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Claro AE, Palanza C, Mazza M, Rizzi A, Corsello A, Tartaglione L, Marano G, Muti Schuenemann GEU, Rigoni M, Pontecorvi A, Janiri L, Muti P, Pitocco D. Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic. World J Diabetes 2024; 15:1374-1380. [DOI: 10.4239/wjd.v15.i6.1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/27/2024] [Accepted: 04/18/2024] [Indexed: 06/11/2024] Open
Abstract
Common psychiatric disorders (CPDs) and depression contribute significantly to the global epidemic of type 2 diabetes (T2D). We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs, promotes the establishment of emotional eating, activation of the reward system, onset of overweight and obesity and, ultimately the increased risk of developing T2D. The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexone-bupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction, but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction. We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.
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Affiliation(s)
- Angelo Emilio Claro
- Diabetes Care Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20122, Italy
| | - Clelia Palanza
- Istituto Italiano di Antropologia, ISItA, Rome 00100, Italy
| | - Marianna Mazza
- Unit of Psychiatry, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Alessandro Rizzi
- Diabetes Care Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
| | - Andrea Corsello
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Linda Tartaglione
- Diabetes Care Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
| | - Giuseppe Marano
- Unit of Psychiatry, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | | | - Marta Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20122, Italy
| | - Alfredo Pontecorvi
- Department of Endocrine-Metabolic and Dermo-Rheumatology, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Luigi Janiri
- Unit of Psychiatry, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Paola Muti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20122, Italy
| | - Dario Pitocco
- Diabetes Care Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
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Li Y, Wang D, Fang J, Zu S, Hu Y. Association between depressive symptoms and prediabetes: NHANES 2007-2016 findings. J Affect Disord 2024; 355:426-431. [PMID: 38537755 DOI: 10.1016/j.jad.2024.03.122] [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: 05/27/2023] [Revised: 02/04/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION The association between diabetes and depressive symptoms is well recognized. However, the impact of depressive symptoms on prediabetes remains unclear. This study aims to explore the specific correlation between depressive symptoms and prediabetes. METHODS A total of 7467 participants from the National Health and Nutrition Examination Survey (NHANES) were included in this study, spanning five rounds of surveys conducted between 2007 and 2016. Weighted logistic regression was utilized to assess the relationship between depressive symptoms and prediabetes. RESULTS Compared with the normoglycemic population, individuals with prediabetes had a significantly higher probability of experiencing trouble sleeping (P = 0.020). After adjusting for non-glucose factors, there was no significant correlation between PHQ-9 and prediabetes; however, severe depressive symptoms were positively associated with abnormal fasting plasma glucose (FPG) levels (OR = 1.093 [95 % CI 1.002, 1.192]). There was a positive correlation between trouble concentrating and FPG abnormalities (OR = 1.065 [95 % CI 1.004, 1.129]). LIMITATIONS The cross-sectional design limits causal inference. CONCLUSION Individuals with depressive symptoms, especially severe cases, should be targeted for prediabetes prevention and management efforts. The diverse symptom presentations may have distinct impacts on glucose, necessitating personalized prevention and management strategies.
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Affiliation(s)
- Yuwei Li
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jiexin Fang
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Si Zu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yongdong Hu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Murphy C, Svansdottir SA, Dupuy O, Louis J. Does overreaching from endurance-based training impair sleep: A systematic review and meta-analysis. PLoS One 2024; 19:e0303748. [PMID: 38809828 PMCID: PMC11135706 DOI: 10.1371/journal.pone.0303748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Overreaching is often linked to a deterioration in sleep quality, yet a comprehensive review is lacking. The aim of this systemic review and meta-analysis was to synthesise the literature and quantify the effect of overreaching from endurance-based training on sleep quality. METHOD The review was conducted following the PRISMA guidelines. The final search was conducted in May 2023 using four electronic databases (Web of Science Core Collection, MEDLINE, Cochrane Central Database, SPORTDiscus). Studies were included for a qualitative review, while random-effects meta-analyses were conducted for objective and subjective sleep. RESULTS AND DISCUSSION The search returned 805 articles. Fourteen studies were included in the systematic review; Three and eight articles were eligible for the meta-analyses (objective and subjective, respectively). On average, the overreaching protocols were sixteen days in length (6 to 28 days) and included exercise modalities such as cycling (number of studies [k] = 5), rowing (k = 4), triathlon (k = 3), running (k = 2), and swimming (k = 1). Actigraphy was the only form of objective sleep measurement used across all studies (k = 3), while various instruments were used to capture subjective sleep quality (k = 13). When comparing objective sleep quality following the overreaching intervention to baseline (or a control), there was a significant reduction in sleep efficiency (mean difference = -2.0%; 95% CI -3.2, -0.8%; Glass' Δ = -0.83; p < 0.01). In contrast, when comparing subjective sleep quality following the overreaching intervention to baseline (or a control), there was no effect on subjective sleep quality (Glass' Δ = -0.27; 95% CI -0.79, 0.25; p = 0.08). Importantly, none of the included studies were judged to have a low risk of bias. While acknowledging the need for more high-quality studies, it appears that overreaching from endurance-based training can deteriorate objective sleep without influencing the perception of sleep quality. PROTOCOL REGISTRATION This protocol was registered in The International Prospective Register of Systematic Reviews (PROSPERO) on 21st November 2022, with the registration number CRD42022373204.
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Affiliation(s)
- Conor Murphy
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
| | - Steinunn Anna Svansdottir
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
| | - Olivier Dupuy
- Laboratory MOVE (UR 20296), Faculty of Sport Sciences, University of Poitiers, Poitiers, France
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences (RISES), Liverpool John Moores University, Liverpool, United Kingdom
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Dutil C, Podinic I, Featherstone RB, Eaton A, Sadler CM, Goldfield GS, Hadjiyannakis S, Gruber R, Tremblay MS, Prud’homme D, Chaput JP. Sleep and insulin sensitivity in adolescents at risk of type 2 diabetes: the Sleep Manipulation in Adolescents at Risk of Type 2 Diabetes randomized crossover study. Sleep 2024; 47:zsad313. [PMID: 38070132 PMCID: PMC11082473 DOI: 10.1093/sleep/zsad313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/01/2023] [Indexed: 01/21/2024] Open
Abstract
STUDY OBJECTIVES To investigate the effect of increasing sleep duration for 1 week, compared to a week of habitual and decreased sleep, on insulin sensitivity (IS) in adolescents at risk for type 2 diabetes (T2D). METHODS Adolescents, 13-18 years old, at risk for T2D, with obesity and other risk factors, were recruited for a randomized (1:1), open-label, sex-stratified crossover study, that manipulated time-in-bed to modify sleep duration (measured by actigraphy). Following a week of habitual (HB) sleep, time-in-bed was increased (IN) and decreased (DE) by 1 hour 30 min/night for 1 week, counterbalanced across participants (HBINDE or HBDEIN), and separated by a week of washout sleep. The main outcome measure was IS, obtained via 2-hour oral-glucose-tolerance-test conducted after each sleep week. RESULTS Of the 43 participants recruited, 36 (84%) completed all sleep interventions (52.8% female, age = 15.1 years, body mass index = 99.9th percentile, order: HBINDE = 18 and HBDEIN = 18). On average, during the HB week, participants slept 7 hours 31 min/night; sleep duration was 1 hour 02 min/night higher during the IN week and 1 hour 19 min/night lower during the DE week. We found a significant effect of sleep week on IS with a large effect size. Following the IN sleep week, IS was 20% higher compared to after the HB and DE sleep weeks, but there was no significant difference in IS following HB versus DE sleep weeks. CONCLUSIONS Whenever possible, clinicians should empower youth at risk of T2D to improve their sleep duration, since even a modest increase in sleep duration of 1 h/night for 1 week can have a positive impact on IS in this population. CLINICAL TRIALS Sleep Extension and IS in Adolescents, https://clinicaltrials.gov/study/NCT03754036, November 23rd, 2018. TRIAL REGISTRATION ClinicalTrials.gov (ID:NCT03754036).
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Affiliation(s)
- Caroline Dutil
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Irina Podinic
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Ryan B Featherstone
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Centre for Healthy Active Living (CHAL), Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Amelia Eaton
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Christin M Sadler
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Gary S Goldfield
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Stasia Hadjiyannakis
- Centre for Healthy Active Living (CHAL), Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Reut Gruber
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Denis Prud’homme
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Université de Moncton, Moncton, NB, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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Speksnijder EM, Bisschop PH, Siegelaar SE, Stenvers DJ, Kalsbeek A. Circadian desynchrony and glucose metabolism. J Pineal Res 2024; 76:e12956. [PMID: 38695262 DOI: 10.1111/jpi.12956] [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: 12/19/2023] [Revised: 04/02/2024] [Accepted: 04/15/2024] [Indexed: 05/09/2024]
Abstract
The circadian timing system controls glucose metabolism in a time-of-day dependent manner. In mammals, the circadian timing system consists of the main central clock in the bilateral suprachiasmatic nucleus (SCN) of the anterior hypothalamus and subordinate clocks in peripheral tissues. The oscillations produced by these different clocks with a period of approximately 24-h are generated by the transcriptional-translational feedback loops of a set of core clock genes. Glucose homeostasis is one of the daily rhythms controlled by this circadian timing system. The central pacemaker in the SCN controls glucose homeostasis through its neural projections to hypothalamic hubs that are in control of feeding behavior and energy metabolism. Using hormones such as adrenal glucocorticoids and melatonin and the autonomic nervous system, the SCN modulates critical processes such as glucose production and insulin sensitivity. Peripheral clocks in tissues, such as the liver, muscle, and adipose tissue serve to enhance and sustain these SCN signals. In the optimal situation all these clocks are synchronized and aligned with behavior and the environmental light/dark cycle. A negative impact on glucose metabolism becomes apparent when the internal timing system becomes disturbed, also known as circadian desynchrony or circadian misalignment. Circadian desynchrony may occur at several levels, as the mistiming of light exposure or sleep will especially affect the central clock, whereas mistiming of food intake or physical activity will especially involve the peripheral clocks. In this review, we will summarize the literature investigating the impact of circadian desynchrony on glucose metabolism and how it may result in the development of insulin resistance. In addition, we will discuss potential strategies aimed at reinstating circadian synchrony to improve insulin sensitivity and contribute to the prevention of type 2 diabetes.
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Affiliation(s)
- Esther M Speksnijder
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), Amsterdam, The Netherlands
| | - Peter H Bisschop
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), Amsterdam, The Netherlands
| | - Sarah E Siegelaar
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), Amsterdam, The Netherlands
| | - Dirk Jan Stenvers
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Andries Kalsbeek
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), Amsterdam, The Netherlands
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Laboratory of Endocrinology, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Kawada T. Comment on Zuraikat et al. Chronic Insufficient Sleep in Women Impairs Insulin Sensitivity Independent of Adiposity Changes: Results of a Randomized Trial. Diabetes Care 2024;47:117-125. Diabetes Care 2024; 47:e36. [PMID: 38527121 DOI: 10.2337/dc23-2470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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Li Y, Tan S. Sleep factors were associated with a higher risk of MAFLD and significant fibrosis. Sleep Breath 2024:10.1007/s11325-024-03017-0. [PMID: 38514588 DOI: 10.1007/s11325-024-03017-0] [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: 11/16/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE The relationships of sleep factors separately and jointly with metabolic associated fatty liver disease (MAFLD) and significant fibrosis remain unclear. We intended to explore the relationships in the United States. METHODS This cross-sectional study included 4477 individuals from the National Health and Nutrition Examination Survey from 2017 to 2018. Information regarding each sleep factor (sleep duration, trouble sleeping, snoring, excessive daytime sleep, and sleep apnea symptoms) was obtained through questionnaires. MAFLD was diagnosed by transient elastography according to the consensus definitions. Multivariable logistic regression models were employed to explore relationships of sleep factors separately and jointly with MAFLD and significant fibrosis. RESULTS Participants having a poor sleep pattern was associated with higher MAFLD and significant fibrosis risk, and poor sleep pattern was related to about threefold (OR, 3.67; 95% CI, 1.82-7.37) increased risk of MAFLD remarkably. When examining specific factors of sleep patterns individually, trouble sleeping (OR, 1.53; 95% CI, 1.10-2.12), snoring (OR, 2.11; 95% CI, 1.40-3.19), excessive daytime sleep (OR, 1.57; 95% CI, 0.93-2.62), and sleep apnea symptoms (OR, 1.87; 95% CI, 1.13-3.10) were positively associated with the odds of MAFLD (all P < 0.05). However, sleep duration was not independently correlated with MAFLD or significant fibrosis. Sleep patterns showed similar relationships with MAFLD, regardless of all age, sex, physical activity, and shift work groups. CONCLUSIONS Poor sleep pattern was linked with a considerably higher risk of MAFLD and significant fibrosis.
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Affiliation(s)
- Yaxin Li
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, China
| | - Shiyun Tan
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, China.
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Nôga DA, Meth EDMES, Pacheco AP, Tan X, Cedernaes J, van Egmond LT, Xue P, Benedict C. Habitual Short Sleep Duration, Diet, and Development of Type 2 Diabetes in Adults. JAMA Netw Open 2024; 7:e241147. [PMID: 38441893 PMCID: PMC10915681 DOI: 10.1001/jamanetworkopen.2024.1147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/14/2024] [Indexed: 03/07/2024] Open
Abstract
Importance Understanding the interplay between sleep duration, dietary habits, and the risk of developing type 2 diabetes (T2D) is crucial for public health and diabetes prevention strategies. Objective To investigate the associations of type of diet and duration of sleep with the development of T2D. Design, Setting, and Participants Data derived from the UK Biobank baseline investigation (2006-2010) were analyzed for this cohort study between May 1 and September 30, 2023. The association between sleep duration and healthy dietary patterns with the risk of T2D was investigated during a median (IQR) follow-up of 12.5 (11.8-13.2) years (end of follow-up, September 30, 2021). Exposure For the analysis, 247 867 participants were categorized into 4 sleep duration groups: normal (7-8 hours per day), mild short (6 hours per day), moderate short (5 hours per day), and extreme short (3-4 hours per day). Their dietary habits were evaluated based on population-specific consumption of red meat, processed meat, fruits, vegetables, and fish, resulting in a healthy diet score ranging from 0 (unhealthiest) to 5 (healthiest). Main Outcomes and Measures Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) and 95% CIs for the development of T2D across various sleep duration groups and healthy diet scores. Results The cohort comprised 247 867 participants with a mean [SD] age of 55.9 [8.1] years, of whom 52.3% were female. During the follow-up, 3.2% of participants were diagnosed with T2D based on hospital registry data. Cox regression analysis, adjusted for confounding variables, indicated a significant increase in the risk of T2D among participants with 5 hours or less of daily sleep. Individuals sleeping 5 hours per day exhibited a 1.16 adjusted HR (95% CI, 1.05-1.28), and individuals sleeping 3 to 4 hours per day exhibited a 1.41 adjusted HR (95% CI, 1.19-1.68) compared with individuals with normal sleep duration. Furthermore, individuals with the healthiest dietary patterns had a reduced risk of T2D (HR, 0.75 [95% CI, 0.63-0.88]). The association between short sleep duration and increased risk of T2D persisted even for individuals following a healthy diet, but there was no multiplicative interaction between sleep duration and healthy diet score. Conclusions and Relevance In this cohort study involving UK residents, habitual short sleep duration was associated with increased risk of developing T2D. This association persisted even among participants who maintained a healthy diet. To validate these findings, further longitudinal studies are needed, incorporating repeated measures of sleep (including objective assessments) and dietary habits.
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Affiliation(s)
- Diana Aline Nôga
- Department of Pharmaceutical Biosciences, Uppsala University, Sweden
| | | | | | - Xiao Tan
- Department of Big Data in Health Science, Zhejiang University School of Public Health, Hangzhou, China
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jonathan Cedernaes
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Lieve Thecla van Egmond
- Department of Pharmaceutical Biosciences, Uppsala University, Sweden
- Department of Psychiatry and Psychotherapy, Tübingen Centre for Mental Health, Medical Faculty, University of Tübingen, Tübingen, Germany
| | - Pei Xue
- Department of Pharmaceutical Biosciences, Uppsala University, Sweden
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Jin X, Chen Y, Feng H, Zhou M, Chan JWY, Liu Y, Kong APS, Tan X, Wing YK, Liang YY, Zhang J. Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:222-232. [PMID: 36871624 PMCID: PMC10980868 DOI: 10.1016/j.jshs.2023.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/28/2022] [Accepted: 02/12/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity (PA) with the risk of incident type 2 diabetes in a population-based prospective cohort study. METHODS Altogether, 88,000 participants (mean age = 62.2 ± 7.9 years, mean ± SD) were included from the UK Biobank. Sleep duration (short: <6 h/day; normal: 6-8 h/day; long: >8 h/day) and PA of different intensities were measured using a wrist-worn accelerometer over a 7-day period between 2013 and 2015. PA was classified according to the median or World Health Organization-recommendation: total volume of PA (high, low), moderate-to-vigorous PA (MVPA) (recommended, not recommended), and light-intensity PA (high, low). Incidence of type 2 diabetes was ascertained using hospital records or death registries. RESULTS During a median follow-up of 7.0 years, 1615 incident type 2 diabetes cases were documented. Compared with normal sleep duration, short (hazard ratio (HR) = 1.21, 95% confidence interval (95%CI): 1.03-1.41) but not long sleep duration (HR = 1.01, 95%CI: 0.89-1.15) was associated with excessive type 2 diabetes risk. This increased risk among short sleepers seems to be protected against by PA. Compared with normal sleepers with high or recommended PA, short sleepers with low volume of PA (HR = 1.81, 95%CI: 1.46-2.25), not recommended (below the World Health Organization-recommended level of) MVPA (HR = 1.92, 95%CI: 1.55-2.36), or low light-intensity PA (HR = 1.49, 95%CI: 1.13-1.90) had a higher risk of type 2 diabetes, while short sleepers with a high volume of PA (HR = 1.14, 95%CI: 0.88-1.49), recommended MVPA (HR = 1.02, 95%CI: 0.71-1.48), or high light-intensity PA (HR = 1.14, 95%CI: 0.92-1.41) did not. CONCLUSION Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes. A higher level of PA, regardless of intensity, potentially ameliorates this excessive risk.
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Affiliation(s)
- Xinyi Jin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Yilin Chen
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; School of Medicine, South China University of Technology, Guangzhou 510641, China
| | - Hongliang Feng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Mingqing Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510282, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Xiao Tan
- Department of Medical Sciences, Uppsala University, Uppsala 751 85, Sweden; Department of Big Data in Health Science, Zhejiang University School of Public Health, Hangzhou 310058, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Yannis Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510180, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou 510260, China.
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Yang X, Zhuo S, Fang T. Interaction between dietary flavonoid intake and trouble sleeping on non-alcoholic fatty liver disease risk: a cross-sectional study. Eur J Gastroenterol Hepatol 2024; 36:210-219. [PMID: 38047726 DOI: 10.1097/meg.0000000000002687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
OBJECTIVE The possible interaction of dietary flavonoid intake and sleep on non-alcoholic fatty liver disease (NAFLD) has not been well studied. This study investigated the interaction between dietary flavonoid intake and trouble sleeping on the risk of NAFLD. METHODS Three discrete National Health and Nutrition Examination Survey data cycles from 2007 to 2010 and 2017 to 2018 were used. NAFLD was diagnosed by a US Fatty Liver Index ≥30. A sleep questionnaire diagnosed trouble sleeping. Univariate and multivariate logistic regression, restricted cubic spline (RCS) and subgroup analyses were used to evaluate the association between dietary flavonoids, trouble sleeping and NAFLD. We employed the relative excess risk due to interaction, attributable proportion of interaction and synergy index to evaluate additive interactions. RESULTS Ultimately, 5056 participants were enrolled, and higher anthocyanidins and flavanones intake was negatively correlated with NAFLD. Conversely, trouble sleeping was positively associated with NAFLD. These correlations remained stable after adjusting for confounders, and there was a sex difference in this relationship. In the RCS model, anthocyanins were negatively non-linearly related to NAFLD, while flavanones showed a negative linear relationship. Moreover, there was a synergistic interplay between low dietary anthocyanin intake and trouble sleeping on the risk of NAFLD. A similar relationship existed for flavanone intake. CONCLUSION Anthocyanin and flavanone intake were negatively associated, whereas trouble sleeping was positively associated with NAFLD risk. There was a synergistic effect of low anthocyanin intake and trouble sleeping. The same relationship existed for low flavanone intake.
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Affiliation(s)
- Xinxia Yang
- Department of Gastroenterology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Shitu Zhuo
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Taiyong Fang
- Department of Gastroenterology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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11
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Al Hinai M, Jansen EC, Song PX, Peterson KE, Baylin A. Iron Deficiency and Vitamin D Deficiency Are Associated with Sleep in Females of Reproductive Age: An Analysis of NHANES 2005-2018 Data. J Nutr 2024; 154:648-657. [PMID: 38042351 PMCID: PMC10997906 DOI: 10.1016/j.tjnut.2023.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Iron and vitamin D deficiencies have been implicated in sleep disturbance. Although females are more susceptible to these deficiencies and frequently report sleep-related issues, few studies have examined these associations in females. OBJECTIVE This study investigates the association of iron and vitamin D deficiencies on sleep in a nationally representative sample of females of reproductive age. METHODS We used 2 samples of 20-49-y-old non-pregnant females from National Health and Nutrition Examination Survey (NHANES) 2005-2008 (N = 2497) and NHANES 2005-2010 and 2015-2018 (N = 6731) to examine the associations of iron deficiency (ID), iron deficiency anemia (IDA), vitamin D deficiency (VDD), vitamin D inadequacy (VDI), and the joint association of both deficiencies with sleep duration, latency, and quality. Sleep outcomes were measured using a self-reported questionnaire. We used the body iron model based on serum ferritin and serum soluble transferrin receptor to identify ID, along with hemoglobin to identify IDA cases. In addition, 25-hydroxyvitamin D levels were used to determine VDD and VDI cases. Logistic regression was used to evaluate these associations, adjusting for potential confounders. In addition, we assessed the multiplicative and additive interactions of both deficiencies. RESULTS ID and IDA were associated with poor sleep quality, with 1.42 [95% confidence interval (CI): 1.02, 2.00)] and 2.08 (95% CI: 1.29, 3.38) higher odds, respectively, whereas VDD and VDI were significantly associated with short sleep duration, with 1.26 (95% CI: 1.02, 1.54) and 1.22 (95% CI: 1.04, 1.44) higher odds, respectively. Subjects with both nutritional deficiencies had significantly higher odds of poorer sleep quality compared with subjects with neither condition. For sleep quality, a significant multiplicative interaction was observed between ID and VDD (P value = 0.0005). No associations were observed between study exposures and sleep latency. CONCLUSIONS Among females of reproductive age, iron and vitamin D deficiencies are associated with sleep health outcomes. The potential synergistic effect of both deficiencies warrants further assessment.
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Affiliation(s)
- Maymona Al Hinai
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States; Department of Food Science and Human Nutrition, Sultan Qaboos University College of Agriculture and Marine Science, Muscat, Oman
| | - Erica C Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Peter Xk Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI United States
| | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States.
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12
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Li G, Zhang J, Cui H, Feng Z, Gao Y, Wang Y, Chen J, Xu Y, Niu D, Yin J. Research Progress on the Effect and Mechanism of Tea Products with Different Fermentation Degrees in Regulating Type 2 Diabetes Mellitus. Foods 2024; 13:221. [PMID: 38254521 PMCID: PMC10814445 DOI: 10.3390/foods13020221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
A popular non-alcoholic beverage worldwide, tea can regulate blood glucose levels, lipid levels, and blood pressure, and may even prevent type 2 diabetes mellitus (T2DM). Different tea fermentation levels impact these effects. Tea products with different fermentation degrees containing different functional ingredients can lower post-meal blood glucose levels and may prevent T2DM. There are seven critical factors that shed light on how teas with different fermentation levels affect blood glucose regulation in humans. These factors include the inhibition of digestive enzymes, enhancement of cellular glucose uptake, suppression of gluconeogenesis-related enzymes, reduction in the formation of advanced glycation end products (AGEs), inhibition of dipeptidyl peptidase-4 (DPP-4) activity, modulation of gut flora, and the alleviation of inflammation associated with oxidative stress. Fermented teas can be used to lower post-meal blood glucose levels and can help consumers make more informed tea selections.
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Affiliation(s)
- Guangneng Li
- College of Light Industry and Food Engineering, Guangxi University, Nanning 530003, China
| | - Jianyong Zhang
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou 310008, China; (J.Z.)
| | - Hongchun Cui
- Tea Research Institute, Hangzhou Academy of Agricultural Sciences, Hangzhou 310024, China
| | - Zhihui Feng
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou 310008, China; (J.Z.)
| | - Ying Gao
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou 310008, China; (J.Z.)
| | - Yuwan Wang
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou 310008, China; (J.Z.)
| | - Jianxin Chen
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou 310008, China; (J.Z.)
| | - Yongquan Xu
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou 310008, China; (J.Z.)
| | - Debao Niu
- College of Light Industry and Food Engineering, Guangxi University, Nanning 530003, China
| | - Junfeng Yin
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou 310008, China; (J.Z.)
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Zuraikat FM, Laferrère B, Cheng B, Scaccia SE, Cui Z, Aggarwal B, Jelic S, St-Onge MP. Chronic Insufficient Sleep in Women Impairs Insulin Sensitivity Independent of Adiposity Changes: Results of a Randomized Trial. Diabetes Care 2024; 47:117-125. [PMID: 37955852 PMCID: PMC10733650 DOI: 10.2337/dc23-1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Insufficient sleep is associated with type 2 diabetes, yet the causal impact of chronic insufficient sleep on glucose metabolism in women is unknown. We investigated whether prolonged mild sleep restriction (SR), resembling real-world short sleep, impairs glucose metabolism in women. RESEARCH DESIGN AND METHODS Women (aged 20-75 years) without cardiometabolic diseases and with actigraphy-confirmed habitual total sleep time (TST) of 7-9 h/night were recruited to participate in this randomized, crossover study with two 6-week phases: maintenance of adequate sleep (AS) and 1.5 h/night SR. Outcomes included plasma glucose and insulin levels, HOMA of insulin resistance (HOMA-IR) values based on fasting blood samples, as well as total area under the curve for glucose and insulin, the Matsuda index, and the disposition index from an oral glucose tolerance test. RESULTS Our sample included 38 women (n = 11 postmenopausal women). Values are reported with ±SEM. Linear models adjusted for baseline outcome values demonstrated that TST was reduced by 1.34 ± 0.04 h/night with SR versus AS (P < 0.0001). Fasting insulin (β = 6.8 ± 2.8 pmol/L; P = 0.016) and HOMA-IR (β = 0.30 ± 0.12; P = 0.016) values were increased with SR versus AS, with effects on HOMA-IR more pronounced in postmenopausal women compared with premenopausal women (β = 0.45 ± 0.25 vs. β = 0.27 ± 0.13, respectively; P for interaction = 0.042). Change in adiposity did not mediate the effects of SR on glucose metabolism or change results in the full sample when included as a covariate. CONCLUSIONS Curtailing sleep duration to 6.2 h/night, reflecting the median sleep duration of U.S. adults with short sleep, for 6 weeks impairs insulin sensitivity, independent of adiposity. Findings highlight insufficient sleep as a modifiable risk factor for insulin resistance in women to be targeted in diabetes prevention efforts.
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Affiliation(s)
- Faris M. Zuraikat
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
| | - Blandine Laferrère
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
- Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Bin Cheng
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
| | - Samantha E. Scaccia
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Zuoqiao Cui
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
| | - Brooke Aggarwal
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Sanja Jelic
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Marie-Pierre St-Onge
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
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14
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Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci 2023; 7:457-466. [PMID: 38084859 PMCID: PMC10754327 DOI: 10.1042/etls20230111] [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: 09/18/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
This review centres around the recent evidence in examining the intersection of sleep and cardiovascular disease (CVD). Sleep in this review will be further subdivided to consider both sleep quantity and quality along and will also consider some of the more common sleep disorders, such as insomnia and obstructive sleep apnoea, in the context of CVD. Sleep disorders have been further explored in several specific populations which are both at risk of sleep disorders and CVD. Secondly, the review will present some of the risk factors for CVD that are affected by sleep and sleep disorders which include hypertension, diabetes, and obesity. It will also examine the potential underlying mechanisms including inflammation, appetite control, endocrine, and genetic processes that are affected by sleep and sleep disorders leading to increased risk of CVD development. In addition, we will consider the observed bi-directional relationships between sleep and cardiovascular risk factors. For example, obesity, a risk factor for CVD can be affected by sleep, but in turn can increase the risk of certain sleep disorder development which disrupts sleep, leading to further risk of obesity development and increased CVD risk. Finally, the review will explore emerging evidence around lifestyle interventions that have included a sleep component and how it impacts the management of CVD risk factor. The need for increased awareness of the health effects of poor sleep and sleep disorders will be discussed alongside the need for policy intervention to improve sleep to facilitate better health and well-being.
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Affiliation(s)
- Michelle A. Miller
- Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, U.K
| | - Nathan E. Howarth
- Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, U.K
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15
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Li CI, Lin CC, Liu CS, Lin CH, Yang SY, Li TC. Three-year trajectories of sleep duration and mortality in patients with type 2 diabetes-a hospital-based retrospective cohort study. Sleep Health 2023; 9:959-967. [PMID: 37648644 DOI: 10.1016/j.sleh.2023.07.017] [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: 04/24/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES Most studies have shown that a single item of self-reported sleep duration is related to mortality risk. However, the long-term effect of sleep duration on mortality remains unclear in patients with diabetes. This study aimed to examine the associations of 3-year trajectory patterns of sleep duration with all-cause and expanded cardiovascular disease mortality in patients with type 2 diabetes. METHODS Patients with type 2 diabetes and self-reported sleep duration during a 3-year interval were included. Expanded cardiovascular disease was defined as death due to cardiovascular disease, diabetes, and kidney diseases. Cox's proportional hazards models were employed to examine the associations between sleep duration patterns and mortality after controlling for sociodemographic factors, lifestyle behaviors, diabetes-related variables, diabetic complications, and medication use. RESULTS A total of 7591 patients were included for analysis, and 995 deaths (13.11%) and 424 expanded cardiovascular disease deaths (5.59%) were observed during a mean follow-up of 8.51 years. Five trajectory patterns of sleep duration were identified: cluster 1: "constant 7- to 8-hour group" (50.03%); cluster 2: "constant low group" (19.68%); cluster 3: "high with decreasing trend group" (3.08%); cluster 4: "low with fluctuation group" (1.28%); and cluster 5: "constant high group" (25.93%). Compared with cluster 1, clusters 3 and 4 were associated with increased risks of all-cause mortality (1.41, 1.08-1.84; 1.44, 1.01-2.05), and cluster 5 was associated with high risks of all-cause and expanded cardiovascular disease mortality (1.26, 1.08-1.46; 1.42, 1.12-1.79). CONCLUSIONS Sleep duration trajectories with constant high or unstable patterns may be associated with higher mortality.
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Affiliation(s)
- Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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16
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Hurtado-Alvarado G, Soto-Tinoco E, Santacruz-Martínez E, Prager-Khoutorsky M, Escobar C, Buijs RM. Suprachiasmatic nucleus promotes hyperglycemia induced by sleep delay. Curr Biol 2023; 33:4343-4352.e4. [PMID: 37725978 DOI: 10.1016/j.cub.2023.08.071] [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: 06/15/2023] [Revised: 08/05/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023]
Abstract
Short sleep is linked to disturbances in glucose metabolism and may induce a prediabetic condition. The biological clock in the suprachiasmatic nucleus (SCN) regulates the glucose rhythm in the circulation and the sleep-wake cycle. SCN vasopressin neurons (SCNVP) control daily glycemia by regulating the entrance of glucose into the arcuate nucleus (ARC). Thus, we hypothesized that sleep delay may influence SCN neuronal activity. We, therefore, investigated the role of SCNVP when sleep is disrupted by forced locomotor activity. After 2 h of sleep delay, rats exhibited decreased SCNVP neuronal activity, a decrease in the glucose transporter GLUT1 expression in tanycytes lining the third ventricle, lowered glucose entrance into the ARC, and developed hyperglycemia. The association between reduced SCNVP neuronal activity and hyperglycemia in sleep-delayed rats was evidenced by injecting intracerebroventricular vasopressin; this increased GLUT1 immunoreactivity in tanycytes, thus promoting normoglycemia. Following sleep recovery, glucose levels decreased, whereas SCNVP neuronal activity increased. These results imply that sleep-delay-induced changes in SCNVP activity lead to glycemic impairment, inferring that disruption of biological clock function might represent a critical step in developing type 2 diabetes.
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Affiliation(s)
- Gabriela Hurtado-Alvarado
- Department of Cellular Biology and Physiology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mario de la Cueva Circuit, 04510 Mexico City, Mexico
| | - Eva Soto-Tinoco
- Department of Cellular Biology and Physiology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mario de la Cueva Circuit, 04510 Mexico City, Mexico
| | - Esteban Santacruz-Martínez
- Department of Cellular Biology and Physiology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mario de la Cueva Circuit, 04510 Mexico City, Mexico
| | - Masha Prager-Khoutorsky
- Department of Physiology, McIntyre Medical Sciences Building, McGill University, 3655 Promenade Sir-William-Osler, Montréal, QC H3G 1Y6, Canada
| | - Carolina Escobar
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
| | - Ruud M Buijs
- Department of Cellular Biology and Physiology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mario de la Cueva Circuit, 04510 Mexico City, Mexico.
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Ramasubbu K, Ramanathan G, Venkatraman G, Rajeswari VD. Sleep-associated insulin resistance promotes neurodegeneration. Mol Biol Rep 2023; 50:8665-8681. [PMID: 37580496 DOI: 10.1007/s11033-023-08710-z] [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: 05/05/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023]
Abstract
Lifestyle modification can lead to numerous health issues closely associated with sleep. Sleep deprivation and disturbances significantly affect inflammation, immunity, neurodegeneration, cognitive depletion, memory impairment, neuroplasticity, and insulin resistance. Sleep significantly impacts brain and memory formation, toxin excretion, hormonal function, metabolism, and motor and cognitive functions. Sleep restriction associated with insulin resistance affects these functions by interfering with the insulin signalling pathway, neurotransmission, inflammatory pathways, and plasticity of neurons. So, in this review, We discuss the evidence that suggests that neurodegeneration occurs via sleep and is associated with insulin resistance, along with the insulin signalling pathways involved in neurodegeneration and neuroplasticity, while exploring the role of hormones in these conditions.
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Affiliation(s)
- Kanagavalli Ramasubbu
- Department of Bio-Medical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Gnanasambandan Ramanathan
- Department of Bio-Medical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Ganesh Venkatraman
- Department of Bio-Medical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - V Devi Rajeswari
- Department of Bio-Medical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
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Guo C, Piao S, Wang C, Yu L, Wang K, Qu Q, Zhang C, Yu X. The prevalence and associated factors of sleep deprivation among healthy college students in China: a cross-sectional survey. PeerJ 2023; 11:e16009. [PMID: 37744238 PMCID: PMC10512935 DOI: 10.7717/peerj.16009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023] Open
Abstract
Background The prevalence of sleep deprivation among college students is increasing and has a few associated factors. Methods The present study analyzed 2,142 college students from 28 provinces in China. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration. Binary logistic regression was conducted to explore the sleep deprivation related factors. Age and gender were controlled as covariates. Results Among the 2,142 college students (27.7% male, 72.3% female), 1,620 (75.6%) reported the average sleep duration was below 7 h per day for one month, 49.3% (1,055/2,142) slept 6∼7 h (contains 6 h), 21.0% (449/2,142) slept 5∼6 h (contains 5 h), and 5.4% (116/2,142) slept <5 h. Age increased the risk of sleep deprivation, the adjusted odds ratio = 1.05 (95% CI [1.01∼1.10]). The adjusted odds ratio (A-OR) for sleep deprivation was higher for students of more than 60 min nap duration per day (A-OR = 2.35, 95% CI [1.45∼3.80]), and age growth (A-OR = 1.05, 95% CI [1.01∼1.10]). In contrast, A-ORs were lower among sleeping inconsistency between work and rest days (A-OR = 0.61, 95% CI [0.49∼0.75]), accustomed to staying up late (A-OR = 0.45, 95% CI [0.36∼0.57]), staying up late to work or study (A-OR = 0.62, 95% CI [0.49∼0.78]), stress (A-OR = 0.75, 95% CI [0.58∼0.98]), and repeated thoughts in bed had (A-OR = 0.79, 95% CI [0.62∼0.99]). Conclusions Sleep deprivation is extremely common among healthy college students in China. It is necessary to perform methods maintaining enough sleep due to the current high incidence of sleep deprivation. Controlling the nap duration and getting enough sleep on rest days to replace missing hours of sleep on workdays might improve college students' sleep.
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Affiliation(s)
- Congcong Guo
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Songzhe Piao
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Linhai, Zhejiang, China
| | - Chenyu Wang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Lili Yu
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Kejun Wang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Qian Qu
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Cuiting Zhang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Xiaofei Yu
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
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Kianersi S, Redline S, Mongraw-Chaffin M, Huang T. Associations of Slow-Wave Sleep With Prevalent and Incident Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab 2023; 108:e1044-e1055. [PMID: 37084404 PMCID: PMC10686689 DOI: 10.1210/clinem/dgad229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 04/23/2023]
Abstract
CONTEXT N3 sleep (i.e., slow-wave sleep), a marker of deep restorative sleep, is implicated in hormonal and blood pressure regulation and may impact cardiometabolic health. OBJECTIVE We conducted cross-sectional and prospective analyses to test whether a higher proportion and longer duration of N3 sleep are associated with reduced type 2 diabetes risk. METHODS A subsample of participants from the Multi-Ethnic Study of Atherosclerosis completed 1-night polysomnography at Exam 5 (2010-2013) and were prospectively followed until Exam 6 (2016-2018). We used modified Poisson regression to examine the cross-sectional associations of N3 proportion and duration with prevalent diabetes and Cox proportional hazards models to estimate risk of diabetes according to N3 measures. RESULTS In cross-sectional analyses (n = 2026, mean age: 69 years), diabetes prevalence was 28% (n = 572). Compared with the first quartile (Q1) of the N3 proportion (<2.0%), participants in Q4 (≥15.4%) were 29% (95% CI 0.58, 0.87) less likely to have prevalent diabetes (P trend = .0016). The association attenuated after adjustment for demographics, lifestyles, and sleep-related factors (P trend = .3322). In prospective analyses of 1251 participants and 129 incident cases over 6346 person-years of follow-up, a curvilinear relationship was observed between N3 proportion and incident diabetes risk. In the fully adjusted model, the hazard ratio (95% CI) of developing diabetes vs Q1 was 0.47 (0.26, 0.87) for Q2, 0.34 (0.15, 0.77) for Q3, and 0.32 (0.10, 0.97) for Q4 (P nonlinearity = .0213). The results were similar for N3 duration. CONCLUSION Higher N3 proportion and longer N3 duration were prospectively associated with lower type 2 diabetes risk in a nonlinear fashion among older American adults.
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Affiliation(s)
- Sina Kianersi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Morgana Mongraw-Chaffin
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
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20
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Zhang Z, Hui Y, Yang W, Guo G, Cui B, Li C, Wang X, Fan X, Sun C. Association between serum trace elements and sleep disturbance in patients with decompensated cirrhosis. Ther Adv Chronic Dis 2023; 14:20406223231192829. [PMID: 37601039 PMCID: PMC10439724 DOI: 10.1177/20406223231192829] [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: 02/03/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Sleep disturbance and trace elements imbalance are common features in patients with decompensated cirrhosis, partially sharing similar mechanistic contributors and linking to adverse outcomes. However, there is a paucity of data concerning their relationship. Objectives To investigate the association between serum trace elements levels and sleep quality in the context of cirrhosis. Design Cross-sectional study. Methods We consecutively enrolled 160 patients with decompensated cirrhosis. The sleep disturbance was determined by the Pittsburgh Sleep Quality Index (PSQI > 5). Serum trace elements [magnesium, calcium, iron, copper (Cu), zinc (Zn), lead, and manganese] was measured by inductively coupled plasma mass spectrometry. Association of examined trace elements levels and sleep disturbance was analyzed by multiple linear (global PSQI scores) and multivariate logistic (dichotomized PSQI categories) regression models, respectively. Results In total, 91 patients (56.88%) represented PSQI-defined sleep disturbance, characterized by female preponderance, lower body mass index levels, and higher serum Cu levels (all p < 0.05). Looking into its clinical relevance with debilitating conditions, we showed that Cu/Zn ratio (CZr) is significantly higher in cirrhosis with poor sleep quality (1.77 versus 1.48, p = 0.003). Diagnostic performance analysis indicated CZr > 1.62 to exhibit better discrimination relative to respective Cu. Both multiple linear (β = 0.355, p < 0.001) and multivariate logistic regression (odds ratio = 2.364, p = 0.019) identified higher CZr as an independent risk factor associated with sleep disturbance. Conclusion Our findings implied an association between higher CZr and the presence of sleep disturbance in patients with decompensated cirrhosis.
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Affiliation(s)
- Ziyue Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Nankai District, Tianjin, China
- Institute of Otolaryngology of Tianjin, China
| | - Yangyang Hui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Wanting Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Gaoyue Guo
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Binxin Cui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
| | - Chaoqun Li
- Department of Internal Medicine, Tianjin Hexi Hospital, Hexi District, Tianjin, China
| | - Xiaoyu Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Xiaofei Fan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin 300052, China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
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21
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Niethard N, Hallschmid M. A sweet spot for the sleeping brain: Linking human sleep physiology and glucoregulation. Cell Rep Med 2023; 4:101123. [PMID: 37467713 PMCID: PMC10394251 DOI: 10.1016/j.xcrm.2023.101123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 07/21/2023]
Abstract
Vallat et al.1 demonstrate a positive association between the coupling of slow oscillations and sleep spindles, neurophysiological markers of NREM sleep, and next-morning glucose homeostasis. Extended findings in an independent dataset raise intriguing questions about its directionality and consistency.
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Affiliation(s)
- Niels Niethard
- Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Manfred Hallschmid
- Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen (IDM), Tübingen, Germany.
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22
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Taheri S. Sleep and cardiometabolic health-not so strange bedfellows. Lancet Diabetes Endocrinol 2023:S2213-8587(23)00170-5. [PMID: 37390838 DOI: 10.1016/s2213-8587(23)00170-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/02/2023]
Affiliation(s)
- Shahrad Taheri
- Department of Medicine, Weill Cornell Medicine-Qatar, Doha PO Box 24144, Qatar; National Obesity Treatment Centre, Hamad Medical Corporation, Doha, Qatar.
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23
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Chuang HH, Lin RH, Hsu JF, Chuang LP, Li HY, Fang TJ, Huang YS, Yang AC, Lee GS, Kuo TBJ, Yang CCH, Lee LA. Dietary profile of pediatric obstructive sleep apnea patients, effects of routine educational counseling, and predictors for outcomes. Front Public Health 2023; 11:1160647. [PMID: 37377550 PMCID: PMC10291126 DOI: 10.3389/fpubh.2023.1160647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
Background Dietary behavior is a main contributing yet modifiable factor to the body weight status of children and may be involved in the pathophysiology of childhood obstructive sleep apnea (OSA). This study aimed to investigate the dietary profile of pediatric OSA patients, effects of educational counseling after adenotonsillectomy, and predictor for disease resolution. Methods This observational study included 50 pediatric OSA patients undergoing adenotonsillectomy with routine educational counseling (Group 1), 50 pediatric OSA patients undergoing adenotonsillectomy without formal educational counseling (Group 2), and 303 healthy children without OSA (Control). The three groups were matched by age. The consumption frequency of 25 food items/groups was assessed by the Short Food Frequency Questionnaire. Quality of life was evaluated by the OSA-18 questionnaire. Sleep architecture and OSA severity were measured by standard polysomnography. Between- and within-group comparisons were analyzed by non-parametric approaches and generalized estimating equations. Prediction of disease recovery was performed by multivariable logistic regression models. Results Group 1 children consumed fruit drinks with sugar, vegetables, sweets, chocolate, rice, and noodles more frequently than Control Group children. At baseline, the distributions of sex, weight status, OSA-18 scores, and polysomnographic variables were comparable between Group 1 and Group 2. After a 12-month follow-up, Group 1 had better improvements in physical suffering, caregiver concerns, sleep architecture, and mean peripheral oxygen saturation compared to Group 2. Furthermore, Group 1 no longer had excessive consumption of fruit drinks with sugar, chocolate, and noodles; however, food consumption frequencies did not change significantly. Notably, younger age and reduced intake of butter/margarine on bread and noodles were independent predictors of cured OSA in Group 1. Conclusion The present study preliminarily characterized an unhealthy dietary profile among pediatric OSA patients and suggested that routine educational counseling in addition to adenotonsillectomy yielded some clinical benefits. Certain items/groups of food frequencies may be associated with disease recovery and further investigations are warranted.
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Affiliation(s)
- Hai-Hua Chuang
- Department of Family Medicine, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Industrial Engineering and Manage-ment, National Taipei University of Technology, Taipei, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Rong-Ho Lin
- Department of Industrial Engineering and Manage-ment, National Taipei University of Technology, Taipei, Taiwan
| | - Jen-Fu Hsu
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Pediatrics, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Pang Chuang
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Pulmonary and Critical Care Medicine, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Sleep Center, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsueh-Yu Li
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Sleep Center, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Otorhinolaryngology – Head and Neck Surgery, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Sleep Center, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Otorhinolaryngology – Head and Neck Surgery, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Shu Huang
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Sleep Center, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Child Psychiatry, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Albert C. Yang
- Department of Psychiatry, Taipei Veter-ans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Guo-She Lee
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Otolaryngology, Ren-Ai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Tsaotun Psychiatric Center, Ministry of Health and Wel-fare, Nantou, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Ang Lee
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Sleep Center, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Otorhinolaryngology – Head and Neck Surgery, Linkou Main Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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24
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Griggs S, Pignatiello G, Hickman RL. A composite measure of sleep health is associated with glycaemic target achievement in young adults with type 1 diabetes. J Sleep Res 2023; 32:e13784. [PMID: 36372966 PMCID: PMC10176021 DOI: 10.1111/jsr.13784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022]
Abstract
We investigated whether sleep health (each individual dimension and a composite measure) was associated with better glycaemia among a cohort of young adults with type 1 diabetes (mean age 21.5 years, mean body mass index 24.55 kg m-2 ). Multiple validated self-report questionnaires were completed, and raw continuous glucose monitor data were shared. One self-reported sleep characteristic for each of the five sleep health dimensions was selected. A composite score was calculated by summing the number of "good" sleep health dimensions. We evaluated the associations between sleep health and glycaemia, and whether covariates, including age, type 1 diabetes duration and sleep apnea risk, influenced the relationships among the study variables using multivariable linear regression. Individual dimensions of sleep satisfaction (β = 0.380, p = 0.019; β = -0.414, p = 0.010), timing (β = 0.392, p = 0.015; β = -0.393, p = 0.015) and sleep efficiency (β = 0.428, p = 0.007) were associated with higher achievement of glycaemic targets (J-index and time in range); however, these associations did not persist after considering covariates. A better Sleep Health Composite score was associated with higher achievement of glycaemic targets even after considering covariates. Using a multidimensional framework can guide future research on causal pathways between sleep and diabetes health, interventions to target sleep health profiles, and may improve sleep screening in routine diabetes care.
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Affiliation(s)
- Stephanie Griggs
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Grant Pignatiello
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ronald L Hickman
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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25
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St-Onge MP, Cherta-Murillo A, Darimont C, Mantantzis K, Martin FP, Owen L. The interrelationship between sleep, diet, and glucose metabolism. Sleep Med Rev 2023; 69:101788. [PMID: 37156196 PMCID: PMC10247426 DOI: 10.1016/j.smrv.2023.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/28/2023] [Accepted: 04/23/2023] [Indexed: 05/10/2023]
Abstract
Obesity and type 2 diabetes (T2D) are increasingly common worldwide. While these disorders have increased in prevalence over the past several decades, there has been a concomitant reduction in sleep duration. Short sleep duration has been associated with higher rates of obesity and T2D, and the causality of these associations and their directionality, continue to necessitate evaluation. In this review we consider the evidence that sleep is an intrinsic factor in the development of obesity and chronic metabolic disorders, such as insulin resistance and T2D, while evaluating a potential bi-directional association. We consider the evidence that diet and meal composition, which are known to impact glycemic control, may have both chronic and acute impact upon sleep. Moreover, we consider that postprandial nocturnal metabolism and peripheral glycemia may affect sleep quality. We propose putative mechanisms whereby acute effects of nighttime glucose excursions may lead to increased sleep fragmentation. We conclude that dietary manipulations, particularly with respect to carbohydrate quality, may confer sleep benefits. Future research may seek to evaluate the effectiveness of synergistic nutrient strategies to promote sleep quality, with particular attention to carbohydrate quality, quantity, and availability as well as carbohydrate to protein ratio.
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Affiliation(s)
- Marie-Pierre St-Onge
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
| | | | - Christian Darimont
- Nestlé Research, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | | | | | - Lauren Owen
- Nestlé Research, Nestlé Institute of Health Sciences, Lausanne, Switzerland
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26
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Son SM, Park EJ, Kwon RJ, Cho YH, Lee SY, Choi JI, Lee Y, Lee SR, Kim YJ, Lee JG, Yi YH, Tak YJ, Lee SH, Kim GL, Ra YJ. Association between weekend catch-up sleep and hyperuricemia with insufficient sleep in postmenopausal Korean women: a nationwide cross-sectional study. Menopause 2023; 30:607-612. [PMID: 37192838 DOI: 10.1097/gme.0000000000002186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Hyperuricemia is associated with metabolic and cardiovascular diseases and mortality. Efforts to lower the risk of hyperuricemia in various ways are needed as the prevalence of these diseases increases in postmenopausal women. Studies have shown that one of these methods is associated with adequate sleep duration, which is related to a low risk of hyperuricemia. Considering that it is difficult for people to get enough sleep in modern society, this study hypothesized that weekend catch-up sleep could be an alternative. To our knowledge, no past study has investigated the relation between weekend catch-up sleep and hyperuricemia in postmenopausal women. Hence, the aim of this research was to estimate the relation between weekend catch-up sleep and hyperuricemia with insufficient sleep in postmenopausal women during weekday or workday. METHODS This study included 1,877 participants extracted from the Korea National Health and Nutrition Examination Survey VII. The study population was divided into weekend catch-up sleep and non-weekend catch-up sleep groups. Odds ratios with 95% confidence intervals were derived using multiple logistic regression analysis. RESULTS Weekend catch-up sleep had a significantly lower prevalence of hyperuricemia after adjusting for confounders (odds ratio, 0.758 [95% confidence interval, 0.576-0.997]). In a subgroup analysis, weekend catch-up sleep of 1 to 2 hours was significantly correlated with a lower prevalence of hyperuricemia after adjusting for confounders (odds ratio: 0.522 [95% confidence interval, 0.323-0.845]). CONCLUSIONS Weekend catch-up sleep had a decreased prevalence of hyperuricemia in postmenopausal women with sleep deprivation.
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Affiliation(s)
- Soo Min Son
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Eun-Ju Park
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Ryuk Jun Kwon
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Young Hye Cho
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Sang Yeoup Lee
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Jung In Choi
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Youngin Lee
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Sae Rom Lee
- From the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - Yun Jin Kim
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jeong Gyu Lee
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Yu Hyeon Yi
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Young Jin Tak
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Seung Hun Lee
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Gyu Lee Kim
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Young Jin Ra
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
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27
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Ansu Baidoo V, Knutson KL. Associations between circadian disruption and cardiometabolic disease risk: A review. Obesity (Silver Spring) 2023; 31:615-624. [PMID: 36750239 PMCID: PMC9974590 DOI: 10.1002/oby.23666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 02/09/2023]
Abstract
The human circadian system plays a vital role in many physiological processes, and circadian rhythms are found in virtually all tissues and organs. The disruption of circadian rhythms may lead to adverse health outcomes. Evidence from recent population-based studies was reviewed because they represent real-world behavior and can be useful in developing future studies to reduce the risk of adverse health conditions, including cardiovascular diseases, obesity, and diabetes mellitus, which may occur because of circadian disruption. An electronic search in PubMed and Web of Science (2012-2022) was performed. Selected articles were based on specific inclusion and exclusion criteria. Five factors that may disrupt circadian rhythm alignment are discussed: shift work, late chronotype, late sleep timing, sleep irregularity, and late meal timing. Evidence from observational studies of these circadian disruptors suggests potential detrimental effects on cardiometabolic health, including higher BMI/obesity, higher blood pressure, greater dyslipidemia, greater inflammation, and diabetes. Future research should identify the specific underlying pathways in order to mitigate the health consequences of shift work. Furthermore, optimal sleep and mealtimes for metabolic health can be explored in intervention studies. Lastly, it is important that the timing of external environmental cues (such as light) and behaviors that influence circadian rhythms are managed.
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Affiliation(s)
- Velarie Ansu Baidoo
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kristen L Knutson
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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28
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Guo J, Dai L, Luo J, Huang R, Xiao Y. Shorter respiratory event duration is related to prevalence of type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1105781. [PMID: 36875453 PMCID: PMC9978406 DOI: 10.3389/fendo.2023.1105781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a heterogeneous sleep disorder often comorbid with metabolic diseases, and type 2 diabetes (T2DM) is one of them. Although apnea hypopnea index (AHI) is currently the diagnostic criteria for OSA severity, a controversial relationship between AHI and T2DM has been found. On the other hand, the duration of apnea-hypopnea events has been shown to be a useful metric for predicting mortality. This study aimed to test whether average respiratory event duration was associated with prevalence of T2DM. METHODS Patients referred to the sleep clinic were recruited in the study. Baseline clinical characteristics and polysomnography parameters including average respiratory event duration were collected. The association of average respiratory event duration with the prevalence of T2DM was evaluated by univariate and multivariate logistic regression analyses. RESULTS A total of 260 participants were enrolled, and 92 (35.4%) had T2DM. Univariate analysis revealed that age, body mass index (BMI), total sleep time, sleep efficiency, history of hypertension, and shorter average respiratory event duration were associated with T2DM. In multivariate analysis, only age and BMI remained significant. While average respiratory event duration was insignificant in multivariate analysis, subtype event analysis showed that shorter average apnea duration was both significant in univariate (OR, 0.95; 95% CI, 0.92-0.98) and multivariate analyses (OR, 0.95; 95% CI, 0.91-0.99). Neither average hypopnea duration nor AHI was associated with T2DM. Significant association (OR, 1.19; 95% CI, 1.12-1.25) was observed between shorter average apnea duration and lower respiratory arousal threshold after multivariate adjustment. However, causal mediation analysis revealed no mediating effect of arousal threshold on average apnea duration and T2DM. CONCLUSION The average apnea duration may be a useful metric in the diagnosis of OSA comorbidity. Shorter average apnea duration indicating poor sleep quality and augmented autonomic nervous system responses might be the potential pathological mechanisms leading to T2DM.
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29
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Treacy C, Levenstein JM, Jefferies A, Metse AP, Schaumberg MA, Villani A, Boucas AP, Hermens DF, Lagopoulos J, Andrews SC. The LEISURE Study: A Longitudinal Randomized Controlled Trial Protocol for a Multi-Modal Lifestyle Intervention Study to Reduce Dementia Risk in Healthy Older Adults. J Alzheimers Dis 2023; 94:841-856. [PMID: 37334601 DOI: 10.3233/jad-230193] [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] [Indexed: 06/20/2023]
Abstract
Dementia is understood to arise from a mixed etiology, enveloping chronic inflammatory and vascular impacts on the brain, driven by a constellation of modifiable risk factors which are largely mediated by lifestyle-related behaviors. These risk factors manifest over a prolonged preclinical period and account for up to 40% of the population attributable risk for dementia, representing viable targets for early interventions aimed at abating disease onset and progression. Here we outline the protocol for a 12-week randomized control trial (RCT) of a multimodal Lifestyle Intervention Study for Dementia Risk Reduction (LEISURE), with longitudinal follow-up at 6-months and 24-months post-intervention. This trial integrates exercise, diet, sleep, and mindfulness to simultaneously target multiple different etiopathogenetic mechanisms and their interplay in a healthy older adult population (aged 50-85 years), and assesses dementia risk reduction as the primary endpoint. The LEISURE study is located in the Sunshine Coast region of Australia, which has one of the nation's highest proportions of adults aged over 50 years (36.4%), and corresponding dementia prevalence. This trial is novel in its inclusion of mindfulness and sleep as multidomain lifestyle targets, and in its comprehensive suite of secondary outcomes (based on psychological, physical health, sleep activity, and cognitive data) as well as exploratory neuroimaging (magnetic resonance imaging and electroencephalography) and molecular biology measures. These measures will provide greater insights into the brain-behavioral underpinnings of dementia prevention, as well as the predictors and impacts of the proposed lifestyle intervention. The LEISURE study was prospectively registered (ACTRN12620000054910) on 19 January 2020.
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Affiliation(s)
- Ciara Treacy
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Jacob M Levenstein
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Annelise Jefferies
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Alexandra P Metse
- School of Health, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Mia A Schaumberg
- School of Health, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
- Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
- Manna Institute, University of the Sunshine Coast, QLD, Australia
| | - Anthony Villani
- School of Health, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Ana P Boucas
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Sophie C Andrews
- Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
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30
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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31
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Liu S, Wang X, Zheng Q, Gao L, Sun Q. Sleep Deprivation and Central Appetite Regulation. Nutrients 2022; 14:nu14245196. [PMID: 36558355 PMCID: PMC9783730 DOI: 10.3390/nu14245196] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Research shows that reduced sleep duration is related to an increased risk of obesity. The relationship between sleep deprivation and obesity, type 2 diabetes, and other chronic diseases may be related to the imbalance of appetite regulation. To comprehensively illustrate the specific relationship between sleep deprivation and appetite regulation, this review introduces the pathophysiology of sleep deprivation, the research cutting edge of animal models, and the central regulatory mechanism of appetite under sleep deprivation. This paper summarizes the changes in appetite-related hormones orexin, ghrelin, leptin, and insulin secretion caused by long-term sleep deprivation based on the epidemiology data and animal studies that have established sleep deprivation models. Moreover, this review analyzes the potential mechanism of associations between appetite regulation and sleep deprivation, providing more clues on further studies and new strategies to access obesity and metabolic disease.
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Affiliation(s)
- Shuailing Liu
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Xiya Wang
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Qian Zheng
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Lanyue Gao
- Experimental Center for School of Public Health, China Medical University, Shenyang 110122, China
| | - Qi Sun
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
- Correspondence: ; Tel./Fax: +86-15840312720
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32
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Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, Rosas SE, Del Prato S, Mathieu C, Mingrone G, Rossing P, Tankova T, Tsapas A, Buse JB. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2022; 65:1925-1966. [PMID: 36151309 PMCID: PMC9510507 DOI: 10.1007/s00125-022-05787-2] [Citation(s) in RCA: 251] [Impact Index Per Article: 125.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the previous consensus statements on the management of hyperglycaemia in type 2 diabetes in adults, published since 2006 and last updated in 2019. The target audience is the full spectrum of the professional healthcare team providing diabetes care in the USA and Europe. A systematic examination of publications since 2018 informed new recommendations. These include additional focus on social determinants of health, the healthcare system and physical activity behaviours including sleep. There is a greater emphasis on weight management as part of the holistic approach to diabetes management. The results of cardiovascular and kidney outcomes trials involving sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, including assessment of subgroups, inform broader recommendations for cardiorenal protection in people with diabetes at high risk of cardiorenal disease. After a summary listing of consensus recommendations, practical tips for implementation are provided.
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Affiliation(s)
- Melanie J Davies
- Leicester Diabetes Research Centre, University of Leicester, Leicester, UK.
- Leicester National Institute for Health Research (NIHR) Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - Vanita R Aroda
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Billy S Collins
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | | | - Jennifer Green
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Nisa M Maruthur
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sylvia E Rosas
- Kidney and Hypertension Unit, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Geltrude Mingrone
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Division of Diabetes and Nutritional Sciences, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Tsvetalina Tankova
- Department of Endocrinology, Medical University - Sofia, Sofia, Bulgaria
| | - Apostolos Tsapas
- Diabetes Centre, Clinical Research and Evidence-based Medicine Unit, Aristotle University Thessaloniki, Thessaloniki, Greece
- Harris Manchester College, University of Oxford, Oxford, UK
| | - John B Buse
- University of North Carolina School of Medicine, Chapel Hill, NC, USA.
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33
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Rutters F, Nefs G. Sleep and Circadian Rhythm Disturbances in Diabetes: A Narrative Review. Diabetes Metab Syndr Obes 2022; 15:3627-3637. [PMID: 36439294 PMCID: PMC9694979 DOI: 10.2147/dmso.s354026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Sleep and circadian rhythm disturbances are less-known risk factors for the development and suboptimal outcomes of diabetes. The goal of this narrative review is to highlight the importance of sleep and circadian rhythm disturbances in the development and outcomes of type 1 diabetes (T1D) and type 2 diabetes (T2D), assess current treatment options and the possible mediating mechanisms. We performed a literature search using PubMed and selected relevant English and Dutch papers. Disturbances of sleep and circadian rhythm are common in people with diabetes. They are associated with an increased risk of developing T2D as well as with suboptimal diabetes outcomes (including higher HbA1c levels and reduced quality of life) for T1D and T2D. Preliminary data suggest that treatment of sleep and circadian rhythm disturbances could improve diabetes outcomes in people with T1D and T2D. Finally, the association with medical parameters appears to be mediated by disturbance in hormones, and by suboptimal self-care including forgetting or postponing glucose monitoring or medication use as well as higher consumption of high fat/high sugary foods. Diabetes may also disturb sleep, for example through nocturnal hypoglycemia and nocturia. We concluded that sleep and circadian rhythm disturbances are closely linked with diabetes. More attention to sleep in regular diabetes care is warranted, while further research is needed on treatment of sleep and circadian rhythm disturbances in the prevention of diabetes and its suboptimal outcomes.
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Affiliation(s)
- Femke Rutters
- Department of Epidemiology and Data Science, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Giesje Nefs
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
- Diabeter, Center for Type 1 Diabetes Care and Research, Rotterdam, the Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, the Netherlands
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34
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Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, Rosas SE, Del Prato S, Mathieu C, Mingrone G, Rossing P, Tankova T, Tsapas A, Buse JB. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2022; 45:2753-2786. [PMID: 36148880 PMCID: PMC10008140 DOI: 10.2337/dci22-0034] [Citation(s) in RCA: 421] [Impact Index Per Article: 210.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 02/07/2023]
Abstract
The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the previous consensus statements on the management of hyperglycemia in type 2 diabetes in adults, published since 2006 and last updated in 2019. The target audience is the full spectrum of the professional health care team providing diabetes care in the U.S. and Europe. A systematic examination of publications since 2018 informed new recommendations. These include additional focus on social determinants of health, the health care system, and physical activity behaviors, including sleep. There is a greater emphasis on weight management as part of the holistic approach to diabetes management. The results of cardiovascular and kidney outcomes trials involving sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists, including assessment of subgroups, inform broader recommendations for cardiorenal protection in people with diabetes at high risk of cardiorenal disease. After a summary listing of consensus recommendations, practical tips for implementation are provided.
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Affiliation(s)
- Melanie J. Davies
- Leicester Diabetes Research Centre, University of Leicester, Leicester, U.K
- Leicester National Institute for Health Research Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, U.K
| | - Vanita R. Aroda
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | | | - Jennifer Green
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Nisa M. Maruthur
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sylvia E. Rosas
- Kidney and Hypertension Unit, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Geltrude Mingrone
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Division of Diabetes and Nutritional Sciences, School of Cardiovascular and Metabolic Medicine and Sciences, King’s College London, London, U.K
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Apostolos Tsapas
- Diabetes Centre, Clinical Research and Evidence-Based Medicine Unit, Aristotle University Thessaloniki, Thessaloniki, Greece
- Harris Manchester College, University of Oxford, Oxford, U.K
| | - John B. Buse
- University of North Carolina School of Medicine, Chapel Hill, NC
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35
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Is Melatonin the “Next Vitamin D”?: A Review of Emerging Science, Clinical Uses, Safety, and Dietary Supplements. Nutrients 2022; 14:nu14193934. [PMID: 36235587 PMCID: PMC9571539 DOI: 10.3390/nu14193934] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
Melatonin has become a popular dietary supplement, most known as a chronobiotic, and for establishing healthy sleep. Research over the last decade into cancer, Alzheimer’s disease, multiple sclerosis, fertility, PCOS, and many other conditions, combined with the COVID-19 pandemic, has led to greater awareness of melatonin because of its ability to act as a potent antioxidant, immune-active agent, and mitochondrial regulator. There are distinct similarities between melatonin and vitamin D in the depth and breadth of their impact on health. Both act as hormones, affect multiple systems through their immune-modulating, anti-inflammatory functions, are found in the skin, and are responsive to sunlight and darkness. In fact, there may be similarities between the widespread concern about vitamin D deficiency as a “sunlight deficiency” and reduced melatonin secretion as a result of “darkness deficiency” from overexposure to artificial blue light. The trend toward greater use of melatonin supplements has resulted in concern about its safety, especially higher doses, long-term use, and application in certain populations (e.g., children). This review aims to evaluate the recent data on melatonin’s mechanisms, its clinical uses beyond sleep, safety concerns, and a thorough summary of therapeutic considerations concerning dietary supplementation, including the different formats available (animal, synthetic, and phytomelatonin), dosing, timing, contraindications, and nutrient combinations.
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36
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Zhang Y, Xie Y, Huang L, Zhang Y, Li X, Fang Q, Wang Q. Association of Sleep Duration and Self-Reported Insomnia Symptoms with Metabolic Syndrome Components among Middle-Aged and Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11637. [PMID: 36141918 PMCID: PMC9517288 DOI: 10.3390/ijerph191811637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
The study aimed to explore the association between sleep duration, insomnia symptoms and the components of metabolic syndrome (MetS) among middle-aged and older adults. A cross-sectional study was conducted in five community health centers and physical check-up centers of two comprehensive hospitals in Guangdong. We recruited 1252 participants (658 female), aged 40-96 years and with a body mass index (BMI) of 16.26-35.56 kg/m2. MetS was assessed based on the guidelines of the International Diabetes Federation. Self-reported sleep duration was evaluated by a simplified questionnaire. Compared with the participants who slept 6-8 h/day, those who slept shorter (<6 h/day) or longer (>8 h/day) periods of time with or without insomnia symptoms had significantly increased odds ratios (ORs) of high blood pressure (except for the SBP in model 2) and high triglycerides (TGs) in all models (p < 0.05), whereas the participants who slept longer (>8 h/day) or shorter (<6 h/day) periods of time with insomnia symptoms had significantly increased ORs of low HDL-C in all models (p < 0.05), but non-significant in those without insomnia symptoms. BMI is significant for insomnia symptoms but not for sleep duration. Our study indicated that the association of sleep duration with MetS components was partially associated with insomnia symptoms. These findings have significant implications to explore the appropriate sleep duration for adults.
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Affiliation(s)
- Yuting Zhang
- Health Science Centre, Shenzhen University, Shenzhen 518060, China
| | - Yingcai Xie
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China
| | - Lingling Huang
- Health Science Centre, Shenzhen University, Shenzhen 518060, China
| | - Yan Zhang
- Health Science Centre, Shenzhen University, Shenzhen 518060, China
| | - Xilin Li
- Health Science Centre, Shenzhen University, Shenzhen 518060, China
| | - Qiyu Fang
- Health Science Centre, Shenzhen University, Shenzhen 518060, China
| | - Qun Wang
- Health Science Centre, Shenzhen University, Shenzhen 518060, China
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