Habitual late sleep initiation is associated with increased incidence of type 2 diabetes mellitus in Korean adults

The Korean Genome and Epidemiology Study

Ji A Seo, Da Young Lee, Ji Hee Yu, Hyunjoo Cho, Seung Ku Lee, Sooyeon Suh, Sin Gon Kim, Kyung Mook Choi, Sei-Hyun Baik, Chol Shin, Nan Hee Kim

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Abstract

Study Objectives: Although sleep duration and quality were significant risk factors of type 2 diabetes (T2D), the impact of sleep initiation time on the development of T2D has not been studied in large longitudinal studies. Methods: A total of 3689 participants without diabetes aged 40-69 years at baseline were enrolled from the Korean Genome and Epidemiology Study and followed up for 12 years. Participants were categorized based on habitual sleep initiation time by questionnaire as follows: 20:00-22:59 (early sleepers, ES, n = 766), 23:00-00:59 (usual sleepers, US, n = 2407), and 1:00-5:59 (late sleepers, LS, n = 516). Incident T2D was identified biennially by fasting plasma glucose or 2-hour glucose after 75-g oral glucose loading or use of anti-diabetes medication. Results: During follow-up, 820 cases of T2D were documented and the LS group showed the highest increase in insulin resistance. Hazard ratio (HR) (95% confidence interval) for T2D of LS compared to ES was 1.34 (1.04-1.74) after adjustment for covariates including sleep duration. The impact of late sleep on the development of T2D was more evident in older individuals (≥65 years at baseline) (HR = 4.24 [1.42-12.68] in older LS vs. older ES, HR = 1.27 [1.00-1.62] in younger LS vs. younger ES, pinteraction = 0.002). In addition, LS with low insulin secretion and sensitivity showed an approximately fivefold increased risk for T2D compared to ES with high insulin secretion and sensitivity. Conclusions/Interpretation: Habitual late sleep initiation is a significant risk factor for T2D in Koreans, especially in people with lower insulin sensitivity, lower β-cell function, and older age.

Original languageEnglish
Article numberzsz090
JournalSleep
Volume42
Issue number7
DOIs
Publication statusPublished - 2019 Apr 23

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Type 2 Diabetes Mellitus
Sleep
Epidemiology
Genome
Incidence
Insulin Resistance
Glucose
Longitudinal Studies
Fasting
Confidence Intervals

Keywords

  • insulin resistance
  • sleep
  • type 2 diabetes

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

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title = "Habitual late sleep initiation is associated with increased incidence of type 2 diabetes mellitus in Korean adults: The Korean Genome and Epidemiology Study",
abstract = "Study Objectives: Although sleep duration and quality were significant risk factors of type 2 diabetes (T2D), the impact of sleep initiation time on the development of T2D has not been studied in large longitudinal studies. Methods: A total of 3689 participants without diabetes aged 40-69 years at baseline were enrolled from the Korean Genome and Epidemiology Study and followed up for 12 years. Participants were categorized based on habitual sleep initiation time by questionnaire as follows: 20:00-22:59 (early sleepers, ES, n = 766), 23:00-00:59 (usual sleepers, US, n = 2407), and 1:00-5:59 (late sleepers, LS, n = 516). Incident T2D was identified biennially by fasting plasma glucose or 2-hour glucose after 75-g oral glucose loading or use of anti-diabetes medication. Results: During follow-up, 820 cases of T2D were documented and the LS group showed the highest increase in insulin resistance. Hazard ratio (HR) (95{\%} confidence interval) for T2D of LS compared to ES was 1.34 (1.04-1.74) after adjustment for covariates including sleep duration. The impact of late sleep on the development of T2D was more evident in older individuals (≥65 years at baseline) (HR = 4.24 [1.42-12.68] in older LS vs. older ES, HR = 1.27 [1.00-1.62] in younger LS vs. younger ES, pinteraction = 0.002). In addition, LS with low insulin secretion and sensitivity showed an approximately fivefold increased risk for T2D compared to ES with high insulin secretion and sensitivity. Conclusions/Interpretation: Habitual late sleep initiation is a significant risk factor for T2D in Koreans, especially in people with lower insulin sensitivity, lower β-cell function, and older age.",
keywords = "insulin resistance, sleep, type 2 diabetes",
author = "Seo, {Ji A} and Lee, {Da Young} and Yu, {Ji Hee} and Hyunjoo Cho and Lee, {Seung Ku} and Sooyeon Suh and Kim, {Sin Gon} and Choi, {Kyung Mook} and Sei-Hyun Baik and Chol Shin and Kim, {Nan Hee}",
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T1 - Habitual late sleep initiation is associated with increased incidence of type 2 diabetes mellitus in Korean adults

T2 - The Korean Genome and Epidemiology Study

AU - Seo, Ji A

AU - Lee, Da Young

AU - Yu, Ji Hee

AU - Cho, Hyunjoo

AU - Lee, Seung Ku

AU - Suh, Sooyeon

AU - Kim, Sin Gon

AU - Choi, Kyung Mook

AU - Baik, Sei-Hyun

AU - Shin, Chol

AU - Kim, Nan Hee

PY - 2019/4/23

Y1 - 2019/4/23

N2 - Study Objectives: Although sleep duration and quality were significant risk factors of type 2 diabetes (T2D), the impact of sleep initiation time on the development of T2D has not been studied in large longitudinal studies. Methods: A total of 3689 participants without diabetes aged 40-69 years at baseline were enrolled from the Korean Genome and Epidemiology Study and followed up for 12 years. Participants were categorized based on habitual sleep initiation time by questionnaire as follows: 20:00-22:59 (early sleepers, ES, n = 766), 23:00-00:59 (usual sleepers, US, n = 2407), and 1:00-5:59 (late sleepers, LS, n = 516). Incident T2D was identified biennially by fasting plasma glucose or 2-hour glucose after 75-g oral glucose loading or use of anti-diabetes medication. Results: During follow-up, 820 cases of T2D were documented and the LS group showed the highest increase in insulin resistance. Hazard ratio (HR) (95% confidence interval) for T2D of LS compared to ES was 1.34 (1.04-1.74) after adjustment for covariates including sleep duration. The impact of late sleep on the development of T2D was more evident in older individuals (≥65 years at baseline) (HR = 4.24 [1.42-12.68] in older LS vs. older ES, HR = 1.27 [1.00-1.62] in younger LS vs. younger ES, pinteraction = 0.002). In addition, LS with low insulin secretion and sensitivity showed an approximately fivefold increased risk for T2D compared to ES with high insulin secretion and sensitivity. Conclusions/Interpretation: Habitual late sleep initiation is a significant risk factor for T2D in Koreans, especially in people with lower insulin sensitivity, lower β-cell function, and older age.

AB - Study Objectives: Although sleep duration and quality were significant risk factors of type 2 diabetes (T2D), the impact of sleep initiation time on the development of T2D has not been studied in large longitudinal studies. Methods: A total of 3689 participants without diabetes aged 40-69 years at baseline were enrolled from the Korean Genome and Epidemiology Study and followed up for 12 years. Participants were categorized based on habitual sleep initiation time by questionnaire as follows: 20:00-22:59 (early sleepers, ES, n = 766), 23:00-00:59 (usual sleepers, US, n = 2407), and 1:00-5:59 (late sleepers, LS, n = 516). Incident T2D was identified biennially by fasting plasma glucose or 2-hour glucose after 75-g oral glucose loading or use of anti-diabetes medication. Results: During follow-up, 820 cases of T2D were documented and the LS group showed the highest increase in insulin resistance. Hazard ratio (HR) (95% confidence interval) for T2D of LS compared to ES was 1.34 (1.04-1.74) after adjustment for covariates including sleep duration. The impact of late sleep on the development of T2D was more evident in older individuals (≥65 years at baseline) (HR = 4.24 [1.42-12.68] in older LS vs. older ES, HR = 1.27 [1.00-1.62] in younger LS vs. younger ES, pinteraction = 0.002). In addition, LS with low insulin secretion and sensitivity showed an approximately fivefold increased risk for T2D compared to ES with high insulin secretion and sensitivity. Conclusions/Interpretation: Habitual late sleep initiation is a significant risk factor for T2D in Koreans, especially in people with lower insulin sensitivity, lower β-cell function, and older age.

KW - insulin resistance

KW - sleep

KW - type 2 diabetes

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