Healthy Sleep Behaviors Reduce the Risk of Microvascular and Cardiovascular Complications in Patients With Type 2 Diabetes and Are Associated With Potential Serum Biomarkers: A UK Biobank Observational Cohort Study

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-06-29 DOI:10.1111/1753-0407.70107

Rui Lan, Lina Mao, Tingting Luo, Wenjin Luo, Yao Qin, Hanwen Ye, Jingbo Hu, Shuming Yang, Qifu Li, Zhihong Wang, Xiangjun Chen

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Abstract

Background

The association of sleep behaviors with microvascular complications and cardiovascular outcomes in diabetic patients is not clear. Furthermore, serum biomarkers that can be used to evaluate this association have not been characterized. Therefore, this study investigated the association of the overall sleep score with the diabetic complications and the potential underlying serum metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM).

Methods

This prospective cohort study included 30 915 T2DM patients without complications from the UK Biobank. The sleep score of the participants was evaluated based on sleep behaviors such as sleep duration, insomnia, snoring, chronotype, and daytime sleepiness. The potential biomarkers, including cystatin C (Cys C), apolipoprotein A (Apo A), C-reactive protein (CRP), albumin, and γ-glutamyl transpeptidase (GGT), were also determined to evaluate their role as potential indicators of the association between the sleep score and the diabetic complications.

Results

Participants with a healthy sleep score of 4–5 had lower risks of microvascular complications (HR = 0.80 [95% CI: 0.72, 0.89]) and cardiovascular outcomes (HR = 0.70 [95% CI: 0.61, 0.81]) compared to those with a sleep score of 0–1. Furthermore, cys C showed the best effects by explaining the associations of overall healthy sleep behaviors with microvascular complications and cardiovascular outcomes by 30.36% and 14.36%, respectively.

Conclusions

Our data showed that healthy sleep behaviors were associated with a reduced risk of diabetic complications. Moreover, serum biomarkers of renal function, lipids, systemic inflammation, and hepatic function partially mediated the relationship between sleep behaviors and diabetic complications.

Abstract Image

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健康的睡眠行为可降低2型糖尿病患者微血管和心血管并发症的风险，并与潜在的血清生物标志物相关：一项英国生物银行观察队列研究

背景糖尿病患者睡眠行为与微血管并发症及心血管结局的关系尚不清楚。此外，可用于评估这种关联的血清生物标志物尚未被表征。因此，本研究探讨了2型糖尿病（T2DM）患者总睡眠评分与糖尿病并发症和潜在血清代谢生物标志物的关系。方法本前瞻性队列研究纳入来自英国生物银行的30915例无并发症的T2DM患者。参与者的睡眠得分是根据睡眠时间、失眠、打鼾、睡眠类型和白天嗜睡等睡眠行为来评估的。潜在的生物标志物，包括胱抑素C （Cys C）、载脂蛋白A （Apo A）、C反应蛋白（CRP）、白蛋白和γ-谷氨酰转肽酶（GGT），也被测定，以评估它们作为睡眠评分与糖尿病并发症之间关联的潜在指标的作用。结果睡眠健康评分为4-5分的受试者微血管并发症（HR = 0.80 [95% CI: 0.72, 0.89]）和心血管结局（HR = 0.70 [95% CI: 0.61, 0.81]）的风险低于睡眠评分为0-1分的受试者。此外，cys C的效果最好，说明整体健康睡眠行为与微血管并发症和心血管结局的相关性分别为30.36%和14.36%。结论：我们的数据显示，健康的睡眠行为与降低糖尿病并发症的风险有关。此外，肾功能、血脂、全身炎症和肝功能的血清生物标志物部分介导了睡眠行为与糖尿病并发症之间的关系。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.