Association of sleep and circadian patterns and genetic risk with incident type 2 diabetes: a large prospective population-based cohort study

in European Journal of Endocrinology
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  • 1 Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
  • | 2 The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
  • | 3 Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
  • | 4 Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  • | 5 Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA

Correspondence should be addressed to C Mao; Email: maochen9@smu.edu.cn

*(Z-H Li and P-D Zhang contributed equally to this work)

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Objective

To examine the association of incident type 2 diabetes (T2D) risk with sleep factors, genetic risk, and their combination effects.

Design

Large prospective population-based cohort study.

Methods

This population-based prospective cohort study included 360 403 (mean (s.d.) age: 56.6 (8.0) years) participants without T2D at baseline from the UK Biobank. Genetic risk was categorised as high (highest quintile), intermediate (quintiles: 2–4), and low (lowest quintile) based on a polygenic risk score for T2D. Sleep scores, including long or short sleep duration, insomnia, snoring, late chronotype, and excessive daytime sleepiness, were categorized as an unfavourable, intermediate, or favourable sleep and circadian pattern.

Results

During a median follow-up of 9.0 years, 13 120 incident T2D cases were recorded. Among the participants with an unfavourable sleep and circadian pattern, 6.96% (95% CI: 6.68–7.24%) developed T2D vs 2.37% (95% CI: 2.28–2.46%) of participants with a favourable sleep and circadian pattern (adjusted hazard ratio (HR): 1.53, 95% CI: 1.45–1.62). Of participants with a high genetic risk, 5.53% (95% CI: 5.36–5.69%) developed T2D vs 2.01% (95% CI: 1.91–2.11%) of participants with a low genetic risk (adjusted HR: 2.89, 95% CI: 2.72–3.07). The association with sleep and circadian patterns was independent of genetic risk strata. Participants in the lowest quintile with an unfavourable sleep and circadian pattern were 3.97-fold more likely to develop T2D than those in the lowest quintile with a favourable sleep and circadian pattern.

Conclusions

Sleep and circadian patterns and genetic risk were independently associated with incident T2D. These results indicate the benefits of adhering to a healthy sleep and circadian pattern in entire populations, independent of genetic risk.

Supplementary Materials

    • Supplementary Appendix Figure S1. Flowchart of participant enrolment.
    • Supplementary Appendix Figure S2. Distribution of the polygenic risk score for type 2 diabetes.
    • Supplementary Appendix Figure S3. The cumulative risk of incident type 2 diabetes during follow-up.
    • Supplementary Appendix Table S11. The joint association of genetic risk and sleep and circadian patterns with incident type 2 diabetes by age group.
    • Supplementary Appendix Table S1. Single-nucleotide polymorphisms were used to generate the genetic risk score for type 2 diabetes.
    • Supplementary Appendix Table S2. Definitions of prevalent diabetes.
    • Supplementary Appendix Table S3. Risk of sleep factors for incident type 2 diabetes.
    • Supplementary Appendix Table S4. Risk of incident type 2 diabetes according to unhealthy sleep score.
    • Supplementary Appendix Table S5. Risk of incident type 2 diabetes according to genetic risk quintile.
    • Supplementary Appendix Table S6. Association of sleep and circadian pattern with incident type 2 diabetes in genetic risk strata.
    • Supplementary Appendix Table S7. The joint association of genetic risk and sleep and circadian patterns with incident type 2 diabetes after excluding participants with missing data for covariates.
    • Supplementary Appendix Table S8. The joint association of genetic risk and sleep and circadian patterns with incident type 2 diabetes after excluding participants with type 2 diabetes within two years of baseline.
    • Supplementary Appendix Table S9. The joint association of genetic risk and weighted sleep and circadian patterns with incident type 2 diabetes.
    • Supplementary Appendix Table S10. The joint association of genetic risk and sleep and circadian patterns with incident type 2 diabetes by sex group.

 

     European Society of Endocrinology

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