Page 101 - 《运动与健康科学》(英文)2024年第2期

Sleep, physical activity, and type 2 diabetes 223
Conclusion: Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes. A higher
level of PA, regardless of intensity, potentially ameliorates this excessive risk.

TaggedAPTARAPKeywords: Light physical activity; Sleep duration; Triaxial accelerometer; Type 2 diabetes; UK BiobankTaggedAPTARAEnd

diabetes, which suggests a counteractive relationship between
TaggedAPTARAH11. IntroductionTaggedAPTARAEnd
16
unhealthy sleep duration and MVPA. However, it remains
TaggedAPTARAPType 2 diabetes is one of the leading causes of disability
unclear whether MVPA and LPA protect short or long sleepers
and mortality, and it places a considerable socioeconomic
from an elevated risk of type 2 diabetes. Answering this ques-
burden on nearly half a billion individuals. The rapid growth
tion will help us better understand how to construct the
of the disease worldwide warrants more effective and practical 13
prevention. 1,2 Short sleep (usually under 6 h) has recently been “diabetes-protective lifestyle” promoted by Kolb and Martin. TaggedAPTARAEnd
TaggedAPTARAPIn the current study, we hypothesized that accelerome-
3
identified as a potential risk factor for type 2 diabetes; like-
ter-measured short and long sleep durations are associated
wise, not meeting recommended amounts of sleep has become with excessive type 2 diabetes risk in the general adult popu-
increasingly prevalent among people with type 2 diabetes. 4,5
lation. We also hypothesized that the elevated risk of type 2
Self-reported short and long sleep durations (those outside the
diabetes may be ameliorated by both MVPA and LPA. To
recommended 68 h of sleep per day) are repeatedly associ- verify these hypotheses, we analyzed the independent and
ated with increased type 2 diabetes risk. 6 Short
joint associations of accelerometer-measured sleep duration
and long sleep has been found to adversely impact diabetes
and PA (total volume of PA, MVPA, and LPA) with the risk
development via multiple pathways, including melatonin and
of incident type 2 diabetes using data from a large-scale
cortisol disruption, neural hyperactivation, low-grade inflam-
mation, and energy homeostasis defects. 7,8 Therefore, population-based cohort, the UK Biobank.TaggedAPTARAEnd
researchers have suggested screening for sleep disturbance,
particularly for short and long sleep duration, as part a preven- TaggedAPTARAH12. Materials and methodsTaggedAPTARAEnd
9
tive measure for type 2 diabetes. However, association of TaggedAPTARAH22.1. Study population and data sourceTaggedAPTARAEnd
device-measured short and long sleep duration with risk of
TaggedAPTARAPIn a population-based prospective cohort study, the UK
type 2 diabetes remains poorly understood.TaggedAPTARAEnd
Biobank recruited over 500,000 participants aged 3773 years
TaggedAPTARAPWhile maintaining healthy sleep duration could be a
from 22 centers across the UK between 2006 and 2010. UK
preventive strategy, unhealthy amounts of sleep are sometimes
Biobank is an open access dataset established for investiga-
inevitable. In these cases, physical activity (PA) may be
tions of determinants of a wide range of complex diseases of
considered an alternative for ameliorating the risk of type 2
middle and old age. Data are available upon reasonable appli-
diabetes. Moderate-to-vigorous PA (MVPA) is recognized and
cation to the UK Biobank (https://www.ukbiobank.ac.uk/) and
recommended by guidelines as a robust preventive factor for
10
type 2 diabetes. On the other hand, evidence of the protective should be used under the restrictions applied to the data avail-
ability. More detailed descriptions of the UK Biobank have
role of light-intensity PA (LPA) remains limited. This is due to 17
been reported. From February 2013 to December 2015,
the inability for self-reported measurements, upon which most
106,053 participants agreed to wear an AX3 accelerometer
existing epidemiological studies have relied, to measure LPA
accurately. 11 Device-based measurements are capable of (Axivity, Newcastle upon Tyne, UK) on the wrist of the hand
capturing a wide range of PA intensities, including LPA. 11 they usually write with for 1 week, resulting in 103,670 data-
sets with acceleration intensity time-series data. The UK
There are device-measured evidences suggesting that LPA is
Biobank Accelerometer Working Group provided quality
beneficial to various diabetes-related health outcomes,
including obesity and glucose metabolism. 11 Considering that metrics. After controlling for data quality, a total number of
88,000 patients were included in the current study. Details of
for some special groups, such as people with morbid obesity or
the inclusion and exclusion criteria are depicted in Fig. 1. The
the elderly, MVPA may not be feasible, the potential of LPA
UK Biobank study was approved by the North West Multi-
for protecting people from excessive type 2 diabetes risk 18
centre Research Ethics Committee; all participants provided
should be investigated and understood.TaggedAPTARAEnd
written informed consent. The present analyses were
TaggedAPTARAPSleep and PA have been widely reported to share a bidirec-
tional relationship and to influence health through overlapping conducted under UK Biobank application Number 58082.TaggedAPTARAEnd
biological pathways. 1214 Examination of the joint association
with type 2 diabetes risks between sleep and PA is therefore TaggedAPTARAH22.2. ExposuresTaggedAPTARAEnd
necessary. Evidence from cohort studies has suggested that TaggedAPTARAPExposures of the current study included accelerome-
MVPA mitigates the negative effect of poor sleep on important ter-measured sleep duration and PA. The raw accelerometer
cardiometabolic health outcomes, such as hypertension and data were processed by the UK Biobank accelerometer
cardiovascular mortality. 14,15 Regarding diabetes, a cross- working group. 19 The acceleration signals were first calibrated
sectional study found that among short sleepers, those with a to local gravity. 20 The valid data were resampled to 100 Hz.
higher level of MVPA tended to have a lower prevalence of To separate out the activity-related components of these