Cross-sectional associations of objectively-measured sleep characteristics with obesity and type 2 diabetes in the PREDIMED-Plus trial

Authors: ROSIQUE-ESTEBAN, NURIA - UNIVERSITY ROVIRA I VIRGILI; PAPANDREOU, CHRISTOPHER - UNIVERSITY ROVIRA I VIRGILI; ROMAGERA, DORA - INSTITUTO DE SALUD CARLOS III; WARNBERG, JULIA - INSTITUTO DE SALUD CARLOS III; CORELLA, DOLORES - INSTITUTO DE SALUD CARLOS III; MARTINEZ-GONZALEZ, MIGUEL - INSTITUTO DE SALUD CARLOS III; DIAZ-LOPEZ, ANDRES - UNIVERSITY ROVIRA I VIRGILI; ESTRUCH, RAMON - INSTITUTO DE SALUD CARLOS III; VIOQUE, JESUS - MIGUEL HERNANDEZ UNIVERSITY; AROS, FERNANDEZ - INSTITUTO DE SALUD CARLOS III; GARCIA-RIOS, ANTONIO - INSTITUTO DE SALUD CARLOS III; BUENO-CAVANILLAS, AURORA - UNIVERSIDAD DE GRANADA; VIDAL, JOSEP - HOSPITAL CLINIC OF BARCELONA; SERRA-MAJEM, LLUIS - MIGUEL HERNANDEZ UNIVERSITY; SIBAI, ABDURRAHMAN - UNIVERSITY OF LEON; TINAHONES, FRANCISCO - INSTITUTO DE SALUD CARLOS III; MARTINEZ, J - INSTITUTO DE SALUD CARLOS III; ORDOVAS, JOSE - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY; TUR, JOSEP - INSTITUTO DE SALUD CARLOS III; TORREGO ELLACURIA, MACARENA - HEALTH RESEARCH INSTITUTE OF THE SAN CARLOS CLINICAL HOSPITAL; SANLLORENTE, ALBERT - INSTITUTO DE SALUD CARLOS III; PINTO, XAVIER - INSTITUTO DE SALUD CARLOS III; BUIL-COSIALES, PILAR - INSTITUTO DE SALUD CARLOS III; FERNANDEZ-CARRION, REBECA - INSTITUTO DE SALUD CARLOS III; CASTANER, OLGA - INSTITUTO DE SALUD CARLOS III; BULLO, MONICA - UNIVERSITY ROVIRA I VIRGILI; RUIZ-CANELA, MIGUEL - UNIVERSITY OF NAVARRA; GARCIA-DE LA HERA, MANOLI - MIGUEL HERNANDEZ UNIVERSITY; PEREZ-FARINOS, NAPOLEON - INSTITUTO DE SALUD CARLOS III; BARON-LOPEZ, F - INSTITUTO DE SALUD CARLOS III; COLOM, ANTONI - INSTITUTO DE SALUD CARLOS III; ABETE, ITZIAR - INSTITUTO DE SALUD CARLOS III; ROS, EMILIO - INSTITUTO DE SALUD CARLOS III; SALAS-SALVADO, JORDI - UNIVERSITY ROVIRA I VIRGILI

Submitted to: Sleep
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/1/2018
Publication Date: 10/4/2018
Citation: Rosique-Esteban, N., Papandreou, C., Romagera, D., Warnberg, J., Corella, D., Martinez-Gonzalez, M.A., Diaz-Lopez, A., Estruch, R., Vioque, J., Aros, F., Garcia-Rios, A., Bueno-Cavanillas, A., Vidal, J., Serra-Majem, L., Sibai, A.A., Tinahones, F.J., Martinez, J.A., Ordovas, J.M., Tur, J.A., Torrego Ellacuria, M., Sanllorente, A., Pinto, X., Buil-Cosiales, P., Fernandez-Carrion, R., Castaner, O., Bullo, M., Ruiz-Canela, M., Garcia-De La Hera, M., Perez-Farinos, N., Baron-Lopez, F.J., Colom, A., Abete, I., Ros, E., Salas-Salvado, J. 2018. Cross-sectional associations of objectively-measured sleep characteristics with obesity and type 2 diabetes in the PREDIMED-Plus trial. Sleep. 41(12). https://doi.org/10.1093/sleep/zsy190.
DOI: https://doi.org/10.1093/sleep/zsy190

Interpretive Summary: A growing body of research suggests that there is a link between how much people sleep and how much they weigh. In general, those who get too little sleep tend to weigh more than those who get enough sleep. Our objective was to examine associations of sleep duration and sleep variability with body composition, obesity and type 2 diabetes (T2D) in elders at high cardiovascular risk. For this purpose, we used the information on 1986 elders with overweight/obesity and the metabolic syndrome from the PREDIMED-Plus trial. "Bad sleepers" and "good sleepers" were characterized by combining sleep duration and sleep variability. Our results show that one hour/night increment in sleep duration was inversely associated with body mass index, waist circumference, obesity, T2D, android fat, and trunk fat. Compared with "good sleepers," "bad sleepers" were positively associated with obesity and T2D. Therefore, this study revealed associations of sleep duration with adiposity parameters and obesity. Sleep duration and sleep variability were associated with T2D.

Technical Abstract: Study Objectives: To examine independent and combined associations of sleep duration and sleep variability with body composition, obesity and type 2 diabetes(T2D) in elders at high cardiovascular risk. Methods: Cross-sectional analysis of 1986 community-dwelling elders with overweight/obesity and metabolic syndrome from PREDIMED-Plus trial. Associations of accelerometry-derived sleep duration and sleep variability with body mass index (BMI), waist circumference (WC) and body composition were assessed fitting multivariable-adjusted linear regression models. Prevalence ratios (PR) and 95% confidence intervals (CI) for obesity and T2D were obtained using multivariable-adjusted Cox regression with constant time. "Bad sleepers" (age-specific non-recommended sleep duration plus sleep variability above the median) and "good sleepers" (age-specific recommended sleep duration plus sleep variability below the median) were characterized by combining sleep duration and sleep variability, and their associations with these outcomes were examined. Results: One hour/night increment in sleep duration was inversely associated with BMI (beta -0.38 kg/m^2 [95% CI -0.54, -0.23]), WC (beta -0.86 cm [95% CI -1.25, -0.47]), obesity (PR 0.96 [95% CI 0.93, 0.98]), T2D (PR 0.93 [95% CI 0.88, 0.98]) and other DXA-derived adiposity-related measurements (android fat and trunk fat, all p < .05). Each 1-hour increment in sleep variability was positively associated with T2D (PR 1.14 [95% CI 1.01, 1.28]). Compared with "good sleepers," "bad sleepers" were positively associated with obesity (PR 1.12 [95% CI 1.01, 1.24]) and T2D (PR 1.62 [95% CI 1.28, 2.06]). Conclusions: This study revealed cross-sectional associations of sleep duration with adiposity parameters and obesity. Sleep duration and sleep variability were associated with T2D. Considering simultaneously sleep duration and sleep variability could have additional value, particularly for T2D, as they may act synergistically.