Comparison of metabolic indexes in type 2 diabetes mellitus patients with different sleep quality

Abstract

Objective To investigate sleep quality of hospitalized type 2 diabetes mellitus(T2DM) patients, and evaluate relationship of sleep quality and metabolic indexes, resting energy expenditure and body composition. Method Three hundred hospitalized T2DM patients were included and Pittsburgh Sleep Quality Index(PSQI) questionnaire was used to evaluate their subjective sleep characteristics. Their general clinical data and biochemical indexes (including blood lipid, glucose, glycosylated hemoglobin (HbA1c) etc.) were collected and steamed bun test was carried out to get the secretion information of insulin and C-peptide in patients at 0 and 120 minutes, and then resting energy expenditure and body composition were measured. Patients with PSQI total scores ≥8 were classified as the sleep-disordered group, others were classified as normal sleep group. Independent samplet test and Independent- samples Mann- Whitney test were used to analyze normal and abnormal distribution measurement data respectively. Chi-squared test was used to analyze enumeration data. The influence factors of sleep disorder were analyzed by multivariate logistic regression analysis. Results 39.7% (119/300) hospitalized T2DM patients had sleeping disorder. Patients in T2DM sleep- disordered group had a female predominance (χ2=10.10,P<0.05) , higher level of HbA1c (8.85% (7.50,10.50)% vs 8.00% (7.10,10.00)% ,Z=- 2.301,P<0.05) and lower resting energy expenditure (Z=- 3.722,P<0.05). Body fat composition analysis showed that patients in sleep- disordered group had lower muscle mass((45±8) vs (49±9) kg,t=-4.066,P<0.05) and lower skeletal muscle mass(t=- 4.083, P<0.05). Besides, in sleep-disordered group, patients had higher proportions of stroke(χ2=4.538, P< 0.05), and usage of statin drugs(73.1% vs 60%, χ2=4.948, P<0.05). Logistic regression analysis showed that HbA1c(OR 1.13, 95%CI 0.999- 1.279,P=0.053), usage of statin drugs (OR 1.75, 95%CI 0.957- 3.203,P= 0.069) and muscle mass (OR 0.956, 95%CI 0.927- 0.986,P=0.005) were related with sleep disorder. Conclusion Female T2DM Patients with stroke or with using of statin drugs are more likely to have sleep disorder. For T2DM patients with above risk factors, more interventions of sleep may make better sleep quality and taking more exercises may bring better glycemic control. Key words: Diabetes mellitus ,type 2; Sleep quality, body composition