Obesity indicators as mediators of association between daytime napping and type 2 diabetes mellitus: the Guangzhou Biobank Cohort Study.
Ontology highlight
ABSTRACT: Objective
To examine the mediating effect of obesity indicators on the association between daytime napping and type 2 diabetes mellitus (T2DM) qualitatively and quantitatively using baseline data from the Guangzhou Biobank Cohort Study.Methods
Twenty-nine thousand three hundred fifty-five participants aged 50+ years were included in this cross-sectional study. Mediation analysis was used to assess the mediating effect of body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) on the association between daytime napping and T2DM after adjustment for sex, age, education, occupation, smoking status, alcohol use and physical activity.Results
The mean (standard deviation) age of participants was 61.5 ( 7.1) years. The prevalence of T2DM and daytime napping was 12.5% and 65.2%, respectively. After adjustment for potential confounders, WC, WHR and WHtR showed partial mediating effects on the association between daytime napping and T2DM, with the proportion (95% confidence interval) of mediation effect being 10.17% (8.14-14.43%), 14.91% (11.95-21.24%) and 9.36% (7.49-13.29%), respectively. No mediating effect of BMI or HC on the association between daytime napping and T2DM was found.Conclusions
Our results showed significant mediating effects of WC, WHR and WHtR on the association between daytime napping and T2DM, suggesting that waist circumference management could be important in daytime nappers.
SUBMITTER: Xiao JY
PROVIDER: S-EPMC8744231 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:We aimed to examine the longitudinal associations between daytime napping and nighttime sleep duration with the risk of diabetes mellitus (DM) among Chinese elderly using data from the China Health and Retirement Longitudinal Study (CHARLS). A cohort study was conducted among 2620 participants aged 60 years or above. Information on daytime napping and nighttime sleep duration was self-reported during the 2011 baseline survey. DM status during the 2015 follow-up survey was confirmed according to the American Diabetes Association criteria. Individuals with long daytime napping (>1 h/day) had increased risk of developing DM than non-nappers (adjusted RR = 1.52, 95%CI: 1.10, 2.10). In addition, we observed a U-shaped association between nighttime sleep duration and incident DM risk. We further found that nappers with <4 h of nighttime sleep, and those with >1 h of daytime napping and >6 h nighttime sleep had approximately two-fold elevated risk of DM, compared to non-nappers with 6-8 h of nighttime sleep. Long daytime napping and extreme nighttime sleep duration were associated with increased DM risk among Chinese elderly. There was a joint effect of long daytime napping and nighttime sleep duration on the risk of DM.
| S-EPMC8125963 | biostudies-literature
Project description:Daytime napping, a habit widely adopted globally, has an unclear association with obesity. In this study, we executed a meta-analysis to explore the relationship between daytime napping and obesity. We conducted a comprehensive search of the PubMed, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science databases for pertinent articles published up to April 2023. Random-effects models were utilized to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and we assessed the heterogeneity of the included studies using the I2 statistic. To explore potential sources of heterogeneity, subgroup analyses were performed. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS), and funnel plots were employed to detect any publication bias. Sensitivity analyses were conducted by sequentially omitting each study. We conducted a meta-analysis of twelve studies that included one each from the UK and Spain, five from the USA, and five from China, totalling 170,134 participants, to probe the association between napping and obesity. The pooled analysis suggested a higher risk of obesity in individuals who nap (OR: 1.22 [1.10-1.35], p < 0.001, I2 = 87%) compared to non-nappers. The meta-analysis results revealed variations in the summary ORs for studies conducted in China, Spain, the USA, and the UK. The ORs for China, Spain, the USA, and the UK were 1.05 (95% CI 0.90-1.23), 9.36 (95% CI 4.74-18.45), 1.27 (95% CI 1.10-1.47), and 1.39 (95% CI 1.32-1.47), respectively. A subgroup analysis based on age within the American population disclosed that napping in both adults and children heightened obesity incidence. A subgroup analysis based on nap duration found a significant rise in obesity occurrence when nap duration exceeded one hour, but no clear relationship emerged when nap duration was less than 1 h. In a subgroup analysis based on the definition of obesity, napping did not demonstrate a significant relationship with obesity when diagnostic criteria set obesity at a BMI of 25 or above. However, when the criteria were set at a BMI of 28 or 30 or more, napping significantly increased obesity risk. Our meta-analysis indicates a positive association between daytime napping and the risk of obesity. However, given the limited number of included studies, potential confounding factors might not have been fully addressed. Future well-designed prospective studies are required to further investigate this relationship. Large-scale studies are necessary to confirm our findings and elucidate the underlying mechanisms that drive these associations and causation.
| S-EPMC10372090 | biostudies-literature
Project description:BackgroundNo studies have assessed the association between daytime napping and obesity in China. The study aimed to examine the association between daytime napping and obesity among Chinese middle-aged and older adults, and to evaluate the difference between the aforementioned association in men and women.MethodsOverall, 14 685 participants aged 45 years and older were included by using data from China Health and Retirement Longitudinal Study (CHARLS) in 2015. A multivariable logistic regression model was used to investigate the relationship between daytime napping and obesity after adjusting for potential confounders. Stratified analyses were performed to examine the association differences by sex. Besides, the Cochran-Armitage test for trend was used to detect if there was a significant dose-response relationship between daytime napping and obesity.ResultsThe mean age of participants was 60.32, and the mean daytime napping duration was 38.97 minutes. In the sample, compared with no daytime napping group, the risks of being obese were higher in both moderate daytime napping group (1-60 minute/d) (odds ratio OR = 1.27, 95% confidence interval (CI) = 1.13-1.44) and extend long daytime napping group (>60 minute/d) (OR = 1.34, 95% CI = 1.15-1.56). In sex stratification, these significant correlations only existed in women but not in men. Compared with no daytime napping, women who napped 1-60 minute/d and over 60 minute/d were more likely to be obese (OR = 1.37, 95% CI = 1.18-1.59 and OR = 1.49, 95% CI = 1.23-1.81, respectively). Besides, the Cochran-Armitage trend test revealed that the prevalence rate of obesity increased as the daytime napping duration increased (P < 0.001).ConclusionsThe study established the relationship between daytime napping and obesity in a general Chinese population. The association, however, was only detected among women. Furthermore, there was a dose-response relationship between daytime napping and obesity among women. Future studies may verify this association by using a longitudinal design and focus on the mechanisms behind such association.
| S-EPMC7719355 | biostudies-literature
Project description:BackgroundWe investigated association of a score incorporating relative grip strength (RGS) and timed up and go (TUG) test with incident type 2 diabetes mellitus (T2DM) in older Chinese.MethodsBoth RGS and TUG scores were classified into tertiles (0~2 points) and summed to yield RGS-TUG score, ranging from 0 to 4 points, with higher points indicating better physical function. Cox proportional hazards regression was used to analyze association of RGS-TUG score with incident T2DM.Results3,892 participants without T2DM were followed up for an average of 3.6 years with 240 developing T2DM. After adjustment, those with the lowest RGS-TUG score, versus the highest, had higher fasting glucose, two-hour post-load glucose and glycosylated hemoglobin A1c, with β (95% confidence interval (CI)) being 0.21 (0.08, 0.33), 1.06 (0.69, 1.43) and 0.16 (0.06, 0.27), respectively. In participants with BMI of ≥25 kg/m2, those with the lowest RGS-TUG score showed a higher risk of T2DM (adjusted hazard ratio 3.01, 95% CI 1.04-8.69). No association was found for BMI of 18.5~<25 kg/m2 (P for interaction < 0.05).ConclusionsThis is the first study showing lower RGS-TUG score was associated with increased glycemia and incident T2DM in older people with overweight/obesity. The underlying mechanisms warrant further investigation.
| S-EPMC8351683 | biostudies-literature
Project description:BackgroundExisting diabetes risk prediction models based on regression were limited in dealing with collinearity and complex interactions. Bayesian network (BN) model that considers interactions may provide additional information to predict risk and infer causation.MethodsBN model was constructed for new-onset diabetes using prospective data of 15,934 participants without diabetes at baseline [73% women; mean (standard deviation) age = 61.0 (6.9) years]. Participants were randomly assigned to a training (n = 12,748) set and a validation (n = 3,186) set. Model performances were assessed using area under the receiver operating characteristic curve (AUC).ResultsDuring an average follow-up of 4.1 (interquartile range = 3.3-4.5) years, 1,302 (8.17%) participants developed diabetes. The constructed BN model showed the associations (direct, indirect, or no) among 24 risk factors, and only hypertension, impaired fasting glucose (IFG; fasting glucose of 5.6-6.9 mmol/L), and greater waist circumference (WC) were directly associated with new-onset diabetes. The risk prediction model showed that the post-test probability of developing diabetes in participants with hypertension, IFG, and greater WC was 27.5%, with AUC of 0.746 [95% confidence interval CI) = 0.732-0.760], sensitivity of 0.727 (95% CI = 0.703-0.752), and specificity of 0.660 (95% CI = 0.652-0.667). This prediction model appeared to perform better than a logistic regression model using the same three predictors (AUC = 0.734, 95% CI = 0.703-0.764, sensitivity = 0.604, and specificity = 0.745).ConclusionsWe have first reported a BN model in predicting new-onset diabetes with the smallest number of factors among existing models in the literature. BN yielded a more comprehensive figure showing graphically the inter-relations for multiple factors with diabetes than existing regression models.
| S-EPMC9382298 | biostudies-literature
Project description:Preliminary evidence suggests that daytime sleepiness may predate clinical diagnosis of Parkinson disease. The authors examined daytime napping and nighttime sleeping durations, reported in 1996-1997 by 220,934 US NIH-AARP Diet and Health Study participants, in relation to Parkinson disease diagnoses at 3 clinical stages: established (cases diagnosed before 1995, n = 267), recent (1995-1999, n = 396), and prediagnostic (2000 and after, n = 770). Odds ratios and 95% confidence intervals were derived from multivariate logistic regression models. Longer daytime napping was associated with higher odds of Parkinson disease at all 3 clinical stages: the odds ratios comparing long nappers (>1 hour/day) with nonnappers were 3.9 (95% confidence interval: 2.8, 5.6) for established cases, 2.2 (95% confidence interval: 1.7, 3.0) for recent cases, and 1.5 (95% confidence interval: 1.2, 1.9) for prediagnostic cases. Further control for health status or nighttime sleeping duration attenuated the association for established cases but made little difference for recent or prediagnostic cases. In the nighttime sleeping analysis, a clear U-shaped association with Parkinson disease was observed for established cases; however, this association was attenuated markedly for recent cases and disappeared for prediagnostic cases. This study supports the notion that daytime sleepiness, but not nighttime sleeping duration, is one of the early nonmotor symptoms of Parkinson disease.
| S-EPMC3121222 | biostudies-literature
Project description:ObjectivesTo explore whether daytime napping and sleep duration are linked to serum C reactive protein (CRP), a pro-inflammatory marker, in an older aged British population.DesignCross-sectional study.SettingEuropean Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study.ParticipantsA total of 5018 men and women aged 48-92 years reported their sleep habits and had serum CRP levels measured.Outcome and measuresCRP was measured (mg/L) during 2006-2011 in fresh blood samples using high-sensitivity methods. Participants reported napping habits during 2002-2004, and reported sleep quantity during 2006-2007. Multivariable linear regression models were used to examine the association between napping and log-transformed CRP, and geometric mean CRP levels were calculated.ResultsAfter adjustment for age and sex, those who reported napping had 10% higher CRP levels compared with those not napping. The association was attenuated but remained borderline significant (β=0.05 (95% CI 0.00 to 0.10)) after further adjustment for social class, education, marital status, body mass index, physical activity, smoking, alcohol intake, self-reported health, pre-existing diseases, systolic blood pressure, hypnotic drug use, depression and in women-only hormone replacement therapy use. The geometric means (95% CI) of CRP levels were 2.38 (2.29 to 2.47) mg/L and 2.26 (2.21 to 2.32) mg/L for those who reported napping and no napping, respectively. A U-shaped association was observed between time spent in bed at night and CRP levels, and nighttime sleep duration was not associated with serum CRP levels. The association between napping and CRP was stronger for older participants, and among extremes of time spent in bed at night.ConclusionsDaytime napping was associated with increased CRP levels in an older aged British population. Further studies are needed to determine whether daytime napping is a cause for systemic inflammation, or if it is a symptom or consequence of underlying health problems.
| S-EPMC4244397 | biostudies-literature
Project description:BackgroundWe aimed to examine the bidirectional associations between daytime napping duration and metabolic syndrome (MetS).MethodsUsing data from the China Health and Retirement Longitudinal Study from 2011 to 2015, modified Poisson regression models were performed to explore the longitudinal associations of baseline napping duration with the occurrence and remission of MetS. Generalized estimating equation was conducted to explore the association between baseline MetS status with subsequent changes in daytime napping duration. Cross-lagged panel analysis was performed to further verify their bidirectional relationships.ResultsDuring the four-year follow-up, among 5041 participants without MetS at baseline, extended naps were significantly associated with MetS occurrence, compared with non-napping. This association was only significant in individuals with adequate night-time sleep duration or good sleep quality of the 2898 participants with MetS at baseline. Excessive napping duration may be not favorable for MetS remission especially for adequate night-time sleepers. With respect to reverse associations, baseline MetS status significantly increased the napping duration during the subsequent follow-up period. Finally, there were significant bidirectional cross-lagged associations between napping duration and MetS severity score after adjusting for all covariates.ConclusionsOur study indicates bidirectional relationships exist between daytime napping duration and MetS. Interestingly, longer napping duration was detrimental to cardiometabolic health only in those with sufficient night-time sleep duration or good sleep quality.
| S-EPMC9785410 | biostudies-literature
Project description:ObjectiveDaytime napping has been associated with poor health outcomes in adults. It is not known whether daytime napping is similarly linked to adverse health in adolescents, although many report napping. The present study evaluated associations between daytime napping and 2 markers of increased inflammation, high-sensitivity C-reactive protein and interleukin-6 (IL-6), in healthy high school students.MethodsTwo hundred thirty-four Black and White high school students completed a week of actigraph and diary measures of sleep and napping and provided a fasting blood sample. Napping measures were the proportion of days napped and the average minutes napped across 1 week during the school year.ResultsLinear regressions adjusted for age, sex, race, average nocturnal sleep duration, time between sleep protocol and blood draw, and body mass index percentile demonstrated that proportion of days napped measured by actigraphy, B(SE) = .41(.19), p < .05, across the full week was positively associated with IL-6. Higher proportions of school days napped between 2 p.m. and 6 p.m., B(SE) = .40(.20), p < .05, and between 6 p.m. and 10 p.m., B(SE) = .57(.28), p < .05, were associated with increased IL-6. No associations emerged between average actigraphy-assessed nap duration and either study outcome. Diary-reported napping was unrelated to either study outcome.ConclusionsActigraphy-assessed napping and IL-6 are associated but the direction of the relationship remains to be determined. Overall, napping is an important factor to consider to better understand the relationship between short sleep and cardiovascular health in adolescents. (PsycINFO Database Record
| S-EPMC5118199 | biostudies-literature
Project description:BackgroundThe causal relationship between daytime napping and the risk of Parkinson's disease (PD) remains unclear, with prospective studies providing limited evidence. This study investigated the association between daytime napping frequency and duration and PD incidence and explored the causality relationship between this association by conducting Mendelian randomization (MR) analysis.MethodsThis prospective cohort study included 393,302 participants, and accelerometer-measured daytime napping data were available only for 78,141 individuals. Cox proportional hazards regression was used to estimate the association between the daytime napping frequency and duration and the PD risk. The role of the systemic immune-inflammation index (SII) in the association between daytime napping frequency and PD risk was assessed through mediation analyses. Moreover, the causal association between the daytime napping frequency and the PD risk was preliminarily explored by conducting two-sample MR analyses.ResultsThe median follow-up duration was 12.18 years. The participants who reported napping sometimes or usually exhibited a significantly higher PD risk than those who never/rarely napped during the day [sometimes: hazard ratio (HR), 1.13; 95% confidence interval (CI), 1.03-1.23; usually: HR, 1.33; 95% CI, 1.14-1.55], and SII played a mediating role in this association. However, the MR analyses did not indicate that the daytime napping frequency and PD risk were significantly associated. The participants napping for over 1 h exhibited a significantly elevated PD risk (HR, 1.54; 95% CI, 1.11-2.16). Moreover, no significant interaction was identified between napping frequency or duration and genetic susceptibility to PD (P for interaction > 0.05).ConclusionsIn this study, increased daytime napping frequency and duration were associated with an increased PD risk, but no causal relationship was observed between napping frequency and PD risk in the MR analysis. Larger GWAS-based cohort studies and MR studies are warranted to explore potential causal relationships.
| S-EPMC11321229 | biostudies-literature