Page 102 - 《运动与健康科学》(英文)2024年第2期

TaggedAPTARAFigure
224 X. Jin et al.
TaggedAPTARAPSleep duration was obtained from the returned dataset of
UK Biobank (Return ID 1862). The procedures of data proce-
ssing and analyses were described previously. 26 Sleep periods
were defined using an automated detection algorithm 26,27
implemented in the GGIR R package 28 and validated using
polysomnography (PSG) in an external cohort. The algo-
rithm facilitates detection of the sleep period time window
(SPT-window) without the use of sleep diaries. The SPT-window
refers to the time window starting at sleep onset and ending
upon waking from the last sleep episode of the night. Sleep
episodes within the SPT-window were defined as periods of
5 min with no z-axis changes greater than 5˚. Sleep duration
for a given SPT-window was calculated by summing the dura-
tions of all sleep episodes within the SPT-window. The mean
sleep duration across all SPT-windows provided a measurement
of average sleep quantity. Due to the expected nonlinear associ-
6,9
ation between sleep duration and type 2 diabetes risks, we
further divided the participants into 3 groups with cutoffs based
29
on previous studies and the American Academy of Sleep
Medicine consensus 5 suggestion: short (<6 h/day), normal
(68h/day), andlongsleep duration(>8h/day).TaggedAPTARAEnd
TaggedAPTARAPParticipants with at least 3 days of accelerometry data (Field
ID 90015) were included in the current study. This inclusion
criterion was defined by the UK Biobank accelerometer expert
working group, who found that 3 days of wear were needed to
be within 10% of a complete 7-day measure after performing
missing data simulations on 29,765 participants who had perfect
wear time compliance. 19 A total number of 4470 participants
were ruled out for not satisfying this inclusion criterion in the
current study (Fig. 1). Participants were also excluded if their
Fig. 1. Flowchart of participant enrollment. HbA1c = glycated hemoglobin; mean sleep duration was less than 3 or longer than 11 h (Fig. 1).
LPA = light-intensity physical activity; MVPA = moderate-to-vigorous phys- Participants included in the final sample had 6.93 valid days of
ical activity; PA = physical activity.TaggedAPTARAEnd
accelerometer wearing on average.TaggedAPTARAEnd
acceleration signals, 1 gravitational unit from the vector TaggedAPTARAH22.3. OutcomesTaggedAPTARAEnd
magnitude was removed, and the remaining negative values
TaggedAPTARAPThe outcome of this study was incident type 2 diabetes, which
were truncated to 0. PA was calculated from the resampled
was defined based on hospital records or death registry (Supple-
data combined in 5-s epochs (Field ID 90004). Three cate-
mentary Table 1). The data on dates and causes of hospital
gories of PA (total volume of PA, MVPA, and LPA) were
records for participants from Scotland were obtained from the
included in the current study. The total volume of PA was
Scottish Morbidity Records, and those for participants from
measured as the weekly average vector magnitude in milli- England and Wales came from health episode statistics. The data
gravity (mg) units (Field ID 90012). 21 MVPA was defined
on dates and causes of death for participants from England and
as reaching the following standard: (a) within a 5-min
Wales were obtained from the death registries of the National
period, over 80% of the 5-s epochs having a mean accelera-
Health Service Information Center, and those for participants
tion between 100mg and 400mg (moderate-intensity PA, from Scotland came from the National Health Service Central
MPA); 22 or (b) any single 5-s epoch having a mean acceler- Register Scotland. Further detailed information on linkage proce-
ation >400mg (vigorous-intensity PA (VPA)). 21 LPA was
dures is available at http://content.digital.nhs.uk/services. At the
defined as any single epoch with a mean acceleration of time of analysis, hospital record data were available for partici-
30100mg. 23 The amounts of MVPA and LPA (min/week)
pants until September 30, 2021, and death registry data were
were calculated for each participant. Similarly, considering
available until November 12, 2021. Therefore, we used
the expected nonlinear associations with type 2 diabetes November 12, 2021 as the censor date unless hospital admission
risks, 24 the total volume of PA and LPA was then divided
or death occurred first.TaggedAPTARAEnd
into high and low groups according to the median, and
MVPA was divided into recommended or not recommended
TaggedAPTARAH22.4. CovariatesTaggedAPTARAEnd
groups according to the World Health Organization (WHO)
guidelines (150 min of MPA, 75 min of VPA, or equiva- TaggedAPTARAPThe following variables were considered likely confounding
25
lent combinations of MPA and VPA per week). TaggedAPTARAEnd factors: age at the time of accelerometer wearing (continuous,