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Sleep. 2018 Dec 1;41(12). doi: 10.1093/sleep/zsy190.

Cross-sectional associations of objectively-measured sleep characteristics with obesity and type 2 diabetes in the PREDIMED-Plus trial.

Author information

1
Universitat Rovira i Virgili. Department of Biochemistry and Biotechnology. Human Nutrition Unit. Sant Joan de Reus Hospital. IISPV, Reus, Spain.
2
CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
3
Instituto de Investigación Sanitaria de Illes Balears (IdISBa), University Hospital of Son Espases, Palma de Mallorca, Spain.
4
Department of Nursing, University of Málaga-IBIMA, Málaga, Spain.
5
Department of Preventive Medicine, University of Valencia, Valencia, Spain.
6
Department of Preventive Medicine and Public Health, Institute for Health Research (DISNA), University of Navarra-Navarra, Pamplona, Spain.
7
Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA.
8
Department of Internal Medicine, Hospital Clínic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain.
9
Nutritional Epidemiology Unit, University of Miguel Hernández, ISABIAL-FISABIO, Alicante, Spain.
10
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
11
Department of Cardiology, University Hospital Araba, Vitoria, Spain.
12
Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain.
13
Departament of Preventive Medicine and Public Health, University of Granada, Spain.
14
Endocrinology and Nutrition Department, Hospital Clínic Barcelona, Spain.
15
Institut Investigacions Biomediques August Pi Sunyer, Barcelona, Spain.
16
CIBER en Diabetes y Enfermedades Metabólicas (CIBERDEM), Madrid, Spain.
17
University of Las Palmas de Gran Canaria. Research Institute of Biomedical and Health Sciences (IUIBS). Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain.
18
Instituto de Biomedicina (IBIOMED) de la Universidad de León; y Gerencia de Atención Primaria del área de salud de León, Leon, Spain.
19
Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, Malaga, Spain.
20
Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.
21
Madrid Institute for Advanced Studies (IMDEA) Food Institute, Madrid, Spain.
22
JM-USDA-Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
23
Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.
24
Servicio de Endocrinología y Nutrición. Instituto de Investigación Sanitaria San Carlos (Idissc), Madrid, Spain.
25
Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.
26
Lipid Unit, Department of Internal Medicine, Bellvitge Biomedical Research Institute (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
27
Atención Primaria. Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain.
28
Department of Public Health, University of Málaga-IBIMA, Málaga, Spain.

Abstract

Study Objectives:

To examine independent and combined associations of sleep duration and sleep variability with body composition, obesity and type 2 diabetes (T2D) in elders at high cardiovascular risk.

Methods:

Cross-sectional analysis of 1986 community-dwelling elders with overweight/obesity and metabolic syndrome from PREDIMED-Plus trial. Associations of accelerometry-derived sleep duration and sleep variability with body mass index (BMI), waist circumference (WC) and body composition were assessed fitting multivariable-adjusted linear regression models. Prevalence ratios (PR) and 95% confidence intervals (CI) for obesity and T2D were obtained using multivariable-adjusted Cox regression with constant time. "Bad sleepers" (age-specific non-recommended sleep duration plus sleep variability above the median) and "good sleepers" (age-specific recommended sleep duration plus sleep variability below the median) were characterized by combining sleep duration and sleep variability, and their associations with these outcomes were examined.

Results:

One hour/night increment in sleep duration was inversely associated with BMI (β -0.38 kg/m2 [95% CI -0.54, -0.23]), WC (β -0.86 cm [95% CI -1.25, -0.47]), obesity (PR 0.96 [95% CI 0.93, 0.98]), T2D (PR 0.93 [95% CI 0.88, 0.98]) and other DXA-derived adiposity-related measurements (android fat and trunk fat, all p < .05). Each 1-hour increment in sleep variability was positively associated with T2D (PR 1.14 [95% CI 1.01, 1.28]). Compared with "good sleepers," "bad sleepers" were positively associated with obesity (PR 1.12 [95% CI 1.01, 1.24]) and T2D (PR 1.62 [95% CI 1.28, 2.06]).

Conclusions:

This study revealed cross-sectional associations of sleep duration with adiposity parameters and obesity. Sleep duration and sleep variability were associated with T2D. Considering simultaneously sleep duration and sleep variability could have additional value, particularly for T2D, as they may act synergistically.

PMID:
30285250
DOI:
10.1093/sleep/zsy190

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