Abstract P526: Association of Hemoglobin A1c With Sleep Duration in Non-Diabetic Population

Abstract

Background: Shorter sleep duration is associated with higher hemoglobin A1c (HbA1c) in patients with type 2 diabetes. We aim to examine the association between HbA1c level and sleep duration in non-diabetic population. Methods: A cross-sectional study using 2017-2020 NHANES included self-questionnaires of the presence or absence of diabetes and sleep duration on weekdays and weekends. The association between the quartile (Q) of HbA1c and sleep duration in non-diabetic patients was examined by multiple linear regression. Results: Of 7,998 non-diabetic participants ≥18 years old, mean±SD age was 47±19 and 52% were female. Mean HbA1c levels from Q1 to Q4 were 5.0±0.2, 5.4±0.1, 5.7±0.1, and 6.5±0.9%, respectively (Figure 1). Mean sleep durations on the weekdays and weekends were 7.6±1.7 and 8.3±1.8 hours, respectively. Compared to participants with HbA1c in Q1, sleep durations in both weekdays and weekends were lower in Q2 to 4 with the lowest sleep duration in Q3 (β weekdays_Q3 -0.32; 95%CI -0.43, -0.21; P <0.001 and β weekends_Q3 -0.43; 95%CI -0.54, -0.31; P <0.001). After adjusting for age, gender, race, SBP, DBP, BMI, serum creatinine, urinary albumin:creatinine ratio, hemoglobin, ferritin and interaction term between HbA1c quartile and race (white vs. non-white), the direction of HbA1c - weekday sleep duration association remains with the lowest sleep duration in Q3 (β weekdays_Q3 -0.34; 95%CI -0.48, -0.19; P <0.001). Furthermore, race was identified as an effect modifier with an increased weekday sleep duration observed in White with HbA1c in Q3 (β weekdays_Q3 0.26; 95%CI 0.04, 0.49; P interaction 0.022). Only HbA1c Q3 was significantly associated with weekend sleep duration (β weekends_Q3 -0.18; 95%CI -0.34, -0.03; P 0.022). Conclusions: In non-diabetic population, HbA1c was inversely associated with sleep duration on both weekdays and weekends and in a U-shaped relationship except for White whose HbA1c was positively related to sleep duration on the weekdays. Glycemic status may be involved in sleep duration or quality.