Effects of sleep duration and changes in body mass index on diabetic kidney disease: a prospective cohort study

作者：Cong Liu, Jia Zhang, Xing Wei, Juan Shi, Qianhua Fang, Weiwei Zhou, Lin Sun, Zhuomeng Hu, Jie Hong, Weiqiong Gu, Weiqing Wang, Ying Peng, Yifei Zhang · 发表于：Frontiers in Endocrinology · 年份：2023 · DOI：10.3389/fendo.2023.1278665 · 被引用次数：11 · 研究领域：Sleep and related disorders、Sleep and Work-Related Fatigue、Dietary Effects on Health

Aims: To examine the associations of sleep duration and changes in BMI with the onset of diabetic kidney disease (DKD). Materials and methods: 2,959 participants with type 2 diabetes were divided into three groups based on sleep duration: short (<7 h/day), intermediate (7-9 h/day), or long (>9 h/day). Changes in BMI during follow-up were trisected into loss, stable, or gain groups. DKD was defined as either the urinary albumin/creatinine ratio (UACR) ≥ 3.39 mg/mmol or the estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m², or both. Cox regression models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During a mean follow-up of 2.3 years, DKD occurred in 613 participants (20.7%). A J-shaped curve was observed between sleep duration and DKD. Compared to intermediate sleep duration, long sleep duration was associated with higher risks of DKD (HR 1.47; 95% CI: 1.19-1.81). In the joint analyses, compared to participants with intermediate sleep duration and stable BMI, long sleep duration with BMI gain had the highest risks of DKD (HR 2.04; 95% CI: 1.48-2.83). In contrast, short or intermediate sleep duration accompanied by decrease in BMI was associated with a reduced risk of DKD, with HRs of 0.50 (95% CI: 0.31-0.82) and 0.61 (95% CI:0.47-0.80), respectively. Conclusions: Long sleep duration is significantly associated with an increased risk of DKD, which is further amplified by obesity or BMI gain. These findings suggest that both ...