Associations Between Sleep and Metabolic Outcomes in Preadolescent Children

Jasmin Marie Alves; Ting Chow; Selena Nguyen-Rodriguez; Brendan Angelo; Alexis Defendis; Shan Luo; Alexandro Smith; Alexandra Grace Yunker; Anny H Xiang; Kathleen Alanna Page

doi:10.1210/jendso/bvac137

Associations Between Sleep and Metabolic Outcomes in Preadolescent Children

J Endocr Soc. 2022 Sep 19;6(11):bvac137. doi: 10.1210/jendso/bvac137. eCollection 2022 Oct 11.

Authors

Jasmin Marie Alves^{1

2}, Ting Chow³, Selena Nguyen-Rodriguez⁴, Brendan Angelo^{1

2}, Alexis Defendis^{1

2}, Shan Luo^{1

2

5

6}, Alexandro Smith^{1

2}, Alexandra Grace Yunker⁷, Anny H Xiang³, Kathleen Alanna Page^{1

2}

Affiliations

¹ Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA.
² Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA.
³ Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, 91101 CA, USA.
⁴ Department of Health Science, California State University Long Beach, Long Beach, 90840-4902 CA, USA.
⁵ Department of Psychology, University of Southern California, Los Angeles, 90089 CA, USA.
⁶ Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, 90027 CA, USA.
⁷ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, 02115 MA, USA.

Abstract

Context: Growing evidence suggests an important role for sleep for the metabolic health of children.

Objective: We aimed to determine how sleep is related to insulin sensitivity, insulin secretion, beta-cell function, and adiposity (BMI z-scores, body fat %, waist to height ratio) using objectively measured sleep and oral glucose tolerance test (OGTT)-derived measures.

Methods: Sixty-two children aged 7-11 years, born at Kaiser Permanente Southern California, wore wrist accelerometers for 7 days to objectively measure sleep, completed an OGTT, and had anthropometric measures (height [cm], weight [kg], waist [cm], body fat [%]) collected. Using linear regression, associations between Matsuda insulin sensitivity index (ISI), insulinogenic index (IGI), disposition index (DI), BMI z-score, waist to height ratio, and body fat % with sleep parameters [total sleep time (TST; min), sleep efficiency (SE; %), time in bed (TIB; min), wake after sleep onset (WASO; min), and sleep latency (SL; min)] were assessed. Body fat % was tested as a mediator of the relationship between TST and ISI.

Results: Longer TST was associated with better insulin sensitivity (P = 0.02), but not after adjusting for body fat %. Sleep parameters were not associated with IGI or DI. Longer TST was associated with lower % body fat (P = 0.01) and lower waist-to-height-ratios (P = 0.05). Body fat % explained 62% (P = 0.01) of the relationship between TST and ISI. Longer TIB was associated with lower adiposity measures (P < 0.05). There were no associations between SE, WASO, or SL and metabolic outcomes.

Conclusion: Objectively measured sleep duration was associated with lower adiposity, and the relationship between sleep duration and ISI appeared partly through adiposity levels in preadolescent children. Longer sleep duration may be important for metabolic health.

Keywords: actigraphy; adiposity; insulin sensitivity; preadolescence; sleep.

Abstract

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