Sleep disturbance exacerbates atherosclerosis in type 2 diabetes mellitus

Bingge Fan; Ting Tang; Xiao Zheng; Haixia Ding; Peng Guo; Hongqing Ma; Yu Chen; Yichao Yang; Lihui Zhang

doi:10.3389/fcvm.2023.1267539

Sleep disturbance exacerbates atherosclerosis in type 2 diabetes mellitus

Front Cardiovasc Med. 2023 Dec 1:10:1267539. doi: 10.3389/fcvm.2023.1267539. eCollection 2023.

Authors

Bingge Fan¹, Ting Tang², Xiao Zheng³, Haixia Ding¹, Peng Guo⁴, Hongqing Ma⁵, Yu Chen⁶, Yichao Yang⁷, Lihui Zhang⁸

Affiliations

¹ Department of Endocrinology, The Forth Hospital of Hebei Medical University, Shijiazhuang, China.
² Department of War and Rescue Medicine Field Internal Medicine Teaching and Research Office, NCO School, Army Medical University, Shijiazhuang, China.
³ Department of Orthopedics, The Affiliated Hospital, NCO School of Army Medical University, Shijiazhuang, China.
⁴ Department of Orthopedics, The Forth Hospital of Hebei Medical University, Shijiazhuang, China.
⁵ Second Department of General Surgery, The Forth Hospital of Hebei Medical University, Shijiazhuang, China.
⁶ Department of Cardiology, Bethune International Peaceful Hospital, Shijiazhuang, China.
⁷ Department of Gastroenterology, Baoding First Central Hospital, Baoding, China.
⁸ Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Abstract

Background: Short sleep duration and poor sleep quality are important risk factors for atherosclerosis. The use of smart bracelets that measure sleep parameters, such as sleep stage, can help determine the effect of sleep quality on lower-extremity atherosclerosis in patients with type 2 diabetes.

Objective: To investigate the correlation between sleep disorders and lower-extremity atherosclerosis in patients with type 2 diabetes.

Methods: After admission, all patients were treated with lower-extremity arterial ultrasound and graded as having diabetic lower-extremity vascular lesions according to the results. A smart bracelet was used to obtain the patient sleep data. The correlation between sleep patterns and diabetic lower-extremity atherosclerosis, diabetic foot, and various metabolic indices was verified.

Results: Between August 2021 and April 2022, we screened 100 patients with type 2 diabetes, with 80 completing sleep monitoring. Univariate ordered logistic regression analysis indicated that patients with a sleep score below 76 (OR = 2.707, 95%CI: 1.127-6.488), shallow sleep duration of 5.3 h or more (OR=3.040, 95 CI: 1.005-9.202), wakefulness at night of 2.6 times or more (OR = 4.112, 95%CI: 1.513-11.174), and a deep sleep continuity score below 70 (OR = 4.141, 95%CI: 2.460-615.674) had greater risk of high-grade lower limb atherosclerosis. Multivariate ordinal logistic regression analysis revealed that the risk of high-grade lower limb atherosclerosis was higher in patients with 2.6 or more instances of nighttime wakefulness (OR = 3.975, 95%CI: 1.297-12.182) compared with those with fewer occurrences. The sleep duration curve of patients with different grades of diabetic lower-extremity atherosclerosis was U-shaped. According to the results of the one-way analysis of variance, the higher the deep sleep continuity score, the lower the Wagner scale score for diabetic foot (P < 0.05).

Conclusions: Sleep disorders (long, shallow sleep duration, frequent wakefulness at night, and poor continuity of deep sleep) can worsen lower limb atherosclerosis in patients with type 2 diabetes. This finding can provide a new method for medical professionals to prevent and treat diabetic lower-extremity vascular lesions.

Keywords: atherosclerosis; peripheral arterial; sleep disorders; smart wristband; type 2 diabetes mellitus.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.