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Sleep architecture and glucose and insulin homeostasis in obese adolescents.

Koren D, Levitt Katz LE, Brar PC, Gallagher PR, Berkowitz RI, Brooks LJ - Diabetes Care (2011)

Bottom Line: Sleep deprivation is associated with increased risk of adult type 2 diabetes mellitus (T2DM).Insufficient and excessive sleep was associated with short-term and long-term hyperglycemia in our obese adolescents.These effects may be related, with reduced insulin secretory capacity leading to hyperglycemia.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Endocrinology and Diabetes, The Children’s Hospital of Philadelphia, PA, USA. koren@email.chop.edu

ABSTRACT

Objective: Sleep deprivation is associated with increased risk of adult type 2 diabetes mellitus (T2DM). It is uncertain whether sleep deprivation and/or altered sleep architecture affects glycemic regulation or insulin sensitivity or secretion. We hypothesized that in obese adolescents, sleep disturbances would associate with altered glucose and insulin homeostasis.

Research design and methods: This cross-sectional observational study of 62 obese adolescents took place at the Clinical and Translational Research Center and Sleep Laboratory in a tertiary care children's hospital. Subjects underwent oral glucose tolerance test (OGTT), anthropometric measurements, overnight polysomnography, and frequently sampled intravenous glucose tolerance test (FSIGT). Hemoglobin A(1c) (HbA(1c)) and serial insulin and glucose levels were obtained, indices of insulin sensitivity and secretion were calculated, and sleep architecture was assessed. Correlation and regression analyses were performed to assess the association of total sleep and sleep stages with measures of insulin and glucose homeostasis, adjusted for confounding variables.

Results: We found significant U-shaped (quadratic) associations between sleep duration and both HbA(1c) and serial glucose levels on OGTT and positive associations between slow-wave sleep (N3) duration and insulin secretory measures, independent of degree of obesity, pubertal stage, sex, and obstructive sleep apnea measures.

Conclusions: Insufficient and excessive sleep was associated with short-term and long-term hyperglycemia in our obese adolescents. Decreased N3 was associated with decreased insulin secretion. These effects may be related, with reduced insulin secretory capacity leading to hyperglycemia. We speculate that optimizing sleep may stave off the development of T2DM in obese adolescents.

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Sleep duration and glucose homeostasis measures. A: Association between sleep duration and fasting plasma glucose levels on OGTT. B: Association between 2-h glucose level on OGTT and total sleep duration (minutes) that evening. C: Association between HbA1c and total sleep duration (minutes) that evening. In all three panels, the U-shaped relationships suggest that a sleep duration of 420–510 min (7–8.5 h) is associated with optimal glucose homeostasis.
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Figure 1: Sleep duration and glucose homeostasis measures. A: Association between sleep duration and fasting plasma glucose levels on OGTT. B: Association between 2-h glucose level on OGTT and total sleep duration (minutes) that evening. C: Association between HbA1c and total sleep duration (minutes) that evening. In all three panels, the U-shaped relationships suggest that a sleep duration of 420–510 min (7–8.5 h) is associated with optimal glucose homeostasis.

Mentions: Total sleep time (TST) was significantly or near-significantly associated with both short- and long-term measures of glucose homeostasis (Table 3). Curve estimation modeling and regression statistics showed that these relationships were U shaped (quadratic) (Fig. 1A–C). There was no association between any measure of OSA and measures of glucose homeostasis (Supplementary Table 1).


Sleep architecture and glucose and insulin homeostasis in obese adolescents.

Koren D, Levitt Katz LE, Brar PC, Gallagher PR, Berkowitz RI, Brooks LJ - Diabetes Care (2011)

Sleep duration and glucose homeostasis measures. A: Association between sleep duration and fasting plasma glucose levels on OGTT. B: Association between 2-h glucose level on OGTT and total sleep duration (minutes) that evening. C: Association between HbA1c and total sleep duration (minutes) that evening. In all three panels, the U-shaped relationships suggest that a sleep duration of 420–510 min (7–8.5 h) is associated with optimal glucose homeostasis.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198280&req=5

Figure 1: Sleep duration and glucose homeostasis measures. A: Association between sleep duration and fasting plasma glucose levels on OGTT. B: Association between 2-h glucose level on OGTT and total sleep duration (minutes) that evening. C: Association between HbA1c and total sleep duration (minutes) that evening. In all three panels, the U-shaped relationships suggest that a sleep duration of 420–510 min (7–8.5 h) is associated with optimal glucose homeostasis.
Mentions: Total sleep time (TST) was significantly or near-significantly associated with both short- and long-term measures of glucose homeostasis (Table 3). Curve estimation modeling and regression statistics showed that these relationships were U shaped (quadratic) (Fig. 1A–C). There was no association between any measure of OSA and measures of glucose homeostasis (Supplementary Table 1).

Bottom Line: Sleep deprivation is associated with increased risk of adult type 2 diabetes mellitus (T2DM).Insufficient and excessive sleep was associated with short-term and long-term hyperglycemia in our obese adolescents.These effects may be related, with reduced insulin secretory capacity leading to hyperglycemia.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Endocrinology and Diabetes, The Children’s Hospital of Philadelphia, PA, USA. koren@email.chop.edu

ABSTRACT

Objective: Sleep deprivation is associated with increased risk of adult type 2 diabetes mellitus (T2DM). It is uncertain whether sleep deprivation and/or altered sleep architecture affects glycemic regulation or insulin sensitivity or secretion. We hypothesized that in obese adolescents, sleep disturbances would associate with altered glucose and insulin homeostasis.

Research design and methods: This cross-sectional observational study of 62 obese adolescents took place at the Clinical and Translational Research Center and Sleep Laboratory in a tertiary care children's hospital. Subjects underwent oral glucose tolerance test (OGTT), anthropometric measurements, overnight polysomnography, and frequently sampled intravenous glucose tolerance test (FSIGT). Hemoglobin A(1c) (HbA(1c)) and serial insulin and glucose levels were obtained, indices of insulin sensitivity and secretion were calculated, and sleep architecture was assessed. Correlation and regression analyses were performed to assess the association of total sleep and sleep stages with measures of insulin and glucose homeostasis, adjusted for confounding variables.

Results: We found significant U-shaped (quadratic) associations between sleep duration and both HbA(1c) and serial glucose levels on OGTT and positive associations between slow-wave sleep (N3) duration and insulin secretory measures, independent of degree of obesity, pubertal stage, sex, and obstructive sleep apnea measures.

Conclusions: Insufficient and excessive sleep was associated with short-term and long-term hyperglycemia in our obese adolescents. Decreased N3 was associated with decreased insulin secretion. These effects may be related, with reduced insulin secretory capacity leading to hyperglycemia. We speculate that optimizing sleep may stave off the development of T2DM in obese adolescents.

Show MeSH
Related in: MedlinePlus