Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

Xinyi Jin; Yilin Chen; Hongliang Feng; Mingqing Zhou; Joey W Y Chan; Yaping Liu; Alice Pik Shan Kong; Xiao Tan; Yun-Kwok Wing; Yannis Yan Liang; Jihui Zhang

doi:10.1016/j.jshs.2023.03.001

Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

J Sport Health Sci. 2024 Mar;13(2):222-232. doi: 10.1016/j.jshs.2023.03.001. Epub 2023 Mar 3.

Authors

Xinyi Jin¹, Yilin Chen², Hongliang Feng³, Mingqing Zhou⁴, Joey W Y Chan⁵, Yaping Liu⁶, Alice Pik Shan Kong⁷, Xiao Tan⁸, Yun-Kwok Wing⁵, Yannis Yan Liang⁹, Jihui Zhang¹⁰

Affiliations

¹ Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
² Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; School of Medicine, South China University of Technology, Guangzhou 510641, China.
³ Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510180, China.
⁴ The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510282, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China.
⁵ Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China.
⁶ Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China.
⁷ Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China.
⁸ Department of Medical Sciences, Uppsala University, Uppsala 751 85, Sweden; Department of Big Data in Health Science, Zhejiang University School of Public Health, Hangzhou 310058, China.
⁹ Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China. Electronic address: liangyan@link.cuhk.edu.hk.
¹⁰ Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510180, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510120, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou 510260, China. Electronic address: zhangjihui@gzhmu.edu.cn.

Abstract

Purpose: The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity (PA) with the risk of incident type 2 diabetes in a population-based prospective cohort study.

Methods: Altogether, 88,000 participants (mean age = 62.2 ± 7.9 years, mean ± SD) were included from the UK Biobank. Sleep duration (short: <6 h/day; normal: 6-8 h/day; long: >8 h/day) and PA of different intensities were measured using a wrist-worn accelerometer over a 7-day period between 2013 and 2015. PA was classified according to the median or World Health Organization-recommendation: total volume of PA (high, low), moderate-to-vigorous PA (MVPA) (recommended, not recommended), and light-intensity PA (high, low). Incidence of type 2 diabetes was ascertained using hospital records or death registries.

Results: During a median follow-up of 7.0 years, 1615 incident type 2 diabetes cases were documented. Compared with normal sleep duration, short (hazard ratio (HR) = 1.21, 95% confidence interval (95%CI): 1.03-1.41) but not long sleep duration (HR = 1.01, 95%CI: 0.89-1.15) was associated with excessive type 2 diabetes risk. This increased risk among short sleepers seems to be protected against by PA. Compared with normal sleepers with high or recommended PA, short sleepers with low volume of PA (HR = 1.81, 95%CI: 1.46-2.25), not recommended (below the World Health Organization-recommended level of) MVPA (HR = 1.92, 95%CI: 1.55-2.36), or low light-intensity PA (HR = 1.49, 95%CI: 1.13-1.90) had a higher risk of type 2 diabetes, while short sleepers with a high volume of PA (HR = 1.14, 95%CI: 0.88-1.49), recommended MVPA (HR = 1.02, 95%CI: 0.71-1.48), or high light-intensity PA (HR = 1.14, 95%CI: 0.92-1.41) did not.

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.

Keywords: Light physical activity; Sleep duration; Triaxial accelerometer; Type 2 diabetes; UK Biobank.

MeSH terms

Accelerometry
Aged
Cohort Studies
Diabetes Mellitus, Type 2* / epidemiology
Diabetes Mellitus, Type 2* / prevention & control
Exercise
Humans
Middle Aged
Prospective Studies
Sleep Duration