The Association between Habitual Sleep Duration and Sleep Quality with Glycemic Traits: Assessment by Cross-Sectional and Mendelian Randomization Analyses

Raymond Noordam,Patrick C. N. Rensen,Gerard Jan Blauw,Maxime M. Bos,Renée de Mutsert,Esther Donga,Diana van Heemst,Frits R. Rosendaal,Nienke R. Biermasz

doi:10.3390/jcm8050682

Raymond Noordam, Patrick C. N. Rensen + Show 7 more

Open Access

https://doi.org/10.3390/jcm8050682

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Abstract

Evidence on whether habitual sleep duration and sleep quality are associated with increased insulin resistance is inconsistent. Here, we investigated the associations between different measures of habitual sleep with glycemic traits through cross-sectional and Mendelian randomization (MR) analyses. We assessed the associations of sleep duration and sleep quality with glycemic traits using multivariable linear regression models adjusted for potential confounders in 4672 middle-aged (45–65 years; 48% men) nondiabetic participants of the Netherlands Epidemiology of Obesity (NEO) study. Genetic variants for total, short, and long sleep duration were used as instrumental variables in MR analyses using summary-level data of glycemic traits in nondiabetic individuals (MAGIC; n = 58,074). In cross-sectional analyses, shortest sleepers (median 5.0 h of sleep per night) had 14.5% (95% confidence interval (CI): 2.0; 28.6%) higher fasting insulin level and 16.3% (95% CI: 2.7; 31.7%) higher HOMA-β. Bad sleep quality was associated with higher insulin resistance (e.g., 14.3% (95% CI: 4.7; 24.9%) higher HOMA-IR). All these associations disappeared after adjustment for BMI and the risk of sleep apnea. MR analyses did not indicate a causal association between total, short or long sleep duration and glycemic traits. Therefore, our used measures of habitual sleep duration and sleep quality are unlikely to directly associate with insulin resistance.

Highlights

During the past few decades, obesity and conditions that reflect disturbances in metabolism have increased [1]
We extended this study with a two-sample Mendelian randomization (MR) analysis to provide evidence as to whether the association between sleep duration and insulin resistance is causal using data of the Meta-Analyses of Glucose and Insulin-Related Traits Consortium (MAGIC)
When analyses were adjusted for age and sex, shortest sleep duration was associated with higher fasting insulin, higher homeostatic model assessment of insulin resistance (HOMA-IR), higher HOMA of β-cell function (HOMA-β), and higher area under the curve (AUC) of insulin

Summary

Introduction

During the past few decades, obesity and conditions that reflect disturbances in metabolism have increased [1]. It has been observed that both short and long total sleep duration were associated with a higher risk of obesity, insulin resistance, diabetes mellitus, and a higher body weight [2,3,4,5,6,7,8,9]. Cut-offs to define either short or long sleep duration are heterogeneous [14] Another explanation might be adjustments for confounding factors. Body mass index (BMI) is known on one hand to be one of the largest risk factors for insulin resistance and diabetes, while on the other hand, it is associated with shorter sleep duration [15,16,17]. Most of the previous performed studies did not adjust for OSA [4,10,11,20,21,22]

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