Dataset Information

A Novel Risk Score for Type 2 Diabetes Containing Sleep Duration: A 7-Year Prospective Cohort Study among Chinese Participants.

ABSTRACT: Background:Sleep duration is associated with type 2 diabetes (T2D). However, few T2D risk scores include sleep duration. We aimed to develop T2D scores containing sleep duration and to estimate the additive value of sleep duration. Methods:We used data from 43,404 adults without T2D in the Beijing Health Management Cohort study. The participants were surveyed approximately every 2 years from 2007/2008 to 2014/2015. Sleep duration was calculated from the self-reported usual time of going to bed and waking up at baseline. Logistic regression was employed to construct the risk scores. Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to estimate the additional value of sleep duration. Results:After a median follow-up of 6.8 years, we recorded 2623 (6.04%) new cases of T2D. Shorter (both 6-8?h/night and <6?h/night) sleep durations were associated with an increased risk of T2D (odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.30-1.59; OR = 1.98, 95%CI = 1.63-2.41, respectively) compared with a sleep duration of >8?h/night in the adjusted model. Seven variables, including age, education, waist-hip ratio, body mass index, parental history of diabetes, fasting plasma glucose, and sleep duration, were selected to form the comprehensive score; the C-index was 0.74 (95% CI: 0.71-0.76) for the test set. The IDI and NRI values for sleep duration were 0.017 (95% CI: 0.012-0.022) and 0.619 (95% CI: 0.518-0.695), respectively, suggesting good improvement in the predictive ability of the comprehensive nomogram. The decision curves showed that women and individuals older than 50 had more net benefit. Conclusions:The performance of T2D risk scores developed in the study could be improved by containing the shorter estimated sleep duration, particularly in women and individuals older than 50.

SUBMITTER: Liu X

PROVIDER: S-EPMC6964717 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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A Novel Risk Score for Type 2 Diabetes Containing Sleep Duration: A 7-Year Prospective Cohort Study among Chinese Participants.

Liu Xiangtong X Li Zhiwei Z Zhang Jingbo J Chen Shuo S Tao Lixin L Luo Yanxia Y Xu Xiaolin X Fine Jason Peter JP Li Xia X Guo Xiuhua X

Journal of diabetes research 20200104

<h4>Background</h4>Sleep duration is associated with type 2 diabetes (T2D). However, few T2D risk scores include sleep duration. We aimed to develop T2D scores containing sleep duration and to estimate the additive value of sleep duration.<h4>Methods</h4>We used data from 43,404 adults without T2D in the Beijing Health Management Cohort study. The participants were surveyed approximately every 2 years from 2007/2008 to 2014/2015. Sleep duration was calculated from the self-reported usual time of ...[more]

PMID: 31998805

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Project description:Aims/hypothesisThis study aimed to investigate whether the effects of sleep duration interacted with the presence of diabetes. We specifically sought to examine the relationship between sleep duration and all-cause and cause-specific mortality in people with type 2 diabetes across sex, age at diagnosis, duration of diabetes and treatment type.MethodsThe sample consisted of 273,029 adults, including 248,817 without diabetes and 24,212 with type 2 diabetes, who participated in the National Health Interview Survey from 2004 to 2013 and whose data were linked to a mortality database up to 31 December 2015. Sleep duration was measured using self-report, whereby participants were asked 'on average how long do you sleep each day (≤5, 6, 7, 8, 9 or ≥10 h/day)?' The relationship between sleep duration and mortality risk was investigated using Cox proportional hazards regression model, with adjustments for demographics, BMI, lifestyle behaviours and clinical variables.ResultsAbsolute mortality rate was higher in adults with diabetes and extremes of sleep duration (≤5 h/day, 215.0 per 10,000 person-years; ≥10 h/day, 363.5 per 10,000 person-years). There was a non-significant interaction between sleep duration and the presence of diabetes (p for interaction = 0.08). A J-shaped relationship existed between sleep duration and all-cause mortality risk in people with type 2 diabetes. Compared with the reference group (7 h/day), both shorter and longer sleep durations were associated with increased risk of all-cause mortality (≤5 h/day, HR 1.24 [95% CI 1.09, 1.40]; 6 h/day, HR 1.13 [1.01, 1.28]; 8 h/day, HR 1.17 [1.06, 1.30]; ≥10 h/day, HR 1.83 [1.61, 2.08]). Similar associations were also observed for mortality risk from CVD, cancer, kidney disease, Alzheimer's disease and chronic lower respiratory diseases. Longer sleep duration in those with a younger age at diabetes onset was associated with greater risks of all-cause and CVD mortality. Shorter sleep duration in individuals treated with both insulin and oral glucose-lowering medication was also associated with higher risks of all-cause and CVD mortality.Conclusions/interpretationThe associations between sleep duration and mortality risk may be different between diabetic and non-diabetic individuals. In people with type 2 diabetes, sleeping less or more than 7 h/day was associated with increased risk of all-cause and condition-specific mortality. The association was more prominent in those with a younger age at diabetes onset and receiving treatment with both oral glucose-lowering medication and insulin. This population may benefit from targeted sleep-related interventions to reduce the risks of adverse health outcomes. Graphical abstract.

Project description:There is limited information on the relationship between risk of cardiovascular disease and the joint effects of sleep quality and sleep duration, especially from large, prospective, cohort studies. This study is to prospectively investigate the joint effects of sleep quality and sleep duration on the development of coronary heart disease.This study examined 60,586 adults aged 40 years or older. A self-administered questionnaire was used to collect information on sleep quality and sleep duration as well as a wide range of potential confounders. Events of coronary heart disease were self-reported in subsequent medical examinations. Two types of Sleep Score (multiplicative and additive) were constructed to reflect the participants' sleep profiles, considering both sleep quality and sleep duration. The Cox regression model was used to estimate the hazard ratio (HR) and the 95% confidence interval (CI).A total of 2,740 participants (4.5%) reported new events of coronary heart disease at follow-up. For sleep duration, participants in the group of < 6 h/d was significantly associated with an increased risk of coronary heart disease (HR: 1.13, 95% CI: 1.04-1.23). However, the association in the participants with long sleep duration (> 8 h/d) did not reach statistical significance (HR: 1.11, 95% CI: 0.98-1.26). For sleep quality, both dreamy sleep (HR: 1.21, 95% CI: 1.10-1.32) and difficult to fall asleep/use of sleeping pills or drugs (HR: 1.40, 95% CI: 1.25-1.56) were associated with an increased risk of the disease. Participants in the lowest quartile of multiplicative Sleep Score (HR: 1.31, 95% CI: 1.16-1.47) and of additive sleep score (HR: 1.31, 95% CI: 1.16-1.47) were associated with increased risk of coronary heart disease compared with those in the highest quartile.Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease. The association for long sleep duration does not reach statistical significance. Lower Sleep Score (poorer sleep profile) increases the risk of coronary heart disease, suggesting the importance of considering sleep duration and sleep quality together when developing strategies to improve sleep for cardiovascular disease prevention.

Dataset Information

A Novel Risk Score for Type 2 Diabetes Containing Sleep Duration: A 7-Year Prospective Cohort Study among Chinese Participants.

Publications

A Novel Risk Score for Type 2 Diabetes Containing Sleep Duration: A 7-Year Prospective Cohort Study among Chinese Participants.

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