Abstract
The aim of this study was to evaluate whether short sleep duration or later sleep timing isa risk factor for insulin resistance (IR) in late adolescence. Mexico City adolescents enrolled in a longitudinal birth cohort (ELEMENT) took part in two study visits during peri-puberty that occurred approximately 2 years apart. IR was assessed with serum glucose and insulin. Four groups were defined using puberty-specific cutpoints: no IR over the follow-up period, transition from normal to IR, transition from IR to normal, and IR at both timepoints. Baseline sleep assessments were measured with 7-day wrist actigraphy. Multinomial logistic regression models were used to evaluate associations between sleep duration and timing with homeostatic model assessment of insulin resistance categories, adjusting for age, sex, and baseline pubertal status. Adolescents who were ≥ 1hour below the sleep duration recommendations-for-age were 2.74 times more likely to develop IR (95% CI: 1.0-7.4). Similarly, adolescents who were in the latest category of sleep midpoint (>4:33 a.m.) were more likely than those with earliest midpoints (1 a.m.-3a.m.) to develop IR (oddsratio=2.63, 95% CI: 1.0-6.7). Changes in adiposity over follow-up did not mediate sleep and IR. Insufficient sleep duration and late sleep timing were associated with development of IR over a 2-year period in late adolescence.
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