Background: Existing evidence concerning the relationship between daytime napping and type 2 diabetes (T2D) is inconsistent, and whether the effects of napping differ by body fat percentage (BFP) and C-reactive protein (CRP) is unclear. We aimed to investigate the association between daytime napping frequency and T2D risk and whether such an association was modified by BFP and CRP.
Methods: We included 435 342 participants free of diabetes from the UK Biobank. Participants were categorized as nonnappers, occasional nappers, and frequent nappers based on napping frequency, and BFP/CRP was divided into quartiles. Cox proportional hazards models were used.
Results: During a median follow-up of 9.2 years, 17 592 T2D cases occurred. Higher frequency of daytime napping was significantly associated with an increased risk of T2D. Compared with nonnappers, the adjusted hazard ratios (HRs) for occasional nappers and habitual nappers were 1.28 (95% confidence interval [CI]: 1.24-1.32) and 1.49 (95% CI: 1.41-1.57), respectively. There was a significant additive and multiplicative interaction (relative excess risk due to interaction [RERI] = 0.490, 95% CI 0.307-0.673; p for multiplicative interaction <.001) between napping and BFP, whereby a higher hazard of T2D associated with more frequent napping was greatest among participants in the highest BFP quartile (HR = 4.45, 95% CI: 3.92-5.06). The results for CRP were similar (RERI = 0.266, 95% CI: 0.094-0.439; p for multiplicative interaction <.001).
Conclusions: Higher daytime napping frequency is associated with an increased T2D risk, and such relationships are modified by BFP and CRP. These findings underscore the importance of adiposity and inflammation control to mitigate diabetes risk.
【摘要】 背景 关于午睡与2型糖尿病之间的关系，现有的证据不一致，并且午睡的效应是否会受到体脂百分比(BFP)和C-反应蛋白(CRP)的影响尚不清楚。本研究旨在调查午睡频率与2型糖尿病风险之间的关联性，以及这种关联是否受到BFP和CRP的调节。方法 本研究纳入了来自英国生物银行(UK-Biobank)的435 342名无糖尿病的参与者。根据午睡频率，参与者被分为不午睡者、偶尔午睡者和经常午睡者，并将BFP/CRP分为四分位数。采用Cox比例风险模型进行分析。结果 在中位随访9.2年期间，共发生2型糖尿病17 592例。白天午睡频率越高，2型糖尿病患病风险也越高。与不午睡者相比，偶尔午睡者和经常午睡者的校正后风险比(HR)分别为1.28(95% CI 1.24~1.32)和1.49(95% CI 1.41~1.57)。午睡与BFP之间存在显著的加性和乘性交互作用[交互作用的相对过度风险(RERI)=0.490，95% CI 0.307~0.673, 乘性交互作用的P<0.001]，即与频繁午睡相关的2型糖尿病风险增加在最高BFP四分位数的参与者中最为显著(HR=4.45，95% CI 3.92~5.06)。CRP的结果也类似(RERI=0.266，95% CI 0.094~0.439, 乘性交互作用的P<0.001)。结论 午睡频率越高，2型糖尿病风险也越高，并且这种关系受到BFP和CRP的调节。这些发现强调了控制脂肪堆积和炎症对降低糖尿病风险的重要性。.
Keywords: 2型糖尿病; adiposity; cohort; daytime napping; inflammation; type 2 diabetes; 午睡; 炎症; 脂肪; 队列研究.
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.