随着2型糖尿病(T2DM)发病率的迅速增加,其后果是严重的,有效的干预和预防,包括与睡眠相关的干预措施,迫切需要。作为睡眠架构的一个组成部分,小睡,单独或与夜间睡眠相结合,可能影响T2DM的发病和进展。总的来说,午睡与女性T2DM风险增加相关,尤其是绝经后的白人女性。我们的研究表明,午睡>30分钟(min)会使T2DM的风险增加8-21%。此外,非最佳夜间睡眠增加T2DM风险,这种效果与午睡效果相结合。对于非糖尿病患者,午睡>30分钟会增加高HbA1c水平和空腹血糖受损(IFG)的风险,这将增加后来发展为T2DM的风险。对于糖尿病患者,长时间打盹可能会进一步损害血糖控制并增加发生糖尿病并发症的风险(例如,糖尿病肾病)在遥远的未来。建议以下三种机制作为午睡与T2DM之间关联的解释。首先,午睡>30分钟会增加重要炎症因子的水平,包括白细胞介素6和C反应蛋白,增加炎症的风险,相关肥胖和T2DM。第二,绝经后荷尔蒙变化和打盹之间的相互作用进一步增加了胰岛素抵抗.第三,长时间的午睡也可能通过干扰夜间睡眠来影响褪黑激素的分泌,导致昼夜节律中断,并进一步增加T2DM的风险。这篇综述总结了关于午睡对T2DM影响的现有证据,并为未来解决午睡的T2DM干预和预防策略提供了详细信息。
As the incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly and its consequences are severe, effective intervention and prevention, including sleep-related interventions, are urgently needed. As a component of sleep architecture, naps, alone or in combination with nocturnal sleep, may influence the onset and progression of T2DM. Overall,
napping is associated with an increased risk of T2DM in women, especially in postmenopausal White women. Our study showed that
napping >30 minutes (min) increased the risk of T2DM by 8-21%. In addition, non-optimal nighttime sleep increases T2DM risk, and this effect combines with the effect of napping. For nondiabetic patients,
napping >30 min could increase the risks of high HbA1c levels and impaired fasting glucose (IFG), which would increase the risk of developing T2DM later on. For diabetic patients, prolonged
napping may further impair glycemic control and increase the risk of developing diabetic complications (e.g., diabetic nephropathy) in the distant future. The following three mechanisms are suggested as interpretations for the association between napping and T2DM. First, napping >30 min increases the levels of important inflammatory factors, including interleukin 6 and C-reactive protein, elevating the risks of inflammation, associated adiposity and T2DM. Second, the interaction between postmenopausal hormonal changes and napping further increases insulin resistance. Third, prolonged napping may also affect melatonin secretion by interfering with nighttime sleep, leading to circadian rhythm disruption and further increasing the risk of T2DM. This review summarizes the existing evidence on the effect of napping on T2DM and provides detailed information for future T2DM intervention and prevention strategies that address
napping.