway, Ireland; (P.O.); (A.S.); (F.D.)
- Department of Diabetes and Endocrinology, Saolta University Health Care Group (SUHCG), University Hospital Galway, H91YR71 Galway, Ireland
| | - Paula O’Shea
- Department of Medicine, School of Medicine, National University of Ireland Galway, H91TK33 Galway, Ireland; (P.O.); (A.S.); (F.D.)
- Department of Clinical Biochemistry, SUHCG, University Hospital Galway, H91YR71 Galway, Ireland;
| | - Claire Lyons
- Department of Clinical Biochemistry, SUHCG, University Hospital Galway, H91YR71 Galway, Ireland;
| | - Amir Shafat
- Department of Medicine, School of Medicine, National University of Ireland Galway, H91TK33 Galway, Ireland; (P.O.); (A.S.); (F.D.)
| | - Fidelma Dunne
- Department of Medicine, School of Medicine, National University of Ireland Galway, H91TK33 Galway, Ireland; (P.O.); (A.S.); (F.D.)
- Department of Diabetes and Endocrinology, Saolta University Health Care Group (SUHCG), University Hospital Galway, H91YR71 Galway, Ireland
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14
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Rønn PF, Andersen GS, Lauritzen T, Christensen DL, Aadahl M, Carstensen B, Grarup N, Jørgensen ME. Abdominal visceral and subcutaneous adipose tissue and associations with cardiometabolic risk in Inuit, Africans and Europeans: a cross-sectional study. BMJ Open 2020; 10:e038071. [PMID: 32928857 PMCID: PMC7490939 DOI: 10.1136/bmjopen-2020-038071] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Abdominal fat has been identified as a risk marker of cardiometabolic disease independent of overall adiposity. However, it is not clear whether there are ethnic disparities in this risk. We investigated the associations of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with cardiometabolic risk factors in three ethnic diverse populations of Inuit, Africans and Europeans. DESIGN Cross-sectional pooled study. SETTING Greenland, Kenya and Denmark. METHODS A total of 5113 participants (2933 Inuit, 1397 Africans and 783 Europeans) from three studies in Greenland, Kenya and Denmark were included. Measurements included abdominal fat distribution assessed by ultrasound, oral glucose tolerance test, hepatic insulin resistance, blood pressure and lipids. The associations were analysed using multiple linear regressions. RESULTS Across ethnic group and gender, an increase in VAT of 1 SD was associated with higher levels of hepatic insulin resistance (ranging from 14% to 28%), triglycerides (8% to 16%) and lower high-density lipoprotein cholesterol (HDL-C, -1.0 to -0.05 mmol/L) independent of body mass index. VAT showed positive associations with most of the other cardiometabolic risk factors in Inuit and Europeans, but not in Africans. In contrast, SAT was mainly associated with the outcomes in Inuit and Africans. Of notice was that higher SAT was associated with higher HDL-C in African men (0.11 mmol/L, 95% CI: 0.03 to 0.18) and with lower HDL-C in Inuit (-0.07 mmol/L, 95% CI: -0.12 to -0.02), but not in European men (-0.02 mmol/L, 95% CI: -0.09 to 0.05). Generally weaker associations were observed for women. Furthermore, the absolute levels of several of the cardiometabolic outcomes differed between the ethnic groups. CONCLUSIONS VAT and SAT were associated with several of the cardiometabolic risk factors beyond overall adiposity. Some of these associations were specific to ethnicity, suggesting that ethnicity plays a role in the pathway from abdominal fat to selected cardiometabolic risk factors.
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Affiliation(s)
- Pernille Falberg Rønn
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Public Health, Centre for Arctic Health, Aarhus University, Aarhus, Denmark
| | | | - Torsten Lauritzen
- Department of Public Health, General Practice, Aarhus University, Aarhus, Denmark
| | - Dirk Lund Christensen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bendix Carstensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation, Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Kobenhavn, Denmark
| | - Marit Eika Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Greenland University, Nuuk, Greenland
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15
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Estimating narrow-sense heritability using family data from admixed populations. Heredity (Edinb) 2020; 124:751-762. [PMID: 32273574 DOI: 10.1038/s41437-020-0311-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 01/05/2023] Open
Abstract
Estimating total narrow-sense heritability in admixed populations remains an open question. In this work, we used extensive simulations to evaluate existing linear mixed-model frameworks for estimating total narrow-sense heritability in two population-based cohorts from Greenland, and compared the results with data from unadmixed individuals from Denmark. When our analysis focused on Greenlandic sib pairs, and under the assumption that shared environment among siblings has a negligible effect, the model with two relationship matrices, one capturing identity by descent and one capturing identity by state, returned heritability estimates close to the true simulated value, while using each of the two matrices alone led to downward biases. When phenotypes correlated with ancestry, heritability estimates were inflated. Based on these observations, we propose a PCA-based adjustment that recovers the true simulated heritability. We use this knowledge to estimate the heritability of ten quantitative traits from the two Greenlandic cohorts, and report differences such as lower heritability for height in Greenlanders compared with Europeans. In conclusion, narrow-sense heritability in admixed populations is best estimated when using a mixture of genetic relationship matrices on individuals with at least one first-degree relative included in the sample.
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16
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Koopman ADM, Beulens JW, Dijkstra T, Pouwer F, Bremmer MA, van Straten A, Rutters F. Prevalence of Insomnia (Symptoms) in T2D and Association With Metabolic Parameters and Glycemic Control: Meta-Analysis. J Clin Endocrinol Metab 2020; 105:5585878. [PMID: 31603475 PMCID: PMC7110921 DOI: 10.1210/clinem/dgz065] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/23/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We aimed to determine the prevalence of insomnia and insomnia symptoms and its association with metabolic parameters and glycemic control in people with type 2 diabetes (T2D) in a systematic review and meta-analysis. DATA SOURCES A systematic literature search was conducted in PubMed/Embase until March 2018. STUDY SELECTION Included studies described prevalence of insomnia or insomnia symptoms and/or its association with metabolic parameters or glycemic control in adults with T2D. DATA EXTRACTION Data extraction was performed independently by 2 reviewers, on a standardized, prepiloted form. An adaptation of Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included studies. DATA SYNTHESIS When possible, results were meta-analyzed using random-effects analysis and rated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS A total of 11 329 titles/abstracts were screened and 224 were read full text in duplicate, of which 78 studies were included. The pooled prevalence of insomnia (symptoms) in people with T2D was 39% (95% confidence interval, 34-44) with I2 statistic of 100% (P < 0.00001), with a very low GRADE of evidence. Sensitivity analyses identified no clear sources of heterogeneity. Meta-analyses showed that in people with T2D, insomnia (symptoms) were associated with higher hemoglobin A1c levels (mean difference, 0.23% [0.1-0.4]) and higher fasting glucose levels (mean difference, 0.40 mmol/L [0.2-0.7]), with a low GRADE of evidence. The relative low methodological quality and high heterogeneity of the studies included in this meta-analysis complicate the interpretation of our results. CONCLUSIONS The prevalence of insomnia (symptoms) is 39% (95% confidence interval, 34-44) in the T2D population and may be associated with deleterious glycemic control.
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Affiliation(s)
- Anitra D M Koopman
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
- Correspondence and Reprint Requests: Femke Rutters, Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands, De Boelelaan 1089a, 1081 HV Amsterdam, the Netherlands. E-mail:
| | - Joline W Beulens
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, GA Utrecht, the Netherlands
| | - Tine Dijkstra
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
| | - Frans Pouwer
- University of Southern Denmark, Department of Psychology, Odense, Denmark
- Deakin University, School of Psychology, Geelong, Australia
- STENO Diabetes Center Odense, Odense, Denmark
| | - Marijke A Bremmer
- Amsterdam UMC, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
| | - Annemieke van Straten
- Faculty of Behavioural and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit, HV Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, location VUmc, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands
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17
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Wei YT, Lee PY, Lin CY, Chen HJ, Lin CC, Wu JS, Chang YF, Wu CL, Guo HR. Non-alcoholic fatty liver disease among patients with sleep disorders: a Nationwide study of Taiwan. BMC Gastroenterol 2020; 20:32. [PMID: 32041532 PMCID: PMC7011431 DOI: 10.1186/s12876-020-1178-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 01/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. Studies have shown that sleep apnea is associated with NAFLD. However, studies on the association between sleep disorders in general and NAFLD are limited. We conducted a nationwide population-based longitudinal study to evaluate this potential association. METHODS We identified patients diagnosed with sleep disorders in the years 2000 through 2005 in Taiwan using the National Health Insurance Research Database and selected an equal number of patients without sleep disorders from the same database as the comparison cohort. The patients were followed from the index date to the diagnosis of NAFLD or the end of 2013. We used Cox proportional hazards models to estimate the risk of NAFLD associated with sleep disorders. RESULTS A total of 33,045 patients with sleep disorders were identified. The incidence of NAFLD was 14.0 per 10,000 person-year in patients with sleep disorders and 6.2 per 10,000 person-year in the comparison cohort. The adjusted hazard ratio (AHR) of NAFLD associated with sleep disorders was 1.78 (95% confidence interval [95%CI]: 1.46-2.16), and other independent risk factors included male sex (AHR = 1.31, 95%CI: 1.12-1.54), age 40-59 years (AHR = 1.49, 95%CI: 1.21-1.82), and dyslipidemia (AHR = 2.51, 95%CI: 2.08-3.04). In the subgroup analyses, both patients with (AHR = 2.24, 95%CI: 1.05-4.77) and without (AHR = 1.77, 95%CI: 1.46-2.15) sleep apnea had an increased risk of NAFLD. CONCLUSIONS Sleep disorders are associated with NAFLD, even in patients without sleep apnea. Further studies are warranted to explore the mechanisms of the association.
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Affiliation(s)
- Yu-Ting Wei
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
- Occupational Safety, Health, and Medicine Research Center, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
- Preventive Medicine Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 88, Sec. 1, Fengxing Road, Taichung, 42743, Taiwan, Republic of China
| | - Peng-Yi Lee
- Department of Radiation Oncology, China Medical University Hospital, No. 2, Yude Road, Taichung, 40447, Taiwan, Republic of China
- Department of Radiation Oncology, China Medical University Beigang Hospital, No.123, Sinde Road, Yunlin, 65152, Taiwan, Republic of China
| | - Cheng-Yu Lin
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
- Sleep Medicine Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, No.2, Yude Road, North District, Taichung, 40447, Taiwan, Republic of China
- College of Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung, 40402, Taiwan, Republic of China
| | - Che-Chen Lin
- Management Office for Health Data, China Medical University Hospital, No.2, Yude Road, North District, Taichung, 40447, Taiwan, Republic of China
- Healthcare Service Research Center, Taichung Veterans General Hospital, No.1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan, Republic of China
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
- Department of Family Medicine, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 70101, Taiwan, Republic of China
| | - Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China
| | - Chen-Long Wu
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China.
- Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China.
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China.
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China.
- Occupational Safety, Health, and Medicine Research Center, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China.
- Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 70403, Taiwan, Republic of China.
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Reynolds RY. Prevalence and characteristics of prediabetes in workers in industry. J Adv Nurs 2019; 76:803-813. [PMID: 31773753 DOI: 10.1111/jan.14276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/02/2019] [Accepted: 11/03/2019] [Indexed: 11/30/2022]
Abstract
AIM To examine the prevalence of work stress and prediabetes in computer technology company employees; to analyse the relationships among stress, work stress, and prediabetes; and to explore the potential mediating effects sleep on the relationship between work stress and prediabetes. DESIGN A descriptive, cross-sectional design was used. A convenience sample included employees from a large computer technology company in central Texas. METHODS Data collection during March-October 2015 included: retrospective electronic medical record review and online surveys. Electronic medical record review data included: height, weight, waist circumference, blood pressure, high-density lipids, triglycerides, and fasting glucose. Online surveys collected demographic, global stress, diet, exercise, coping, sleep and work stress data from participants. Spearman rho calculations analyzed associations between demographic, socio-cultural factors, health behaviours, work stress, and prediabetes variables. Logistic regression analyses identified probability variables. A structural equation model examined mediating variables. RESULTS Prediabetes prevalence was lower and prevalence of work stress was higher in the participant sample than in the USA population. Findings suggested that low job imbalance increases the probability for prediabetes. Job imbalance was inversely related to prediabetes. Three variables increased the probability prediabetes: alcohol, job imbalance, and sleep. Sleep potentially modified the relationship between job imbalance and prediabetes. Participants were college-educated males working in white-collar, technical jobs. Participants had high rates of work stress. Job imbalance was inversely related to prediabetes, which challenges previous empirical data. Future research should continue to explore the relationship between work stress and prediabetes in this population. CONCLUSIONS This study explored the relationship between work stress and prediabetes in a white-collar worker population in technical industry. Findings suggested that workers in industry have a unique type of stress. Nurses who learn to recognize the non-traditional risk factors for prediabetes can improve screening for prediabetes by including work stress and poor sleep questions.
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Petroni ML, Barbanti FA, Bonadonna R, Bruno G, Caletti MT, Croci M, D'Eusebio C, Dei Cas A, Invitti C, Merlo F, Molteni A, Pontiroli A, Trento M, Veronelli A, Vigili de Kreutzenberg S, Marchesini G. Dysfunctional eating in type 2 diabetes mellitus: A multicenter Italian study of socio-demographic and clinical associations. Nutr Metab Cardiovasc Dis 2019; 29:983-990. [PMID: 31353206 DOI: 10.1016/j.numecd.2019.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND AIMS Dysfunctional eating might impact on the management and metabolic control of type 2 diabetes (T2DM), modifying adherence to healthy diet and food choices. METHODS AND RESULTS In a multicenter study, we assessed the prevalence of dysfunctional eating in 895 adult outpatients with T2DM (51% males, median age 67, median BMI 30.3 kg/m2). Socio-demographic and clinical characteristics were recorded; dysfunctional eating was tested by validated questionnaires (Eating Attitude Test-EAT-26, Binge Eating Scale-BES; Night Eating Questionnaire-NEQ); food intake and adherence to Mediterranean diet were also measured (in-house developed questionnaire and Mediterranean Diet Score-MDS). Obesity was present in 52% of cases (10% obesity class III), with higher rates in women; 22% had HbA1c ≥ 8%. The EAT-26 was positive in 19.6% of women vs. 10.2% of men; BES scores outside the normal range were recorded in 9.4% of women and 4.4% of men, with 3.0% and 1.5% suggestive of binge eating disorder, respectively. Night eating (NEQ) was only present in 3.2% of women and 0.4% of men. Critical EAT and BES values were associated with higher BMI, and all NEQ + ve cases, but one, were clustered among BES + ve individuals. Calorie intake increased with BES, NEQ, and BMI, and decreased with age and with higher adherence to Mediterranean diet. In multivariable logistic regression analysis, female sex, and younger age were associated with increase risk of dysfunctional eating. CONCLUSION Dysfunctional eating is present across the whole spectrum of T2DM and significantly impacts on adherence to dietary restriction and food choices.
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Affiliation(s)
- Maria L Petroni
- Department of Medical & Surgical Sciences-DIMEC, "Alma Mater" University, Bologna, Italy
| | - Francesca A Barbanti
- Department of Medical & Surgical Sciences-DIMEC, "Alma Mater" University, Bologna, Italy
| | | | - Graziella Bruno
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maria T Caletti
- Department of Medical & Surgical Sciences-DIMEC, "Alma Mater" University, Bologna, Italy
| | - Marina Croci
- Department of Medical Sciences and Rehabilitation, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara D'Eusebio
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Cecilia Invitti
- Department of Medical Sciences and Rehabilitation, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Fabio Merlo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alberto Molteni
- "Villa Aprica" Cinical Institute, San Donato Group, Como, Italy
| | | | - Marina Trento
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Anna Veronelli
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Giulio Marchesini
- Department of Medical & Surgical Sciences-DIMEC, "Alma Mater" University, Bologna, Italy.
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20
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The Association between Habitual Sleep Duration and Sleep Quality with Glycemic Traits: Assessment by Cross-Sectional and Mendelian Randomization Analyses. J Clin Med 2019; 8:jcm8050682. [PMID: 31096629 PMCID: PMC6572144 DOI: 10.3390/jcm8050682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022] Open
Abstract
Evidence on whether habitual sleep duration and sleep quality are associated with increased insulin resistance is inconsistent. Here, we investigated the associations between different measures of habitual sleep with glycemic traits through cross-sectional and Mendelian randomization (MR) analyses. We assessed the associations of sleep duration and sleep quality with glycemic traits using multivariable linear regression models adjusted for potential confounders in 4672 middle-aged (45–65 years; 48% men) nondiabetic participants of the Netherlands Epidemiology of Obesity (NEO) study. Genetic variants for total, short, and long sleep duration were used as instrumental variables in MR analyses using summary-level data of glycemic traits in nondiabetic individuals (MAGIC; n = 58,074). In cross-sectional analyses, shortest sleepers (median 5.0 h of sleep per night) had 14.5% (95% confidence interval (CI): 2.0; 28.6%) higher fasting insulin level and 16.3% (95% CI: 2.7; 31.7%) higher HOMA-β. Bad sleep quality was associated with higher insulin resistance (e.g., 14.3% (95% CI: 4.7; 24.9%) higher HOMA-IR). All these associations disappeared after adjustment for BMI and the risk of sleep apnea. MR analyses did not indicate a causal association between total, short or long sleep duration and glycemic traits. Therefore, our used measures of habitual sleep duration and sleep quality are unlikely to directly associate with insulin resistance.
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Jeremiah OJ, Cousins G, Leacy FP, Kirby BP, Ryan BK. Evaluation of the effect of insulin sensitivity-enhancing lifestyle- and dietary-related adjuncts on antidepressant treatment response: protocol for a systematic review and meta-analysis. Syst Rev 2019; 8:62. [PMID: 30803432 PMCID: PMC6388470 DOI: 10.1186/s13643-019-0978-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 02/14/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Depression is the leading cause of disability worldwide and is known to be associated with insulin resistance (IR). Insulin resistance worsens the symptoms of depression and reduces the effectiveness of antidepressant medications in some depressed patients. Many studies have assessed the effect of adjunctive exercise, vitamin D supplementation, zinc supplementation, magnesium, probiotics, unsaturated fatty acids, and hygienic-dietary recommendations (sleep hygiene, healthy diet, physical activity, and sunlight exposure, combined or singly used), individually, on antidepressant treatment response. However, despite the reported insulin sensitivity-enhancing potential of these adjuncts, no systematic review has collectively analysed their antidepressant effect with regards to insulin sensitivity. METHODS/DESIGN In this systematic review, we will analyse the effect of the above-stated adjuncts on antidepressant treatment response (primary outcome) in comparison with treatment as usual with or without adjunctive placebo after identifying the relevant trials from a systematic literature search. Randomised controlled trials involving clinically depressed patients with diagnosis of major depressive, dysthymic or bipolar disorder will be considered. Changes in insulin sensitivity parameters, following treatment, will also be analysed as the secondary outcome. Effect estimates of the included trials will be combined using random-effects meta-analysis, while addressing risk of bias issues. Any significant heterogeneity between studies will be explored using sensitivity and subgroup analyses. DISCUSSION The findings of this review will contribute to the evidence base regarding the utility of non-pharmacological insulin-sensitising treatments in enhancing conventional antidepressant treatment response.
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Affiliation(s)
- Olaitan J Jeremiah
- School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), 123, St Stephen's Green, Dublin 2, Ireland
| | - Gráinne Cousins
- School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), 123, St Stephen's Green, Dublin 2, Ireland
| | - Finbarr P Leacy
- Data Science Centre, Royal College of Surgeons in Ireland (RCSI), 123, St Stephen's Green, Dublin 2, Ireland
| | - Brian P Kirby
- School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), 123, St Stephen's Green, Dublin 2, Ireland
| | - Benedict K Ryan
- School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), 123, St Stephen's Green, Dublin 2, Ireland.
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22
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Kronimus Y, Dodel R, Galuska SP, Neumann S. IgG Fc N-glycosylation: Alterations in neurologic diseases and potential therapeutic target? J Autoimmun 2019; 96:14-23. [DOI: 10.1016/j.jaut.2018.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 12/30/2022]
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van Dijk D, Balkau B, Segrestin B, Gottsäter M, Gabriel R, Hatunic M, Mari A, Dekker JM, Rutters F. Associations between sleep duration and sleep debt with insulin sensitivity and insulin secretion in the EGIR-RISC Study. DIABETES & METABOLISM 2018; 45:375-381. [PMID: 30439506 DOI: 10.1016/j.diabet.2018.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 12/30/2022]
Abstract
AIM Extremes in sleep duration play an important role in the development of type 2 diabetes. We examined the associations between sleep duration and sleep debt with estimates of insulin sensitivity and insulin secretion. METHODS Data were derived from the European multi-centre EGIR-RISC study. Sleep duration and sleep debt were derived from a sleep questionnaire asking about sleeping time during the week and during the weekend. Insulin sensitivity and insulin secretion were estimated from a 2-hour Oral Glucose Tolerance Test, with samples every 30 minutes. Associations between sleep duration and sleep debt with insulin sensitivity and insulin secretion, were analysed by multiple linear regression models corrected for possible confounders. RESULTS Sleep data were available in 1002 participants, 46% men, mean age 48 ± 8 years, who had an average sleep duration of 7 ± 1 hours [range 3-14] and an average sleep debt (absolute difference hours sleep weekend days minus weekdays) of 1 ± 1 hour [range 0-8]. With regard to insulin sensitivity, we observed an inverted U-shaped association between sleep duration and the Stumvoll MCR in (mL/kg/min), with a corrected β (95% CI) of 2.05 (0.8; 3.3) and for the quadratic term -0.2 (-0.3; -0.1). Similarly, a U-shaped association between sleep duration and log HOMA-IR in (µU/mL), with a corrected βs of -0.83 (-1.4; -0.24) and 0.06 (0.02; 0.10) for the quadratic term. Confounders showed an attenuating effect on the associations, while BMI mediated 60 to 91% of the association between sleep duration and insulin sensitivity. No significant associations were observed between sleep duration with insulin secretion or between sleep debt with either insulin sensitivity or insulin secretion. CONCLUSIONS Short and long sleep duration are associated with a lower insulin sensitivity, suggesting that sleep plays an important role in insulin resistance and may provide the link with development of type 2 diabetes.
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Affiliation(s)
- D van Dijk
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | - B Balkau
- Centre for Research in Epidemiology and Population Health (CESP), University Paris-Saclay, Université Paris Sud, UVSQ, UMRS 1018, 92300 Villejuif, France
| | - B Segrestin
- Department of Nutrition, CRNH-RA, Lyon 1 University, Hospices civils de Lyon, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - M Gottsäter
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - R Gabriel
- Instituto de Investigación Princesa IP, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Hatunic
- Endocrinology Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Mari
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - J M Dekker
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | - F Rutters
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands.
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Yan M, Fu Z, Qin T, Wu N, Lv Y, Wei Q, Jiang H, Yin P. Associations of sleep duration and prediabetes prevalence in a middle-aged and elderly Chinese population with regard to age and hypertension: The China Health and Retirement Longitudinal Study baseline survey. J Diabetes 2018; 10:847-856. [PMID: 29573578 DOI: 10.1111/1753-0407.12662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/04/2018] [Accepted: 03/17/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The aim of the present study was to examine the age-specific associations between self-reported sleep duration and prevalent prediabetes in middle-aged and elderly Chinese with or without hypertension. METHODS In all, 2985 Chinese adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey were selected for analysis. Sleep duration was assessed by structured questionnaires and then categorized into three groups (≤6, 6-8, and >8 h). The prevalence of prediabetes was defined using fasting plasma glucose (100-125 mg/dL) and/or HbA1c (5.7%-6.4%) in conjunction with no previous diabetes diagnosis and no antidiabetic medication. Relationships between self-reported sleep duration and prevalent prediabetes were examined according to age (45-60 years, middle-aged; ≥60 years, elderly) and hypertension groups using Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CI). RESULTS Compared with the reference group of 6-8 h sleep/night, short sleep (≤6 h/night) was associated with an increased risk of prediabetes in the whole sample (PR 1.09, 95% CI 1.01-1.17) after adjusting for confounders. This association was more pronounced in elderly participants without hypertension (PR 1.27, 95% CI 1.07-1.51). CONCLUSION This study suggests that participants with a short sleep period are at a moderately increased risk of prediabetes, particularly in elderly subjects without hypertension. Aging and hypertension may be important in the relationship between short sleep and impaired glucose metabolism.
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Affiliation(s)
- Mingming Yan
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Fu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Qin
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nanjin Wu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yalan Lv
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qinyun Wei
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongwei Jiang
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Kline CE, Hall MH, Buysse DJ, Earnest CP, Church TS. Poor Sleep Quality is Associated with Insulin Resistance in Postmenopausal Women With and Without Metabolic Syndrome. Metab Syndr Relat Disord 2018; 16:183-189. [PMID: 29649378 DOI: 10.1089/met.2018.0013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Poor sleep quality has previously been shown to be related to insulin resistance in apparently healthy adults. However, it is unclear whether an association between sleep quality and insulin resistance exists among adults with metabolic syndrome (MetS). METHODS Participants included 347 overweight/obese postmenopausal women without type 2 diabetes (age: 57.5 ± 6.5 years; body mass index [BMI]: 31.7 ± 3.7 kg/m2; 54% with MetS). Sleep quality was assessed with the six-item Medical Outcomes Study Sleep Scale; values were categorized into quartiles. Insulin resistance was calculated from fasting glucose and insulin with the homeostasis model assessment of insulin resistance (HOMA2-IR) method. Analysis of covariance models were used to examine the association between sleep quality and HOMA2-IR after accounting for MetS and covariates (e.g., BMI, cardiorespiratory fitness, and energy intake). RESULTS Women with the worst sleep quality had significantly higher HOMA2-IR values than women in all other quartiles (P ≤ 0.05 for each), and women with MetS had significantly higher HOMA2-IR values than women without MetS (P < 0.0001), but the relationship between sleep quality and HOMA2-IR did not differ between those with or without MetS (P = 0.26). Women with MetS in the worst quartile of sleep quality had higher HOMA2-IR values than all other women (P < 0.02). Taking >30 min to fall asleep, frequent restless sleep, and frequent daytime drowsiness were each related to higher HOMA2-IR values (each P < 0.04). CONCLUSIONS Sleep quality is an important correlate of insulin resistance in postmenopausal women with and without MetS. Intervention studies are needed to determine whether improving sleep improves insulin resistance in populations at elevated cardiometabolic risk.
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Affiliation(s)
- Christopher E Kline
- 1 Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Martica H Hall
- 2 Department of Psychiatry, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Daniel J Buysse
- 2 Department of Psychiatry, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Conrad P Earnest
- 3 Department of Health and Kinesiology, Exercise and Sports Nutrition Laboratory, Texas A&M University , College Station, Texas
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Abbott S, Dindol N, Tahrani AA, Piya MK. Binge eating disorder and night eating syndrome in adults with type 2 diabetes: a systematic review. J Eat Disord 2018; 6:36. [PMID: 30410761 PMCID: PMC6219003 DOI: 10.1186/s40337-018-0223-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/02/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2DM) is increasing in prevalence worldwide, and is closely linked to obesity. Binge Eating Disorder (BED) and Night Eating Syndrome (NES) are eating disorders that are common in obesity, and may affect the management as well as long term outcomes of T2DM. Therefore, the aim of this review was to assess the prevalence and associations of BED or NES in adults with T2DM. METHODS We conducted a systematic review. The databases MEDLINE, CINAHL and AMED were searched for articles which met the inclusion criteria; including patients > 18 years old, with T2DM, and BED and/or NES. The reference lists of included studies were also searched. Meta-analysis was not attempted due to the limited number of studies that measured the outcomes of interest. RESULTS A total of 10 studies (2 included NES) were included in this systematic review. The number screened for BED and NES were 6527 and 1039 participants, respectively. Point prevalence was 1.2-8.0% for BED and 3.8-8.4% for NES. Patients with T2DM and BED had higher BMI than patients with T2DM without BED in the two studies that reported BMI. There was no statistically significant difference in HbA1c between patients with and without BED in the two studies that measured HbA1c. CONCLUSIONS BED and NES are common in adults with T2DM, and BED is associated with higher BMI in patients with T2DM. However, only two studies reported important outcomes measures such as BMI and HbA1c in patients with T2DM. Hence, further well-designed studies are needed to assess the impact of BED and NES in patients with T2DM. Health Care Professionals should consider the diagnosis of BED and NES in patients with T2DM.
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Affiliation(s)
- Sally Abbott
- 1Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,2Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,Centre of Endocrinology and Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Naomi Dindol
- 1Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Abd A Tahrani
- 1Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,2Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,Centre of Endocrinology and Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Milan K Piya
- 4Macarthur Clinical School, School of Medicine, Western Sydney University, Campbelltown, NSW Australia.,5Macarthur Diabetes Service, Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Campbelltown, NSW Australia
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Chojnacki KC, Kanagasabai T, Riddell MC, Ardern CI. Associations Between Sleep Habits and Dysglycemia in Adults in the United States: A Cross-Sectional Analysis. Can J Diabetes 2017. [PMID: 28647295 DOI: 10.1016/j.jcjd.2017.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To examine the independent and joint associations between sleep duration and quality with glycated hemoglobin (A1C) levels and dysglycemia in non-institutionalized adults living in the United States. METHODS Data from the United States National Health and Nutrition Examination Survey (2005-2008) were used (N=9478; ≥20 years). Information on sleep quantity and quality were derived from the Sleep Disorders Questionnaire and used to classify sleep quality as good, fair, poor, or very poor. RESULTS Overall, sleep quantity and quality were related to A1C levels in our unadjusted models. In general, a U-shaped relationship between sleep quantity and A1C levels was observed. Compared to those who slept for 7 to 8 hours per night, sleeping for 4 hours or fewer was associated with higher A1C levels (mean, 95% CI; 5.49%, 5.45 to 5.53 vs. 5.69%, 5.60 to 5.77; p<0.05), whereas only those reporting good and very poor sleep quality had higher A1C levels than poor sleepers (mean, 95% CI: 5.63%, 5.57 to 5.69; 5.56%, 5.52 to 5.60 vs. 5.46%, 5.42 to 5.50; p<0.05). The relationships among sleep duration and quality and the joint effects of sleep quality and quantity and dysglycemia were not significant after multivariable adjustment. CONCLUSIONS Between 7 and 8 hours of sleep and fair/poor sleep quality were associated with optimal A1C levels, while sleeping for fewer or more hours appeared to increase dysglycemia, without adjustment for covariates. These relationships were attenuated following multivariable adjustment. Future research is necessary to refine our understanding of the sleep/glycemic-control relationship to provide a context for the clinical significance of these findings for longer-term A1C control in adults with diabetes.
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Affiliation(s)
| | | | - Michael C Riddell
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Chris I Ardern
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
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Rønn PF, Andersen GS, Lauritzen T, Christensen DL, Aadahl M, Carstensen B, Jørgensen ME. Ethnic differences in anthropometric measures and abdominal fat distribution: a cross-sectional pooled study in Inuit, Africans and Europeans. J Epidemiol Community Health 2017; 71:536-543. [DOI: 10.1136/jech-2016-207813] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 12/13/2016] [Accepted: 12/16/2016] [Indexed: 01/27/2023]
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Bhushan B, Ayub B, Thompson DM, Abdullah F, Billings KR. Impact of short sleep on metabolic variables in obese children with obstructive sleep apnea. Laryngoscope 2016; 127:2176-2181. [PMID: 27868206 DOI: 10.1002/lary.26420] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/14/2016] [Accepted: 10/13/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To analyze the association between sleep duration, metabolic variables, and insulin resistance in obese children with and without obstructive sleep apnea. The decline in sleep duration has paralleled a dramatic increase in the prevalence of obesity and diabetes, suggesting a mechanistic relationship. STUDY DESIGN Retrospective, case series. METHODS Consecutive obese patients 3 to 12 years of age who underwent polysomnography (PSG) and a metabolic panel and who completed a 14-item sleep questionnaire were analyzed. All laboratory testing was conducted within 3 months of PSG. Total sleep times were obtained from the PSG and confirmed by the questionnaire. RESULTS A total of 171 patients (55.0% male) were studied. All patients were obese (body mass index [BMI] z score > 95th percentile). Patients were categorized into three groups: short sleepers, borderline sleepers, and optimal sleepers. Eighty-six (50.3%) patients were short sleepers, 71 (41.5%) were borderline sleepers, and 14 (8.2%) were optimal sleepers. The mean BMI z score was 3.13 ± 1.3 in short sleepers, 3.3 ± 1.1 in borderline sleepers, and 3.5 ± 1.5 in optimal sleepers (P = .39). There was no statistical difference in high- and low-density lipoprotein levels (P = .21 and P = .76, respectively) and total cholesterol (P = .43) among subgroups. Triglycerides, blood glucose, insulin, and homeostasis model assessment-insulin resistance were significantly higher in short sleepers when compared to borderline or normal sleepers (P = .008, P < .001, P < .001, and P < .001, respectively). CONCLUSIONS Short sleep duration was correlated with alterations in metabolic variables and insulin resistance in obese patients. This raises concern for development of comorbid conditions that can persist into adulthood. LEVEL OF EVIDENCE 4 Laryngoscope, 127:2176-2181, 2017.
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Affiliation(s)
- Bharat Bhushan
- Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.,Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine
| | - Bushra Ayub
- Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Dana M Thompson
- Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.,Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine
| | - Fizan Abdullah
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.,Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
| | - Kathleen R Billings
- Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.,Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine
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Gozashti MH, Eslami N, Radfar MH, Pakmanesh H. Sleep Pattern, Duration and Quality in Relation with Glycemic Control in People with Type 2 Diabetes Mellitus. IRANIAN JOURNAL OF MEDICAL SCIENCES 2016; 41:531-538. [PMID: 27853334 PMCID: PMC5106569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Sleep disturbances have been shown to be associated with diabetes control, but the relation between planned wakings or napping with glycemic indices has not been evaluated yet. This study evaluated the relation between sleep quality, duration, and pattern, including daytime napping of people with diabetes and their glycemic control. A cross-sectional correlation research design was used for this study. We enrolled 118 people with type 2 diabetes receiving oral agents without major complications at the Shahid Bahonar Center, Kerman. The age, weight, height, serum HbA1c, as well as other glycemic indices and lipid profile were measured. BMI was also calculated. All participants were requested to fill in the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep quality. In addition, they were inquired about their sleep schedule during day and night. Pearson correlation and multiple regression analyses were conducted to examine the correlation between HbA1c and sleep pattern variables. The variables were also compared between participants with or without napping using t-test. All analyses were performed with the SPSS version 19 (SPSS, Chicago, IL, USA). The mean age was 58±11 years and mean HbA1c (%) was 7.8±11 (62±13 mmol/mol). Sleep duration and the number of sleep segments significantly predicted HbA1c (F (2,114)=5.232, P=0.007, R2=0.084). A one-hour increment in sleep duration was associated with a 0.174% (1.4 mmol/mol) decrement in HbA1c. PSQI score did not contribute to the regression model. Moreover, participants who napped (66%) had a lower HbA1c (7.6±1) compared to others (8.1±1.3) (P=0.04). We concluded that napping and segmented sleep are associated with a better glycemic control in type 2 diabetes and there is a linear correlation between sleep duration and better glycemic control.
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Affiliation(s)
- Mohammad Hossein Gozashti
- Department of Endocrinology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran,Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, Kerman, Iran
| | - Nazanin Eslami
- Department of Internal Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hadi Radfar
- Department of Endourology, School of Medicine, Shahid Beheshti University Medical Sciences, Tehran, Iran
| | - Hamid Pakmanesh
- Department of Endourology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran,Correspondence: Hamid Pakmanesh, MD; Department of Endourology, Shahid Bahonar Hospital, Shahid Qarani Street, Kerman, Iran Tel: +98 913 3986871 Fax: +98 34 32235011
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31
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Ahluwalia TS, Troelsen JT, Balslev-Harder M, Bork-Jensen J, Thuesen BH, Cerqueira C, Linneberg A, Grarup N, Pedersen O, Hansen T, Dalgaard LT. Carriers of a VEGFA enhancer polymorphism selectively binding CHOP/DDIT3 are predisposed to increased circulating levels of thyroid-stimulating hormone. J Med Genet 2016; 54:166-175. [PMID: 27627987 DOI: 10.1136/jmedgenet-2016-104084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/08/2016] [Accepted: 08/22/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Levels of serum thyroid-stimulating hormone (TSH) indicate thyroid function, because thyroid hormone negatively controls TSH release. Genetic variants in the vascular endothelial growth factor A (VEGFA) gene are associated with TSH levels. The aim of this study was to characterise the association of VEGFA variants with TSH in a Danish cohort and to identify and characterise functional variants. METHODS We performed an association study of the VEGFA locus for circulating TSH levels in 8445 Danish individuals. Lead variants were tested for allele-specific effects in vitro using luciferase reporter and gel-shift assays. RESULTS Four SNPs in VEGFA were associated with circulating TSH (rs9472138, rs881858, rs943080 and rs4711751). For rs881858, the presence of each G-allele was associated with a corresponding decrease in TSH levels of 2.3% (p=8.4×10-9) and an increase in circulating free T4 levels (p=0.0014). The SNP rs881858 is located in a binding site for CHOP (C/EBP homology protein) and c/EBPβ (ccaat enhancer binding protein β). Reporter-gene analysis showed increased basal enhancer activity of the rs881858 A-allele versus the G-allele (34.5±9.9% (average±SEM), p=0.0012), while co-expression of CHOP effectively suppressed the rs881858 A-allele activity. The A-allele showed stronger binding to CHOP in gel-shift assays. CONCLUSIONS VEGF is an important angiogenic signal required for tissue expansion. We show that VEGFA variation giving allele-specific response to transcription factors with overlapping binding sites associate closely with circulating TSH levels. Because CHOP is induced by several types of intracellular stress, this indicates that cellular stress could be involved in the normal or pathophysiological response of the thyroid to TSH. TRIAL REGISTRATION NUMBER NCT00289237, NCT00316667; Results.
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Affiliation(s)
- Tarunveer Singh Ahluwalia
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center, Gentofte, Denmark
| | | | - Marie Balslev-Harder
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jette Bork-Jensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Charlotte Cerqueira
- Research Centre for Prevention and Health, The Capital Region, Glostrup, Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, The Capital Region, Glostrup, Denmark.,Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Simpson NS, Gibbs EL, Matheson GO. Optimizing sleep to maximize performance: implications and recommendations for elite athletes. Scand J Med Sci Sports 2016; 27:266-274. [PMID: 27367265 DOI: 10.1111/sms.12703] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 01/07/2023]
Abstract
Despite a growing body of literature demonstrating a positive relationship between sleep and optimal performance, athletes often have low sleep quality and quantity. Insufficient sleep among athletes may be due to scheduling constraints and the low priority of sleep relative to other training demands, as well as a lack of awareness of the role of sleep in optimizing athletic performance. Domains of athletic performance (e.g., speed and endurance), neurocognitive function (e.g., attention and memory), and physical health (e.g., illness and injury risk, and weight maintenance) have all been shown to be negatively affected by insufficient sleep or experimentally modeled sleep restriction. However, healthy adults are notoriously poor at self-assessing the magnitude of the impact of sleep loss, underscoring the need for increased awareness of the importance of sleep among both elite athletes and practitioners managing their care. Strategies to optimize sleep quality and quantity in athletes include approaches for expanding total sleep duration, improving sleep environment, and identifying potential sleep disorders.
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Affiliation(s)
- N S Simpson
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - E L Gibbs
- PGSP-Stanford PsyD Consortium, Palo Alto, CA, USA
| | - G O Matheson
- Division of Sports Medicine & Human Performance Lab, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Vestmar MA, Andersson EA, Christensen CR, Hauge M, Glümer C, Linneberg A, Witte DR, Jørgensen ME, Christensen C, Brandslund I, Lauritzen T, Pedersen O, Holst B, Grarup N, Schwartz TW, Hansen T. Functional and genetic epidemiological characterisation of the FFAR4 (GPR120) p.R270H variant in the Danish population. J Med Genet 2016; 53:616-23. [PMID: 27068006 DOI: 10.1136/jmedgenet-2015-103728] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/17/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND p.R270H (rs116454156) in the long chain fatty acid 7TM receptor FFAR4 (GPR120) which results in impaired Gαq (Gq) coupled signalling, has been associated with obesity. We aimed to extend the functional in vitro analyses of p.R270H and to investigate the association with obesity and glucose-related traits in the Danish population. METHODS Surface expression, Gq and Gi coupled signalling as well as β-arrestin recruitment were examined in vitro. p.R270H was genotyped using the exome chip array in 11 479 Danish adult individuals. Of these 4391 were obese and 4415 were normal weight. Association with quantitative metabolic traits comprised 8720 non-diabetic individuals. RESULTS p.R270H showed reduced surface expression of FFAR4. Ligand-independent activity was eliminated and strongly impaired through the Gq and Gi signalling pathways, respectively. The ligand-induced maximal signalling efficacy of p.R270H was reduced only through the Gq pathway. The p.R270H variant did not affect β-arrestin recruitment. p.R270H was not associated with increased risk of obesity nor increased fasting plasma glucose levels in the Danish study populations. Nor was it associated with these two traits in the European Network for Genetic and Genomic Epidemiology consortium data (N=34 901-71 175; p>0.70). It was also not associated with waist-hip ratio, glucose metabolism during an oral glucose tolerance test, lipid levels or with markers of adiposity (leptin, adiponectin), inflammation (high-sensitive C reactive protein; hs-CRP) and liver function (alanine aminotransferase) in the Danish population (p>0.05). CONCLUSIONS We demonstrate that p.R270H of FFAR4 impairs Gq and Gi signalling of FFAR4 in vitro; however, this impaired signalling for p.R270H does not translate into associations with human metabolic phenotypes in the investigated populations.
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Affiliation(s)
- Marie A Vestmar
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark Section for Metabolic Receptology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ehm A Andersson
- Section of Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte R Christensen
- Section for Metabolic Receptology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Section of Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Hauge
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark Section for Metabolic Receptology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Glümer
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen, Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen, Denmark Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Daniel R Witte
- Section for General Practice, Department of Public Health, Aarhus University, Denmark
| | - Marit E Jørgensen
- Steno Diabetes Center, Gentofte, Denmark Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Cramer Christensen
- Department of Internal Medicine and Endocrinology, SLB, Vejle Hospital, Vejle, Denmark
| | - Ivan Brandslund
- Department of Clinical Biochemistry, Vejle Hospital, Vejle, Denmark Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Torsten Lauritzen
- Section for General Practice, Department of Public Health, Aarhus University, Denmark
| | - Oluf Pedersen
- Section of Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Holst
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark Section for Metabolic Receptology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Section of Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thue W Schwartz
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark Section for Metabolic Receptology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Section of Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Turner SL, Queen TL, Butner J, Wiebe D, Berg CA. Variations in Daily Sleep Quality and Type 1 Diabetes Management in Late Adolescents. J Pediatr Psychol 2016; 41:661-9. [PMID: 26994852 DOI: 10.1093/jpepsy/jsw010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 01/23/2016] [Indexed: 11/12/2022] Open
Abstract
UNLABELLED OBJECTIVE : To determine how between- and within-person variability in perceived sleep quality were associated with adolescent diabetes management. METHODS A total of 236 older adolescents with type 1 diabetes reported daily for 2 weeks on sleep quality, self-regulatory failures, frequency of blood glucose (BG) checks, and BG values. Average, inconsistent, and daily deviations in sleep quality were examined. RESULTS : Hierarchical linear models indicated that poorer average and worse daily perceived sleep quality (compared with one's average) was each associated with more self-regulatory failures. Sleep quality was not associated with frequency of BG checking. Poorer average sleep quality was related to greater risk of high BG. Furthermore, inconsistent and daily deviations in sleep quality interacted to predict higher BG, with more consistent sleepers benefitting more from a night of high-quality sleep. CONCLUSIONS : Good, consistent sleep quality during late adolescence may benefit diabetes management by reducing self-regulatory failures and risk of high BG.
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Affiliation(s)
| | - Tara L Queen
- Department of Psychology, University of Utah and
| | | | - Deborah Wiebe
- Department of Psychological Sciences, University of California
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35
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Tanik N, Sarp U, Ucar M, Celikbilek A, Balbaloglu O, Ak H, Atalay T, Arik HO, Okyay MY, Inan LE. Pain, depression and sleep disorders in patients with diabetic and nondiabetic carpal tunnel syndrome: a vicious cycle. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:207-11. [DOI: 10.1590/0004-282x20160020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 11/10/2015] [Indexed: 12/18/2022]
Abstract
ABSTRACT Carpal tunnel syndrome (CTS) is a condition involving nerve entrapment that often leads to chronic neuropathic pain. We aimed to evaluate sleep quality and related parameters in diabetic and non-diabetic CTS patients. Method This study included a total of 366 patients with chronic CTS. These patients’ sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and depression using the Beck Depression Inventory (BDI). The severity of neuropathic pain was evaluated using the Douleur Neuropathique-4 (DN4) questionnaire and a visual analogue scale (VAS). Results In the non-diabetic patient group, the total PSQI score was found to affect BDI and VAS, while in the diabetic patient group, the duration of symptoms affected VAS, BDI and fasting glucose levels. Conclusion For diabetic patients, hyperglycemia depression and chronification of neuropathic pain may lead to deterioration of sleep quality. Therefore, consideration of these parameters in the treatment may break a vicious cycle.
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Affiliation(s)
| | | | | | | | | | - Hakan Ak
- Bozok University Medical School, Turkey
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36
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Damgaard-Olesen A, Johannsen TH, Holmboe SA, Søeborg T, Petersen JH, Andersson A, Aadahl M, Linneberg A, Juul A. Reference ranges of 17-hydroxyprogesterone, DHEA, DHEAS, androstenedione, total and free testosterone determined by TurboFlow-LC-MS/MS and associations to health markers in 304 men. Clin Chim Acta 2016; 454:82-8. [PMID: 26765096 DOI: 10.1016/j.cca.2015.12.042] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 12/31/2015] [Indexed: 12/01/2022]
Abstract
We report reference ranges based on LC-MS/MS for testosterone (T), free testosterone (FT) and its precursors, i.e. 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHEA), DHEA-sulfate (DHEAS) and androstenedione (Adione), in relation to different health markers and lifestyle factors. The study was based on 304 healthy men aged 30-61 years participating in a population-based cross-sectional study (Health2008). Examination program consisted of a clinical examination, completion of a self-administered questionnaire and blood sampling. Steroid metabolites were measured by a validated and sensitive LC-MS/MS method. Older age-groups were significantly associated with decreased concentrations of DHEA, DHEAS, Adione, and FT, while no significant associations with age were shown for 17-OHP or T. Participants with BMI≥30 kg/m(2) had lower age-related steroid metabolite z-scores compared to participants with BMI<30 kg/m(2), i.e. 17-OHP: -0.51 vs. 0.08 (p<0.001); DHEA: -0.27 vs. 0.09 (p=0.014); Adione: -0.29 vs. 0.09 (p=0.012); T: -0.99 vs. 0.14 (p<0.001); and FT -0.55 vs. 0.05 (p<0.001), respectively. In conclusion, this large study on serum steroid metabolites and concomitant assessment of health markers in healthy men provides age-related reference ranges, and furthermore evaluates the impact of lifestyle factors and metabolic syndrome on androgen metabolite levels.
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Affiliation(s)
- A Damgaard-Olesen
- Department of Growth and Reproduction Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, EDMaRC, Denmark
| | - T H Johannsen
- Department of Growth and Reproduction Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, EDMaRC, Denmark
| | - S A Holmboe
- Department of Growth and Reproduction Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, EDMaRC, Denmark
| | - T Søeborg
- Department of Growth and Reproduction Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, EDMaRC, Denmark
| | - J H Petersen
- Department of Growth and Reproduction Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark; Department of Biostatistics, University of Copenhagen, Denmark
| | - Am Andersson
- Department of Growth and Reproduction Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, EDMaRC, Denmark
| | - M Aadahl
- Research Centre for Prevention and Health, Glostrup University Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark; Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - A Linneberg
- Research Centre for Prevention and Health, Glostrup University Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark; Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - A Juul
- Department of Growth and Reproduction Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, EDMaRC, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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Abstract
Pre-diabetes and diabetes occur secondary to a constellation of pathophysiological abnormalities that culminate in insulin resistance, which results in reduced cellular glucose uptake and increased glucose production. Although pre-diabetes and diabetes have a strong genetic basis, they are largely environmentally driven through lifestyle factors. Traditional lifestyle factors such as diet and physical activity do not fully explain the dramatic rise in the incidence and prevalence of diabetes mellitus. Sleep has emerged as an additional lifestyle behavior, important for metabolic health and energy homeostasis. In this article, we review the current evidence surrounding the sleep-diabetes association.
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Affiliation(s)
- Teresa Arora
- Department of Medicine, Weill Cornell Medical College in Qatar, Room C008, Qatar Foundation, Education City, PO Box 24144, Doha, Qatar
- Department of Medicine, Weill Cornell Medical College, New York, USA
| | - Shahrad Taheri
- Department of Medicine, Weill Cornell Medical College in Qatar, Room C008, Qatar Foundation, Education City, PO Box 24144, Doha, Qatar.
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Skaaby T, Husemoen LLN, Thuesen BH, Jørgensen T, Linneberg A. Lifestyle-Related Factors and Atopy in Seven Danish Population-Based Studies from Different Time Periods. PLoS One 2015; 10:e0137406. [PMID: 26372449 PMCID: PMC4570778 DOI: 10.1371/journal.pone.0137406] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 08/17/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence of allergic respiratory disease tends to increase in populations that adopt the so-called Westernized lifestyle. We investigated the association between atopy and several possible lifestyle-related factors in seven Danish population-based studies. METHODS A total of 20048 persons participated in the seven studies. We used logistic regression to analyse the associations between possible determinants and atopy defined as serum specific IgE or skin prick test positivity against inhalant allergens. Associations were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). In addition, individual participant data meta-analyses were performed. RESULTS Atopy was significantly associated with younger age (OR per 1 year increase in age: 0.97; 95% CI: 0.97, 0.98); male sex (OR for males versus females: 1.34; 95% CI: 1.24, 1.45), heavy drinking (OR for heavy drinkers versus light drinkers: 1.15; 95% CI: 1.04, 1.27), never smoking (OR for current versus never smokers: 0.73; 95% CI: 0.67, 0.80), and higher educational level (OR for educated versus uneducated: 1.27; 95% CI: 1.15, 1.41). Atopy was not associated with blood pressure, serum total cholesterol, physical activity or body mass except in women only, where we found a positive association (OR for obese vs. normal weight: 1.18; 95% CI: 1.00, 1.39) with ptrend = 0.032. CONCLUSIONS Of interest for preventive purposes, we found that atopy was associated with some of the reversible lifestyle-related factors that characterize a Westernized lifestyle.
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Affiliation(s)
- Tea Skaaby
- Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark
| | | | | | - Torben Jørgensen
- Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Medicine, Alborg University, Alborg, Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark
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39
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Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. J Clin Sleep Med 2015; 11:931-52. [PMID: 26235159 DOI: 10.5664/jcsm.4950] [Citation(s) in RCA: 267] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 12/19/2022]
Abstract
The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.
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40
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Husemoen LLN, Ebstrup JF, Mortensen EL, Schwarz P, Skaaby T, Thuesen BH, Jørgensen T, Linneberg A. Serum 25-hydroxyvitamin D and self-reported mental health status in adult Danes. Eur J Clin Nutr 2015; 70:78-84. [PMID: 26264349 DOI: 10.1038/ejcn.2015.129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 06/20/2015] [Accepted: 06/28/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Vitamin D receptors and vitamin D-metabolising enzymes are present in the brain and in the central nervous system at sites responsible for the regulation of emotions and behaviour. This raises the hypothesis that low vitamin D is related to poor mental health. Our aim was to examine the association between serum 25-hydroxyvitamin D (25(OH)D) and the self-reported symptoms and diagnosis of depression and anxiety in the adult general population. SUBJECTS/METHODS Serum 25(OH)D was measured in three Danish population-based studies, including 5308 adults aged 18-64 years. After 5 years, 2004 participants were re-examined. Symptoms of depression and anxiety were assessed by the Symptom Check List (SCL)-90-R, and self-reported doctor-diagnosed depression and anxiety was recorded by using a questionnaire. RESULTS Serum 25(OH)D was not associated with SCL average scores for depression and anxiety when analysed by quantile median regression adjusted for sex, age and other potential confounders. The β-coefficient and 95% confidence interval (CI) per 10 nmol/l serum 25(OH)D were 0.00 (-0.00 to 0.01) and P=0.23 for depression and -0.00 (-0.01 to 0.00) and P=0.19 for anxiety. Furthermore, no evidence of an association was observed with longitudinal changes (combining depression and anxiety score: β (95% CI)=0.00 (-0.00 to 0.00), P=0.90), with scores >90 percentiles (odds ratio (OR) (95% CI)=1.02 (0.98-1.07), P=0.32), or with self-reported history (OR (95% CI)=1.02 (0.97-1.07), P=0.47) or incidence (OR (95% CI)=1.02 (0.92-1.12), P=0.77) of doctor-diagnosed depression and/or anxiety. CONCLUSIONS Our results suggest that low serum 25(OH)D is not associated with self-reported symptoms/diagnosis of depression and anxiety.
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Affiliation(s)
- L L N Husemoen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup Hospital, Glostrup, Denmark
| | - J F Ebstrup
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup Hospital, Glostrup, Denmark
| | - E L Mortensen
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P Schwarz
- Research Centre for Ageing and Osteoporosis, Department of Medicine M, Copenhagen University Hospital Glostrup, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Skaaby
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup Hospital, Glostrup, Denmark
| | - B H Thuesen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup Hospital, Glostrup, Denmark
| | - T Jørgensen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup Hospital, Glostrup, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Faculty of Medicine, University of Aalborg, Aalborg, Denmark
| | - A Linneberg
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup Hospital, Glostrup, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark
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Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. Sleep 2015; 38:1161-83. [PMID: 26194576 DOI: 10.5665/sleep.4886] [Citation(s) in RCA: 494] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 12/24/2022] Open
Abstract
The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.
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Harder MN, Appel EVR, Grarup N, Gjesing AP, Ahluwalia TS, Jørgensen T, Christensen C, Brandslund I, Linneberg A, Sørensen TIA, Pedersen O, Hansen T. The type 2 diabetes risk allele of TMEM154-rs6813195 associates with decreased beta cell function in a study of 6,486 Danes. PLoS One 2015; 10:e0120890. [PMID: 25799151 PMCID: PMC4370672 DOI: 10.1371/journal.pone.0120890] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/27/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES A trans-ethnic meta-analysis of type 2 diabetes genome-wide association studies has identified seven novel susceptibility variants in or near TMEM154, SSR1/RREB1, FAF1, POU5F1/TCF19, LPP, ARL15 and ABCB9/MPHOSPH9. The aim of our study was to investigate associations between these novel risk variants and type 2 diabetes and pre-diabetic traits in a Danish population-based study with measurements of plasma glucose and serum insulin after an oral glucose tolerance test in order to elaborate on the physiological impact of the variants. METHODS Case-control analyses were performed in up to 5,777 patients with type 2 diabetes and 7,956 individuals with normal fasting glucose levels. Quantitative trait analyses were performed in up to 5,744 Inter99 participants naïve to glucose-lowering medication. Significant associations between TMEM154-rs6813195 and the beta cell measures insulinogenic index and disposition index and between FAF1-rs17106184 and 2-hour serum insulin levels were selected for further investigation in additional Danish studies and results were combined in meta-analyses including up to 6,486 Danes. RESULTS We confirmed associations with type 2 diabetes for five of the seven SNPs (TMEM154-rs6813195, FAF1-rs17106184, POU5F1/TCF19-rs3130501, ARL15-rs702634 and ABCB9/MPHOSPH9-rs4275659). The type 2 diabetes risk C-allele of TMEM154-rs6813195 associated with decreased disposition index (n=5,181, β=-0.042, p=0.012) and insulinogenic index (n=5,181, β=-0.032, p=0.043) in Inter99 and these associations remained significant in meta-analyses including four additional Danish studies (disposition index n=6,486, β=-0.042, p=0.0044; and insulinogenic index n=6,486, β=-0.037, p=0.0094). The type 2 diabetes risk G-allele of FAF1-rs17106184 associated with increased levels of 2-hour serum insulin (n=5,547, β=0.055, p=0.017) in Inter99 and also when combining effects with three additional Danish studies (n=6,260, β=0.062, p=0.0040). CONCLUSION Studies of type 2 diabetes intermediary traits suggest the diabetogenic impact of the C-allele of TMEM154-rs6813195 is mediated through reduced beta cell function. The impact of the diabetes risk G-allele of FAF1-rs17106184 on increased 2-hour insulin levels is however unexplained.
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Affiliation(s)
- Marie Neergaard Harder
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Emil Vincent Rosenbaum Appel
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anette Prior Gjesing
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tarunveer S. Ahluwalia
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Danish Pediatric Asthma Center, Gentofte Hospital, The Capital Region, Copenhagen, Denmark
| | - Torben Jørgensen
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Ivan Brandslund
- Department of Clinical Immunology and Biochemistry, Lillebaelt Hospital, Vejle Hospital, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
- Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I. A. Sørensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Imaizumi H, Takahashi A, Tanji N, Abe K, Sato Y, Anzai Y, Watanabe H, Ohira H. The Association between Sleep Duration and Non-Alcoholic Fatty Liver Disease among Japanese Men and Women. Obes Facts 2015; 8:234-42. [PMID: 26138724 PMCID: PMC5644852 DOI: 10.1159/000436997] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/23/2015] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To examine the relationship between sleep duration and non-alcoholic fatty liver disease (NAFLD). METHODS We evaluated 3,968 subjects who underwent health check-ups from June 2012 to May 2013 at the Watari Hospital Health Center in Fukushima Prefecture in Japan. Fatty liver was detected by ultrasonography. Sleep duration and lifestyle factors were estimated using a questionnaire. Sleep duration was categorized into the following groups: ≤ 6, 6 to ≤ 7, >7 to ≤ 8, and >8 h. The four sleep duration groups were compared using the χ(2) test and Kruskal-Wallis test. RESULTS In total, 2,172 subjects were enrolled. The overall prevalence of NAFLD was 29.6% (men, 38.0%; women, 25.3%). The proportion of NAFLD tended to decrease as sleep duration increased in men. The proportion with NAFLD was lowest in the group with a sleep duration of 6 to ≤ 7 h and highest in the groups with sleep durations of ≤ 6 and >8 h in women. The distribution showed a U-shaped curve. The age-adjusted odds ratio (OR) (95% confidence interval (CI)) for subjects with NAFLD with a sleep duration ≤ 6 h compared to the reference (6 to ≤ 7 h) was 1.44 (1.06-1.96) in women. CONCLUSION Sleep shortage tends to be associated with NAFLD in women and may be mediated by body adiposity.
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Affiliation(s)
- Hiromichi Imaizumi
- Department of Gastroenterology and Rheumatology, Fukushima Medical School of Medicine, Fukushima, Japan
| | - Atsushi Takahashi
- Department of Gastroenterology and Rheumatology, Fukushima Medical School of Medicine, Fukushima, Japan
- Department of Gastroenterology, Watari Hospital, Fukushima, Japan
- *Atsushi Takahashi, MD, Department of Gastroenterology and Rheumatology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan,
| | - Nobuo Tanji
- Department of Gastroenterology, Watari Hospital, Fukushima, Japan
| | - Kazumichi Abe
- Department of Gastroenterology and Rheumatology, Fukushima Medical School of Medicine, Fukushima, Japan
| | - Yuji Sato
- Department of Surgery, Watari Hospital, Fukushima, Japan
| | - Yukio Anzai
- Department of Gastroenterology, Watari Hospital, Fukushima, Japan
| | - Hiroshi Watanabe
- Department of Gastroenterology and Rheumatology, Fukushima Medical School of Medicine, Fukushima, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology and Rheumatology, Fukushima Medical School of Medicine, Fukushima, Japan
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WANG QIUYAN, SUN XIAOHUI, LI XIAOBIN, DONG XIANG, LI PENG, ZHAO LI. Resveratrol attenuates intermittent hypoxia-induced insulin resistance in rats: involvement of Sirtuin 1 and the phosphatidylinositol-4,5-bisphosphate 3-kinase/AKT pathway. Mol Med Rep 2015; 11:151-8. [PMID: 25352008 PMCID: PMC4237082 DOI: 10.3892/mmr.2014.2762] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 10/01/2014] [Indexed: 02/03/2023] Open
Abstract
Obstructive sleep apnea can induce chronic intermittent hypoxia (CIH) during sleep and is associated with obesity and diabetes. Resveratrol (RSV), a polyphenolic phytoalexin, can regulate glucose metabolism, thereby reducing insulin resistance. The present study aimed to assess whether RSV attenuates CIH-induced insulin resistance in rats and the underlying mechanisms. A total of 40 rats were randomly assigned into five groups: i) Control; ii) subjected to CIH only; iii) subjected to CIH and treated with 3 mg/kg/day of RSV; iv) subjected to CIH and treated with 30 mg/kg/day of RSV; v) subjected to CIH and treated with 60 mg/kg/day of RSV. All animals were sacrificed following 28 days of treatment. Subsequently, the blood and livers were harvested and blood insulin and glucose levels were measured. Levels of sirtuin (Sirt) 1, insulin receptor (InsR) and glucose transporter 2 (Glut2) in the liver were measured. RSV treatment was demonstrated to suppress weight gain and improve hepatic morphology. RSV treatment also significantly reduced the homeostasis model assessment estimate of insulin resistance of the rats exposed to CIH. This effect occurred in a dose-dependent manner. RSV significantly upregulated liver Sirt1 levels and inhibited InsR and Glut2 expression in the liver. Additionally, RSV activated the phosphorylation of phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) and AKT. The present study demonstrates that RSV prevents CIH-induced insulin resistance in rats. Upregulation of Sirt1 and activation of PI3K/AKT signaling may be involved in this process.
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Affiliation(s)
- QIUYAN WANG
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - XIAOHUI SUN
- Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian 116011, P.R. China
| | - XIAOBIN LI
- Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian 116011, P.R. China
| | - XIANG DONG
- Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian 116011, P.R. China
| | - PENG LI
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - LI ZHAO
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
- Correspondence to: Dr Li Zhao, Department of Respiratory Medicine, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping, Shenyang, Liaoning 110001, P.R. China, E-mail:
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Hui SKA, Grandner MA. Associations between Poor Sleep Quality and Stages of Change of Multiple Health Behaviors among Participants of Employee Wellness Program. Prev Med Rep 2015; 2:292-299. [PMID: 26046013 PMCID: PMC4450439 DOI: 10.1016/j.pmedr.2015.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. METHODS The current study is an analysis of data collected in 2008 from an online health risk assessment (HRA) survey completed by participants of the Kansas State employee wellness program (N=13,322). Using multinomial logistic regression, associations between self-reported sleep quality and stages of change (i.e. precontemplation, contemplation, preparation, action, maintenance) in five health behaviors (stress management, weight management, physical activities, alcohol use, and smoking) were analyzed. RESULTS Adjusted for covariates, poor sleep quality was associated with an increased likelihood of contemplation, preparation, and in some cases action stage when engaging in the health behavior change process, but generally a lower likelihood of maintenance of the healthy behavior. CONCLUSIONS The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population.
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Affiliation(s)
- Siu-kuen Azor Hui
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Michael A. Grandner
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Galindo Muñoz JS, Jiménez Rodríguez D, Hernández Morante JJ. Diurnal rhythms of plasma GLP-1 levels in normal and overweight/obese subjects: lack of effect of weight loss. J Physiol Biochem 2014; 71:17-28. [PMID: 25543251 DOI: 10.1007/s13105-014-0375-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 12/17/2014] [Indexed: 12/16/2022]
Abstract
Food intake is regulated by not only neurohormonal, but also social, educational, and even cultural factors. Within the former, there is a complex interaction between orexigenic (ghrelin) and anorexigenic (glucagon-like peptide-1 (GLP-1)) factors in order to adjust the food intake to caloric expenditure; however, the number of subjects that are unable to properly balance appetite and body weight is increasing continuously. A loss of circadian or diurnal coordination of any of these factors may be implied in this situation. Special attention has retrieved GLP-1 due to its usefulness as a therapeutic agent against obesity and related alterations. Thus, the objective of the present study was to compare GLP-1 diurnal synthesis between normal weight and overweight/obese subjects, and to evaluate whether weight loss can restore the synthesis rhythms of GLP-1. Three groups of 25 subjects were divided attending to their body mass index (BMI) in normal weight, overweight, or obese subjects. Diurnal (5 points) GLP-1 levels were analyzed. Secondly, an intervention (behavioral-dietary treatment) study was conducted to analyze the effect of weight loss on plasma GLP-1 concentrations. Our results showed that baseline GLP-1 level was significantly lower in normal weight subjects (p = 0.003); furthermore, our cosinor analysis revealed a higher amplitude (p = 0.040) and daily GLP-1 variation (47%) in these subjects. In fact, our ANOVA data showed a lack of rhythmicity in overweight/obese patients. Weight loss was not able to restore a diurnal rhythm of plasma GLP-1 levels. In summary, the present work shows a disruption of diurnal GLP-1 levels in overweight/obese subjects, which worsen as body fat progresses. The attenuation of the GLP-1 synthesis rhythms may be important to understand the impairment of food intake regulation in overweight/obese subjects.
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Affiliation(s)
- Joaquín Santiago Galindo Muñoz
- Department of Nursing. Faculty of Nursing, Catholic University of Murcia, Campus de Guadalupe, s/n, 30107, Murcia, Spain
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Baoying H, Hongjie C, Changsheng Q, Peijian W, Qingfei L, Yinghua L, Huibin H, Jixing L, Liantao L, Ling C, Kaka T, Zichun C, Lixiang L, Jieli L, Yufang B, Guang N, Penli Z, Junping W, Gang C. Association of napping and night-time sleep with impaired glucose regulation, insulin resistance and glycated haemoglobin in Chinese middle-aged adults with no diabetes: a cross-sectional study. BMJ Open 2014; 4:e004419. [PMID: 25056969 PMCID: PMC4120253 DOI: 10.1136/bmjopen-2013-004419] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess associations between napping and night-time sleep duration with impaired glucose regulation, insulin resistance (IR) and glycated haemoglobin (HbA1c). DESIGN Cross-sectional study. SETTING Fujian Province, China, from June 2011 to January 2012. PARTICIPANTS This study enrolled 9028 participants aged 40-65 years. Data of 7568 participants with no diabetes were included for analysis. Type 2 diabetes was defined applying WHO criteria. OUTCOME MEASURES Participants' daytime napping and night-time sleep duration data were collected using a standardised self-reported Chinese-language questionnaire about sleep frequency and quality. Anthropometric and laboratory parameters were also measured. IR was defined as a HOMA-IR index value >2.50. ORs and 95% CIs were derived from multivariate logistic regression models. RESULTS Participants (mean age 51.1±7.0 years) included 3060 males and 4508 females with average night-time sleep of 7.9 h. A higher proportion of males napped than females. After adjustment for potential confounders, ORs for HbA1c >6.0% were 1.28 and 1.26 for those napping ≤1 h and >1 h (p=0.002 and p=0.018), respectively. Statistically significant differences in IR between nappers and non-nappers were only marginal clinically. Odds for HbA1c >6.0% were significantly lower in participants with longer night-time sleep durations than in the reference group (>8 h vs 6-8 h). Odds for IR were significantly lower in participants whose night-time sleep hours deviated from the reference group (<6 h, >8 h vs 6-8 h) CONCLUSIONS Chinese middle-aged adults with no diabetes who napped had higher HbA1c and IR; those with shorter night-time sleep durations had increased HbA1c. Night-time sleep hours that are either <6 or >8 tend to be associated with lower odds for IR. Further studies are necessary to determine the underlying clinical significance and mechanisms behind these associations.
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Affiliation(s)
- Huang Baoying
- Department of Endocrinology, Ningde Municipal Hospital, Fujian Medical University, Ningde, China
| | - Chen Hongjie
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Qiu Changsheng
- Department of Osteology, Wuyishan Municipal Hospital, Fujian Provincial Hospital, Wuyishan, China
| | - Wu Peijian
- Department of Endocrinology, Ningde Municipal Hospital, Fujian Medical University, Ningde, China
| | - Lin Qingfei
- Department of Osteology, Wuyishan Municipal Hospital, Fujian Provincial Hospital, Wuyishan, China
| | - Lin Yinghua
- Department of Endocrinology, Ningde Municipal Hospital, Fujian Medical University, Ningde, China
| | - Huang Huibin
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Liang Jixing
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Li Liantao
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Chen Ling
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Tang Kaka
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Chen Zichun
- Department of Endocrinology, Ningde Municipal Hospital, Fujian Medical University, Ningde, China
| | - Lin Lixiang
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Lu Jieli
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bi Yufang
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ning Guang
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhu Penli
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Wen Junping
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
| | - Chen Gang
- Department of Endocrinology, Fujian Provincial Hospital Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou, China
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Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 2014; 6:338-50. [PMID: 24164804 PMCID: PMC4557691 DOI: 10.1111/1753-0407.12101] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 09/11/2013] [Accepted: 10/21/2013] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is limited information from population-based investigations of the associations between sleep duration and sleep disorders and parameters of glucose homeostasis. The objective of the present study was to examine cross-sectional associations between sleep duration and sleep disordered breathing with concentrations of insulin, fasting and 2-h glucose, and HbA1c. METHODS Data from 11 815 adults aged ≥20 years without diagnosed diabetes (5002 with an oral glucose tolerance test) from the National Health and Nutrition Examination Survey 2005-2010 were used. Information about sleep duration (2005-2010) and sleep apnea and sleep-disordered breathing (2005-2008) was obtained via questionnaire. RESULTS An estimated 36.0% of participants reported sleeping ≤6 h/night, 62.0% reported sleeping 7-9 h/night, and 2.0% reported sleeping ≥10 h/night. In 2005-2008, 33.0% reported snoring ≥5 nights per week, 5.9% reported they snorted, gasped, or stopped breathing ≥5 nights/week, and 4.2% reported sleep apnea. Sleep duration was significantly associated with fasting concentrations of insulin and concentrations of HbA1c only in models that did not adjust for body mass index (BMI). Concentrations of fasting and 2-h glucose were significantly associated with sleep duration in models that adjusted only for age. Snoring frequency was positively associated with concentrations of insulin and HbA1c. Frequency of snorting or stopping breathing and sleep apnea status were associated with concentrations of insulin and of HbA1c only when BMI was not accounted for. CONCLUSION In a representative sample of US adults, concentrations of insulin and HbA1c were significantly associated with short sleep duration, possibly mediated by BMI.
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Affiliation(s)
- Earl S Ford
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Ohkuma T, Fujii H, Iwase M, Ogata-Kaizu S, Ide H, Kikuchi Y, Idewaki Y, Jodai T, Hirakawa Y, Nakamura U, Kitazono T. U-shaped association of sleep duration with metabolic syndrome and insulin resistance in patients with type 2 diabetes: the Fukuoka Diabetes Registry. Metabolism 2014; 63:484-91. [PMID: 24411997 DOI: 10.1016/j.metabol.2013.12.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 11/19/2013] [Accepted: 12/03/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Sleep duration is suggested to be associated with adverse health outcomes. However, few studies are available on the impact of sleep duration on metabolic syndrome in patients with diabetes, who were at high risk for cardiovascular diseases (CVD). The objective of the present study was to examine the associations of sleep duration with metabolic syndrome and insulin resistance, a major pathophysiologic feature of metabolic syndrome, in patients with type 2 diabetes. MATERIALS/METHODS A total of 4402 Japanese patients with type 2 diabetes aged ≥20years were divided into 5 groups according to self-reported sleep duration: less than 5.5h, 5.5-6.4h, 6.5-7.4h, 7.5-8.4h, and more than 8.5h. The associations of sleep duration with metabolic syndrome and other cardiovascular risk factors were examined cross-sectionally. RESULTS The proportions of patients who had metabolic syndrome increased significantly in both patients with shorter and longer sleep duration compared with those with 6.5-7.4h of sleep (P for quadratic trend <0.001). This U-shaped association remained significant after adjustment for potential confounders, including total energy intake, current smoking, current drinking and depressive symptoms. Each component of metabolic syndrome also showed similar trends. Furthermore, sleep duration had a quadratic association with homeostasis model assessment of insulin resistance and high sensitivity C-reactive protein. CONCLUSIONS Sleep duration was shown to have a U-shaped relationship with metabolic syndrome and insulin resistance, independent of potential confounders, and therefore may be an important modifiable risk factor for CVD prevention in patients with type 2 diabetes.
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Affiliation(s)
- Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Internal Medicine, Fukuoka Dental College Medical and Dental Hospital, Fukuoka, Japan
| | - Hiroki Fujii
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Diabetes Center, Hakujyuji Hospital, Fukuoka, Japan.
| | - Shinako Ogata-Kaizu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hitoshi Ide
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yohei Kikuchi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiro Idewaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tamaki Jodai
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Udai Nakamura
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Abstract
There is increasing awareness of the role of sleep disturbance as an important factor in health and disease. Although sub-clinical sleep disturbances (insufficient sleep duration or inadequate sleep quality) may be difficult to assess with conceptual and/or methodological clarity, this review attempts to summarize and synthesize these findings. First, the concept of sleep disturbance in a public health context is introduced, to provide context and rationale. Second, operational definitions of 'cardiometabolic disease' and 'sleep disturbance' are offered, to address many unclear operationalizations. Third, the extant literature is summarized regarding short or long sleep duration and/or insufficient sleep, insomnia and insomnia symptoms, general (non-specific sleep disturbances), circadian rhythm abnormalities that result in sleep disturbances, and, briefly, sleep-disordered breathing. Fourth, the review highlights the social/behavioural context of sleep, including discussions of sleep and race/ethnicity, socio-economic position, and other social/environmental factors, in order to place these findings in a social-environmental context relevant to public health. Fifth, the review highlights the issue of sleep as a domain of health behaviour and addresses issues regarding development of healthy sleep interventions. Finally, a research agenda of future directions is proposed.
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Affiliation(s)
- Michael A Grandner
- Behavioral Sleep Medicine Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA
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