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Widjaja NA, Kurube CF, Ardianah E. Sleep duration and insulin resistance in obese adolescents with metabolic syndrome: is there a correlation? ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023079. [PMID: 37539611 PMCID: PMC10440761 DOI: 10.23750/abm.v94i4.14142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/29/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND AIM Short sleep duration causes many changes in several hormones (leptin, ghrelin, insulin, cortisol, growth hormone) and increases sympathetic activity with elevated levels of catecholamines, which causes an energy imbalance and leads to overweight or obesity and insulin resistance. The present study aimed to analyze the relationship between sleep duration and insulin resistance in obese adolescents with metabolic syndrome. METHODS An observational cross-sectional research design concluded 124 obese adolescents with metabolic syndrome (MetS) aged 13-18 years. Anthropometry, blood pressure, and blood tests were conducted to determine obesity according to CDC 2000. MetS determination based on International Diabetes Federation 2007. Insulin resistance was assessed using HOMA-IR. Sleep duration was determined based on direct interviews with the research subjects. The obtained data were analyzed using the Spearman correlation test, Chi-Square, Mann-Whitney, and T-test (significant at P <0.05). RESULTS The subjects were dominated by male adolescents 67.5%. There was a strong relationship between age and sleep duration (p = 0.035). Subjects were divided into two age groups based on sleep duration: those with < 8 hours and > 8 hours of sleep. There was a significant difference in fasting insulin levels and HOMA IR value between the two groups, higher in the subjects with < 8 hours of sleep than the subjects with > 8 hours of sleep. Sleep duration and HOMA-IR values as a marker of insulin resistance had a significant negative correlation (rs= -0.581; P <0.001) and insulin levels (rs=-0.565, P <0.001). CONCLUSIONS Sleep duration has a robust negative correlation with the HOMA-IR value, which is a parameter of insulin resistance. (www.actabiomedica.it).
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Affiliation(s)
- Nur Aisiyah Widjaja
- Child Health Department, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
| | - Claudia Felisia Kurube
- Child Health Department, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
| | - Eva Ardianah
- Child Health Department, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
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Kazemi M, Khalili P, Kazemi M, Hasani H, Sadeghi M, Jamali Z. Investigation of the relationship between sleep-related parameters and metabolic syndrome (MetS) among youths in the Southeast of Iran. Diabetol Metab Syndr 2023; 15:91. [PMID: 37147707 PMCID: PMC10161496 DOI: 10.1186/s13098-023-01072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/27/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND AND AIM There are few studies and inconsistent findings on the role of sleep-related parameters in the development of metabolic syndrome (MetS) among youths. In this study, we aim to investigate the relationship between sleep-related parameters and MetS among youths in a large sample size in Rafsanjan, a region in the southeast of Iran. METHODS The current cross-sectional study was performed on 3,006 young adults aged 15-35, who registered for Rafsanjan Youth Cohort Study (RYCS), as part of Rafsanjan Cohort Study (RCS)). In fact, RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, we included 2,867 youths after excluding some subjects with missing information on MetS components. MetS was diagnosed based on Adult Treatment Panel III (ATP III) criteria. Besides, data on sleep-related parameters were collected by self-report questionnaires. RESULTS The overall prevalence of MetS was 7.74% among the participants. In addition, bedtime, wake time, napping, night shift work, and sleep duration per night and day had no association with the higher odds of having MetS. In contrast, long sleep duration at night was associated with the lower odds of high waist circumference (WC) (OR: 0.82,95% CI :0.67-0.99). CONCLUSION In the present study, long sleep duration at night was associated with lower odds of central obesity. However, more longitudinal studies with the objective measurement of sleep-related parameters are needed to verify the associations reported in the current study.
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Affiliation(s)
- Majid Kazemi
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Non- Communicable Disease Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Department of Epidemiology, School of Public Health, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mahsa Kazemi
- Department of Neurology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Hasani
- Department of Medical Surgical Nursing, Jovein School of Nursing, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Marjan Sadeghi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Alves JM, Chow T, Nguyen-Rodriguez S, Angelo B, Defendis A, Luo S, Smith A, Yunker AG, Xiang AH, Page KA. Associations Between Sleep and Metabolic Outcomes in Preadolescent Children. J Endocr Soc 2022; 6:bvac137. [PMID: 36249413 PMCID: PMC9557847 DOI: 10.1210/jendso/bvac137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Indexed: 01/29/2023] Open
Abstract
Context Growing evidence suggests an important role for sleep for the metabolic health of children. Objective We aimed to determine how sleep is related to insulin sensitivity, insulin secretion, beta-cell function, and adiposity (BMI z-scores, body fat %, waist to height ratio) using objectively measured sleep and oral glucose tolerance test (OGTT)-derived measures. Methods Sixty-two children aged 7-11 years, born at Kaiser Permanente Southern California, wore wrist accelerometers for 7 days to objectively measure sleep, completed an OGTT, and had anthropometric measures (height [cm], weight [kg], waist [cm], body fat [%]) collected. Using linear regression, associations between Matsuda insulin sensitivity index (ISI), insulinogenic index (IGI), disposition index (DI), BMI z-score, waist to height ratio, and body fat % with sleep parameters [total sleep time (TST; min), sleep efficiency (SE; %), time in bed (TIB; min), wake after sleep onset (WASO; min), and sleep latency (SL; min)] were assessed. Body fat % was tested as a mediator of the relationship between TST and ISI. Results Longer TST was associated with better insulin sensitivity (P = 0.02), but not after adjusting for body fat %. Sleep parameters were not associated with IGI or DI. Longer TST was associated with lower % body fat (P = 0.01) and lower waist-to-height-ratios (P = 0.05). Body fat % explained 62% (P = 0.01) of the relationship between TST and ISI. Longer TIB was associated with lower adiposity measures (P < 0.05). There were no associations between SE, WASO, or SL and metabolic outcomes. Conclusion Objectively measured sleep duration was associated with lower adiposity, and the relationship between sleep duration and ISI appeared partly through adiposity levels in preadolescent children. Longer sleep duration may be important for metabolic health.
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Affiliation(s)
- Jasmin Marie Alves
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Ting Chow
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, 91101 CA, USA
| | - Selena Nguyen-Rodriguez
- Department of Health Science, California State University Long Beach, Long Beach, 90840-4902 CA, USA
| | - Brendan Angelo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Alexis Defendis
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Shan Luo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Department of Psychology, University of Southern California, Los Angeles, 90089 CA, USA
- Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, 90027 CA, USA
| | - Alexandro Smith
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Alexandra Grace Yunker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, 02115 MA, USA
| | - Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, 91101 CA, USA
| | - Kathleen Alanna Page
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
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Wu N, Jamnik VK, Koehle MS, Guan Y, Li Y, Kaufman K, Warburton DER. Associations between Sleep Characteristics and Cardiovascular Risk Factors in Adolescents Living with Type 1 Diabetes. J Clin Med 2022; 11:5295. [PMID: 36142941 PMCID: PMC9503476 DOI: 10.3390/jcm11185295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Adolescents living with type 1 diabetes (T1D) have an increased risk of developing cardiovascular disease. Sleep patterns have physiological and behavioral impacts on diabetes outcomes. This study aimed to investigate the associations between sleep patterns and CVD risk factors in adolescents living with T1D and their peers living without T1D. This cross-sectional study assessed CVD risk factors and sleep characteristics (and their associations) in adolescents, aged 12-18 years, living with T1D (n = 48) and their peers (n = 19) without T1D. Outcomes included blood pressure, lipid profiles, and sleep characteristics (accelerometry). Statistical differences between groups were determined with chi-square or independent samples t-tests. The associations between sleep characteristics and CVD risk factors were assessed with multivariate linear regression analyses. We found no significant differences between the two groups in terms of sleep duration, efficiency, sleep onset and offset, and frequency of awakenings, and there were associations between sleep efficiency and LDL-C (β = -0.045, p = 0.018, model R2 = 0.230) and triglycerides (β = -0.027, p = 0.012, model R2 = 0.222) after adjusting confounders (diabetes status, sex, age, pubertal stage) in all participants. In conclusion, adolescents with T1D and without T1D sleep less than the recommended eight hours per night. The associations between sleep efficiency and LDL-C and triglycerides are independent of sleep duration, regardless of sex, age, and pubertal stage.
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Affiliation(s)
- Nana Wu
- Physical Activity Promotion and Chronic Disease Prevention Unit, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Veronica K. Jamnik
- School of Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada
| | - Michael S. Koehle
- Division of Sports Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Yanfei Guan
- Physical Activity Promotion and Chronic Disease Prevention Unit, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Yongfeng Li
- College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Kai Kaufman
- Physical Activity Promotion and Chronic Disease Prevention Unit, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Darren E. R. Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Confortin SC, Aristizábal LYG, da Silva Magalhães EI, Barbosa AR, Ribeiro CCC, Batista RFL, Silva AAMD. Association between sleep duration and cardiometabolic factors in adolescents. BMC Public Health 2022; 22:686. [PMID: 35395941 PMCID: PMC8991664 DOI: 10.1186/s12889-022-13119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background The sleep reduction can change healthy people's hemodynamic control and cardiovascular regulation through increased inflammatory response and altered endothelial function. The objective the study to analyze the association between sleep duration and cardiometabolic risk factors in adolescents in the birth cohort of São Luís (1997/98). Methods This is a cross-sectional study with adolescents participating in the birth cohort of São Luís (1997/98). Sleep duration was evaluated using accelerometer data (Actigraph wGT3X-BT). Glycemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglycerides were considered cardiometabolic factors. The Directed Acyclic Graph (DAG) was used to identify the minimum set of adjustment for confounding. Results Out of 1,268 adolescents, 50.3% of them were male. The prevalence of sleep duration of less than 6 h per day was 31.1%. The mean glycemia value was 91.8 mg/dL (± 15.9), DBP was 71.3 mmHg (± 7.5), SBP was 114.9 mmHg (± 12.3), HDL was 48.5 mg/dL (± 11.6), LDL was 89.0 mg/dL (± 25.7), the total cholesterol was 156.0 mg/dL (± 31.1), and triglycerides was 93.6 mg/dL (± 47.2). The crude analysis showed an association between sleep duration and SBP and LDL-c. In the adjusted analysis, the associations did not remain. Conclusion Our study showed no association between sleep duration and cardiometabolic outcomes in adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13119-7.
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Affiliation(s)
- Susana Cararo Confortin
- Federal University of Maranhão, Collective Health Post-Graduate Program, São Luís, Maranhão, Brazil.
| | | | | | - Aline Rodrigues Barbosa
- School of Sports, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Kim J, Noh JW, Kim A, Kwon YD. Demographic and Socioeconomic Influences on Sleep Patterns among Adolescent Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124378. [PMID: 32570823 PMCID: PMC7345986 DOI: 10.3390/ijerph17124378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022]
Abstract
Although proper sleep is an important topic in adolescent health, little is known about the sleep patterns of adolescents from a longitudinal and non-Western perspective. To fill this gap, the present research conducted a longitudinal study of the impact of demographic and socioeconomic factors on sleep patterns among Korean adolescent students. The relationship could positively or negatively affect sleep. Therefore, it is important to understand which demographic and socioeconomic factors are related to sleep patterns. This study used nationally representative panel data from the Korean Children and Youth Panel Survey. A series of descriptive analyses were conducted to provide overall characteristics of the sample. Furthermore, mixed effect regression analysis techniques were employed to test the relationship between demographic and socioeconomic factors and sleep patterns. Paternal employment status was associated with adolescent sleep patterns, while maternal employment status was not. Adolescents with both parents working compared to adolescents with one parent or none working showed different sleep patterns on weekdays but not on weekends. Both parents possessing college degrees, household income, living in an urban area, and family type were associated with adolescent sleep pattern indicators to varying degrees. Some of these associations varied according to adolescent sex. This study provides insight into the impact of demographic and socioeconomic factors on weekend and weekday sleep patterns among adolescent students by sex. These findings provide information for the promotion of healthy sleep in adolescents by addressing demographic and socioeconomic factors.
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Affiliation(s)
- Jinseok Kim
- Department of Social Welfare, Seoul Women’s University, Seoul 01797, Korea; (J.K.); (A.K.)
| | - Jin-Won Noh
- Department of Health Administration, Dankook University, Cheonan 31116, Korea;
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Ahraemi Kim
- Department of Social Welfare, Seoul Women’s University, Seoul 01797, Korea; (J.K.); (A.K.)
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: ; Tel.: +82-2-2258-8251; Fax: +82-2-2258-8257
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Abiri B, Sarbakhsh P, Vafa M. Prevalence of overweight, obesity, and associated risk factors in healthy female adolescents in Tehran, Iran. Cent Asian J Glob Health 2019; 8:413. [PMID: 32002316 DOI: 10.5195/cajgh.2019.413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction Obesity is an important health concern worldwide and is a growing problem in Iran. Adolescent obesity has a major role in development of adulthood obesity and its complications. The present study was conducted to evaluate the prevalence of overweight, obesity, and associated risk factors in female adolescents living in Tehran, Iran. Methods This cross-sectional study was carried out among 2,132 female adolescents aged 14-17 years in Tehran recruited between 2017 and 2018. Weight and height were measured and body mass index (BMI) was calculated. Underweight, overweight, and obesity were considered as < 5th, ≥ 85th, and ≥ 95th percentile, respectively, of CDC BMI-for age and sex criteria. Adolescents and their mothers filled in the questionnaires on physical activity, computer use, duration of breastfeeding, total sleep time, and family socioeconomic status. Statistical analysis was performed using SPSS version 22.0 software. P < 0.05 was considered statistically significant. Results The overall prevalence rates of overweight and obesity were 24.1% and 6.5%, respectively. The prevalences of overweight and obesity were highest in the South District (28.9% and 7.7%, respectively) and were lowest in the North District (19.1% and 5.2%, respectively). There were significant differences in physical activity level (P < 0.001), total sleep time (P < 0.001), duration of breastfeeding (P < 0.01), and daily computer use (P < 0.001) among the four groups (underweight, normal, overweight, and obese). Regarding the socioeconomic status, parental education level and economic status were significantly higher in those who had normal weight compared to other weight groups (in both, P < 0.001). Conclusion This study showed that overweight and obesity among female adolescents in Tehranhave become a major public health concern. Level of physical activity, computer use, sleep duration, breastfeeding duration, levels of parental education, and economic status were associated with overweight and obesity prevalence.
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Affiliation(s)
- Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Sarbakhsh
- Department of Statistics and Epidemiology, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
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Smiley A, King D, Bidulescu A. The Association between Sleep Duration and Metabolic Syndrome: The NHANES 2013/2014. Nutrients 2019; 11:E2582. [PMID: 31717770 PMCID: PMC6893635 DOI: 10.3390/nu11112582] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND We aimed to assess the association of sleep with metabolic syndrome in the 2013/2014 National Health and Nutrition Examination Survey (NHANES). METHODS Sample size included 2737 out of 2013 and 2014 NHANES surveys. Cross-sectional study of metabolic syndrome and sleep duration was conducted. Metabolic syndrome was defined according to NCEP ATPIII (National Cholesterol Education Program Adult Treatment Panel III) criteria. Metabolic syndrome severity score was calculated based on actual measurement of each component, adjusted for sex and race. The generalized additive model (GAM) was built to assess the smooth relationship between metabolic syndrome/metabolic syndrome severity score and sleep duration. Adjustment of models were done for age, sex, race, and sitting time. The value of effective degree of freedom (EDF) formed by the GAM model shows the degree of curvature of the relationship. A value of 1 for EDF is translated as the linear shape of relationship. Values larger than one denote a more complex relationship between the response variable and the predicting one. RESULTS There was a U-shaped association between sleep duration and metabolic syndrome in univariable GAM (EDF = 2.43, p = 0.06) and multivariable GAM (EDF = 2.03, p = 0.20). The lowest risk of metabolic syndrome was observed in people sleeping 7 hours/night. There was a significant U-shaped association between sleep duration and metabolic syndrome severity score in multivariable GAM (EDF = 2.94, p = 0.0004). Similarly, the lowest mean metabolic syndrome severity score was observed in people sleeping 7 hours/night. There was an effect modification of sex and sleep duration indicating strong U-shaped relationship of metabolic syndrome severity score and sleep duration in women (EDF = 3.43, p = 0.00002) and semi-linear association in men (EDF = 1.76, p = 0.04). CONCLUSION Short and long sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in women. Short sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in men.
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Affiliation(s)
- Abbas Smiley
- Department of Surgery, Westchester Medical Center, School of Medicine, New York Medical College, New York, NY 10595, USA
| | - David King
- Henry M Jackson Foundation for the advancement of Military Medicine, Bethesda, MD 20817, USA;
| | - Aurelian Bidulescu
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN 47404, USA;
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Association of Sleep Duration with Obesity and Cardiometabolic Risk Factors in Children and Adolescents: A Population-Based Study. Sci Rep 2019; 9:9463. [PMID: 31263172 PMCID: PMC6603036 DOI: 10.1038/s41598-019-45951-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/18/2019] [Indexed: 12/21/2022] Open
Abstract
This study aimed to evaluate the relationships between sleep duration and overweight/obesity, obesity, and metabolic syndrome (MetS) and its components in children and adolescents. A total of 6,048 participants aged 10–18 years were divided into the following four sleep-duration groups based on age-specific sleep duration: i) very short; ii) short; iii) recommended; and iv) long. The participants in the very short sleep-duration group had an increased odds ratio (OR) of 1.76 for overweight/obesity, 1.69 for obesity, and 1.49 for elevated waist circumference (WC) compared with the recommended sleep-duration group. The subjects in the long sleep-duration group had an increased OR of 2.71 for elevated triglyceride (TG) compared with those in the recommended sleep-duration group. In subgroup analyses, boys in the very short sleep-duration group exhibited an increased OR of 1.78 for overweight/obesity compared with those in the recommended sleep-duration group. Compared with girls in the recommended sleep-duration group, those in the very short sleep-duration group exhibited an increased OR of 1.69 for overweight/obesity, 2.28 for obesity, and 1.57 for elevated WC; in contrast, girls in the very short sleep-duration group exhibited a decreased OR of 0.58 for elevated TG. The girls in the long sleep-duration group had an increased OR of 3.86 for elevated TG compared with those with recommended sleep-duration. Our results suggest that shorter sleep durations may be related to overweight/obesity, obesity, and central obesity, and longer sleep durations may be associated with elevated TG. However, the nature of these relationships may be dependent on sex.
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Kim J, Noh JW, Kim A, Kwon YD. Relationships between Sleep Patterns, Health Risk Behaviors, and Health Outcomes among School-Based Population of Adolescents: A Panel Analysis of the Korean Children and Youth Panel Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132278. [PMID: 31252654 PMCID: PMC6650950 DOI: 10.3390/ijerph16132278] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/23/2019] [Accepted: 06/25/2019] [Indexed: 12/28/2022]
Abstract
Sleep patterns among adolescents are related to health outcomes and health risk behaviors. This study aimed to describe sleep patterns of Korean adolescents and to find the association between sleep patterns and health risk behaviors and health outcomes. Using the junior high school students’ panel data (n = 2351, 12–15 years old) from the Korean Children and Youth Panel Survey, this study described the sleep patterns operationalized as rising time, bedtime, and sleep duration both on weekdays and weekends. The relationships of sleep patterns with health outcomes and/or health risk behaviors were tested using mixed effect linear regression for continuous health variables and using mixed effect logit regression for binary health variables. Obesity status, the number of chronic symptoms, self-rated health status, smoking, and alcohol consumption were associated with rising time on weekdays after controlling for gender, living area, and housing type. The same set of variables except for the number of chronic symptoms were associated with bedtime during the weekdays. Sleep duration during the weekdays was associated with obesity status, smoking, and alcohol consumption. Similar patterns of association between sleep pattern variables during the weekends and health-related outcome variables were found, but were less obvious than those for weekdays. Significant relationships between sleep patterns and various health-related variables were found among adolescents in Korea. The results from this study indicate that helping adolescents change their sleeping times as necessary to ensure adequate sleep should be considered important in diminishing health risk behaviors and promoting positive health outcomes.
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Affiliation(s)
- Jinseok Kim
- Department of Social Welfare, Seoul Women's University, Seoul 01797, Korea
| | - Jin-Won Noh
- Department of Healthcare Management, Eulji University, Seongnam 13135, Korea
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen 9713 GZ, The Netherlands
| | - Ahraemi Kim
- Department of Social Welfare, Seoul Women's University, Seoul 01797, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul 06591, Korea.
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Simon SL, Behn CD, Cree-Green M, Kaar JL, Pyle L, Hawkins SMM, Rahat H, Garcia-Reyes Y, Wright KP, Nadeau KJ. Too Late and Not Enough: School Year Sleep Duration, Timing, and Circadian Misalignment Are Associated with Reduced Insulin Sensitivity in Adolescents with Overweight/Obesity. J Pediatr 2019; 205:257-264.e1. [PMID: 30497764 PMCID: PMC6357957 DOI: 10.1016/j.jpeds.2018.10.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/04/2018] [Accepted: 10/11/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To examine the relationship between insulin resistance (IR) and sleep/circadian health in overweight/obese adolescents. We hypothesized that insufficient and delayed sleep would be associated with IR in this population. STUDY DESIGN Thirty-one adolescents (mean age, 16.0 ± 1.4 years; 77% female) with body mass index ≥90th percentile for age/sex were recruited from outpatient clinics at a children's hospital. Participants underwent 1 week of objective home sleep monitoring with wrist actigraphy during the academic year. A 3-hour oral glucose tolerance test was conducted, followed by in-laboratory salivary dim-light melatonin sampling every 30-60 minutes from 5 p.m. to noon the next day. Regression analyses between sleep and circadian variables with IR were examined. RESULTS Longer sleep time and time in bed on weekends and weekdays and earlier weekday bedtime were significantly associated with better insulin sensitivity. Participants who obtained less than the median duration of sleep per night (6.6 hours) had evidence of IR with compensatory insulin secretion compared with those obtaining ≥6.6 hours of sleep. A wider phase angle between bedtime and melatonin onset, indicating a later circadian timing of sleep onset, was significantly associated with IR. CONCLUSIONS Short sleep duration, later weekday bedtime, and later circadian timing of sleep were associated with IR in a cohort of adolescents with overweight/obesity during the school year. Further research is needed to better understand the physiology underlying these observations and to evaluate the impact of improved sleep and circadian health on metabolic health in this at-risk population.
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Affiliation(s)
- Stacey L Simon
- Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children's Hospital Colorado, Aurora, CO.
| | - Cecilia Diniz Behn
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, CO; Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Melanie Cree-Green
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jill L Kaar
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Stephen M M Hawkins
- Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children's Hospital Colorado, Aurora, CO
| | - Haseeb Rahat
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Yesenia Garcia-Reyes
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Kenneth P Wright
- Sleep & Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO; Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kristen J Nadeau
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
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12
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Rawat A, Gangwar AK, Tiwari S, Kant S, Garg RK, Singh PK. Sleep quality and insulin resistance in adolescent subjects with different circadian preference: A cross-sectional study. J Family Med Prim Care 2019; 8:2502-2505. [PMID: 31463284 PMCID: PMC6691405 DOI: 10.4103/jfmpc.jfmpc_400_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Studies have shown that alterations in the sleep cycle can predispose to several disorders. Most of the previous studies were done on the adults. Hence, the aim of the study was to see the effect of circadian disruption on the health of adolescent population. Materials and Methods: In this cross-sectional study, 203 subjects were enrolled. Study subjects were divided into three groups: definite evening chronotype, intermediate chronotype, and definite morning chronotype. Sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI). Daytime sleepiness and chronotype were measured by Epworth Sleepiness Score and Morningness-Eveningness Questionnaire Self-Assessment version, respectively. Two hours postprandial glucose was measured after oral glucose tolerance test. Fasting blood glucose and fasting insulin were measured. Homeostasis model of assessment for insulin resistance (HOMA-IR) was calculated. Data were summarized as mean ± standard deviation. Crude odds ratios and Karl Pearson's correlation coefficient of metabolic parameters with poor sleep were calculated. Results: Statistically significant difference was found in the mean value of poor sleep quality, 2 h postprandial blood glucose level, and insulin resistance among subjects of three groups. Subjects of evening chronotype have more significant positive correlation of 2 h postprandial blood glucose level and HOMA-IR value with poor sleep quality when compared with subjects of intermediate and morning chronotypes. Conclusion: Subjects with evening chronotype are more prone for development of metabolic syndrome compared with subjects of intermediate and morning chronotypes if proper health policies are not adopted for adolescents.
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Affiliation(s)
- Anita Rawat
- Department of Physiology, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India
| | - Anil Kumar Gangwar
- Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sunita Tiwari
- Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Surya Kant
- Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ravindra Kumar Garg
- Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Prithvi Kumar Singh
- Center for Advance Research (Cytogenetics Unit), King George's Medical University, Lucknow, Uttar Pradesh, India
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13
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Hemati Z, Mozafarian N, Heshmat R, Ahadi Z, Motlagh ME, Ziaodini H, Taheri M, Aminaee T, Qorbani M, Kelishadi R. Association of sleep duration with metabolic syndrome and its components in children and adolescents; a propensity score-matched analysis: the CASPIAN-V study. Diabetol Metab Syndr 2018; 10:78. [PMID: 30410582 PMCID: PMC6215637 DOI: 10.1186/s13098-018-0381-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 10/24/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the association of sleep duration with metabolic syndrome (MetS) and its components in a pediatric population. METHODS This multi-centric cross-sectional study was conducted in 2015 in 30 provinces of Iran. Participants consisted of 4200 school students aged 7-18 years, studied in a national school-based surveillance program (CASPIAN-V). Physical examinations and laboratory tests were performed using standard protocols. The analysis was conducted based on the propensity score matching and conditional logistic regression was used to evaluate the association of short sleep (less than 8 h a day) and the onset of sleep with MetS and its components. Results of conditional logistic regression was reported as odds ratios (OR) and 95% confidence intervals (CI). RESULTS Overall, 3843 of participants completed the survey (response rate: 91.5%). Their mean (SD) age was 12.3 (3.2) years and 50.6% were boys. In the multivariate model, individuals who slept less than 8 h a day had significantly higher odds of MetS (OR 2.05, 95% CI 1.19-3.63) and high blood pressure (BP) (OR 1.46, 95% CI 1.04-2.06). Association between short sleep duration with other MetS components (including abdominal obesity, hypertriglyceridemia, hyperglycemia, and low levels of high-density lipoprotein-cholesterol was not statistically significant (P > 0.05). Moreover, association between the onset of sleep with MetS and its components was not statistically significant (P > 0.05). CONCLUSION Short sleep duration is associated with increased risk of MetS and high BP in children and adolescents. The clinical impact of current findings should be assessed in future longitudinal studies.
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Affiliation(s)
- Zeinab Hemati
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran
| | - Nafiseh Mozafarian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Ahadi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hasan Ziaodini
- Office of Health and Fitness, Ministry of Education, Tehran, Iran
| | - Majzoubeh Taheri
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Tahereh Aminaee
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran
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14
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Cespedes Feliciano EM, Quante M, Rifas-Shiman SL, Redline S, Oken E, Taveras EM. Objective Sleep Characteristics and Cardiometabolic Health in Young Adolescents. Pediatrics 2018; 142:peds.2017-4085. [PMID: 29907703 PMCID: PMC6260972 DOI: 10.1542/peds.2017-4085] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5778442247001PEDS-VA_2017-4085Video Abstract BACKGROUND AND OBJECTIVES: Shorter sleep duration is associated with childhood obesity. Few studies measure sleep quantity and quality objectively or examine cardiometabolic biomarkers other than obesity. METHODS This cross-sectional study of 829 adolescents derived sleep duration, efficiency and moderate-to-vigorous physical activity from >5 days of wrist actigraphy recording for >10 hours/day. The main outcome was a metabolic risk score (mean of 5 sex-specific z-scores for waist circumference, systolic blood pressure, high-density lipoprotein cholesterol scaled inversely, and log-transformed triglycerides and homeostatic model assessment of insulin resistance), for which higher scores indicate greater metabolic risk. Secondary outcomes included score components and dual-energy radiograph absorptiometry fat mass. We measured socioeconomic status, race and/or ethnicity, pubertal status, and obesity-related behaviors (television-viewing and fast food and sugar-sweetened beverage consumption) using questionnaires. RESULTS The sample was 51.5% girls; mean (SD) age 13.2 (0.9) years, median (interquartile range) sleep duration was 441.1 (54.8) minutes per day and sleep efficiency was 84.0% (6.3). Longer sleep duration was associated with lower metabolic risk scores (-0.11 points; 95% CI: -0.19 to -0.02, per interquartile range). Associations with sleep efficiency were similar and persisted after adjustment for BMI z score and physical activity, television-viewing, and diet quality. Longer sleep duration and greater sleep efficiency were also favorably associated with waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, and fat mass. CONCLUSIONS Longer sleep duration and higher sleep efficiency were associated with a more favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors. These results support the need to assess the role of sleep quantity and quality interventions as strategies for improving cardiovascular risk profiles of adolescents.
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Affiliation(s)
| | - Mirja Quante
- Division of Sleep and Circadian Disorders, Department
of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess
Medical Center,,Department of Neonatology, University of
Tübingen, Tübingen, Germany; and
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the
Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care
Institute, Harvard Medical School, and
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department
of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess
Medical Center
| | - Emily Oken
- Division of Chronic Disease Research Across the
Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care
Institute, Harvard Medical School, and
| | - Elsie M. Taveras
- Department of Nutrition, Harvard T. H. Chan School of
Public Health, Harvard University, Boston, Massachusetts;,Division of General Academic Pediatrics,
Massachusetts General Hospital for Children, Boston, Massachusetts
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15
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Bal C, Öztürk A, Çiçek B, Özdemir A, Zararsız G, Ünalan D, Ertürk Zararsız G, Korkmaz S, Göksülük D, Eldem V, İsmailoğulları S, Erdem E, Mazıcıoğlu MM, Kurtoğlu S. The Relationship Between Blood Pressure and Sleep Duration in Turkish Children: A Cross-Sectional Study. J Clin Res Pediatr Endocrinol 2018; 10:51-58. [PMID: 28619699 PMCID: PMC5838373 DOI: 10.4274/jcrpe.4557] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE As in adults, hypertension is also an important risk factor for cardiovascular disease in children. We aimed to evaluate the effect of sleep duration on blood pressure in normal weight Turkish children aged between 11-17 years. METHODS This cross-sectional study was conducted in the primary and secondary schools of the two central and ten outlying districts of Kayseri, Turkey. Subjects were 2860 children and adolescents (1385 boys, 1475 girls). Systolic and diastolic blood pressures were measured according to the recommendations of the Fourth Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Sleep duration was classified as follows: ≤8 hours, 8.1-8.9 hours, 9.0-9.9 hours or ≥10 hours. RESULTS For short sleeper boys and girls (participants with a sleep duration ≤8 h) the prevalence of prehypertension and hypertension was 35.0% and 30.8%, respectively. In univariate binary logistic regression analyses (age-adjusted), each unit increment in sleep duration (hours) in boys and girls, decreased the prehypertension and hypertension risk by 0.89 [odds ratio (OR)] [confidance interval (CI); 0.82-0.98] and 0.88 (OR) (CI; 0.81-0.97), respectively (p<0.05). In multiple binary logistic regression analyses [age- and body mass index (BMI)-adjusted] the location of the school and sleep duration categories were shown to be the most important factors for prehypertension and hypertension in both genders, while household income was the most important factor, only in boys. CONCLUSIONS A sleep duration ≤8 h is an independent risk factor for prehypertension and hypertension in Turkish children aged 11-17 years.
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Affiliation(s)
- Cengiz Bal
- Eskişehir Osmangazi University Faculty of Medicine, Department of Biostatistics, Eskişehir, Turkey
| | - Ahmet Öztürk
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Betül Çiçek
- Erciyes University Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri, Turkey,* Address for Correspondence: Erciyes University Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri, Turkey Phone: +90 352 207 66 66/28654 E-mail:
| | - Ahmet Özdemir
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Gökmen Zararsız
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Demet Ünalan
- Erciyes University Halil Bayraktar Health Services Vocational College, Kayseri, Turkey
| | - Gözde Ertürk Zararsız
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Selçuk Korkmaz
- Trakya University Faculty of Medicine, Department of Biostatistics, Edirne, Turkey
| | - Dinçer Göksülük
- Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Vahap Eldem
- İstanbul University Faculty of Science, Department of Biology, İstanbul, Turkey
| | - Sevda İsmailoğulları
- Erciyes University Faculty of Medicine, Department of Neurology, Kayseri, Turkey
| | - Emine Erdem
- Erciyes University Faculty of Health Sciences, Department of Pediatric Nursing, Kayseri, Turkey
| | - Mümtaz M Mazıcıoğlu
- Erciyes University Faculty of Medicine, Department of Family Medicine, Kayseri, Turkey
| | - Selim Kurtoğlu
- Memorial Hospital, Department of Pediatrics, Kayseri, Turkey
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16
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Pulido-Arjona L, Correa-Bautista JE, Agostinis-Sobrinho C, Mota J, Santos R, Correa-Rodríguez M, Garcia-Hermoso A, Ramírez-Vélez R. Role of sleep duration and sleep-related problems in the metabolic syndrome among children and adolescents. Ital J Pediatr 2018; 44:9. [PMID: 29334985 PMCID: PMC5769404 DOI: 10.1186/s13052-018-0451-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/08/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is increasing recognition that sleep is a risk factor for metabolic syndrome (MetS). The aim of the present study was to analyze the relationship between self-reported sleep duration, sleep-related problems and the presence of MetS in children and adolescents from Bogotá, D.C., Colombia. METHODS This is a cross-sectional analysis from the FUPRECOL study (2014-15). Participants included 2779 (54.2% girls) youth from Bogota (Colombia). MetS was defined as the presence of ≥3 of the metabolic abnormalities (hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-c], hypertension, and increased waist circumference) according to the criteria of de Ferranti/Magge and colleges. Self-reported sleep duration and sleep-related problems were assessed with the BEARS questionnaire. RESULTS Logistic regression analysis showed that boys who meet recommended duration of sleep had a decreased risk of elevated blood glucose levels (Odds Ratio [OR] = 0.71, 95%CI [0.40-0.94]; p = 0.031) compared to boys who have short-long sleep duration. Also, compared to young without sleep problems, excessive sleepiness during the day was related to low HDL-c levels in boys (OR = 1.36, 95%CI [1.02-1.83]; p = 0.036) and high triglyceride levels in girls (OR = 1.28, 95%CI [1.01-1.63]; p = 0.045). Girls with irregular sleep patterns had decreased HDL-c levels (OR = 0.71, 95%CI [0.55-0.91]; p = 0.009). CONCLUSIONS Recommended sleep duration was associated with a decreased risk of elevated fasting glucose levels in boys, and sleep problems was related to lower HDL-c in girls and higher triglyceride levels in boys. These findings suggested the clinical importance of improving sleep hygiene to reduce metabolic risk factors in children and adolescents.
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Affiliation(s)
- Leonardo Pulido-Arjona
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
| | - Jorge Enrique Correa-Bautista
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
| | - Cesar Agostinis-Sobrinho
- Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Early Start Research Institute, Faculty of Social Sciences, School of Education, University of Wollongong, Wollongong, Australia
| | | | - Antonio Garcia-Hermoso
- Physical Activity, Sport and Health Sciences Laboratory, Faculty of Medical Sciences, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Robinson Ramírez-Vélez
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
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17
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Plumptre L, Anderson LN, Chen Y, Carsley S, Narang I, Hamilton J, McCrindle B, Parkin PC, Maguire JL, Birken CS, on behalf of the TARGet Kids! Colla. Longitudinal Analysis of Sleep Duration and Cardiometabolic Risk in Young Children. Child Obes 2017; 13:291-299. [PMID: 30433827 DOI: 10.1089/chi.2016.0279] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The aim of this study is to determine if sleep duration in early childhood is associated with cardiometabolic risk (CMR) in later childhood as assessed by a CMR cluster score [sum of age- and sex-standardized z-scores of waist circumference (WC), systolic blood pressure, triglycerides, glucose, and (inverse) high-density lipoprotein (HDL)]. Secondary objectives included examining sleep duration and the individual CMR factors and BMI z-score. PATIENTS AND METHODS A prospective cohort study was conducted using data from the TARGet Kids! practice-based research network in Toronto, Canada. Children (n = 597) with parent-reported 24-hour sleep duration in early childhood (12-36 months) and a follow-up visit (36-96 months) with all five CMR factors were included in the analysis. Multivariable linear regression was used to assess the relationship between early childhood sleep duration and later childhood CMR, adjusting for relevant covariates. RESULTS Average 24-hour sleep duration in early childhood [mean age: 28.1 (6.6) months] was 11.8 (1.4) hours, with 87% meeting or exceeding total sleep recommendations for their age. Sleep duration in early childhood was not associated with the CMR cluster score in later childhood. Shorter sleep duration was associated with higher HDL concentrations [adjusted β = -0.028 (95% confidence interval: -0.049 to -0.007), p = 0.009]. CONCLUSIONS Further research is needed to determine if early childhood sleep duration is associated with HDL in later childhood. Future studies, which investigate sleep quality in addition to sleep duration, may be helpful.
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Affiliation(s)
- Lesley Plumptre
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada
| | - Laura N Anderson
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,2 Department of Clinical Epidemiology and Biostatistics, McMaster University , Hamilton, Ontario, Canada
| | - Yang Chen
- 3 The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital , Toronto, Ontario, Canada
| | - Sarah Carsley
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada
| | - Indra Narang
- 5 Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada
| | - Jill Hamilton
- 6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,7 Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children , Toronto, Ontario, Canada
| | - Brian McCrindle
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,8 Division of Cardiology, Department of Pediatrics, Hospital for Sick Children, University of Toronto , Toronto, Ontario, Canada
| | - Patricia C Parkin
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,9 Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children , Toronto, Ontario, Canada
| | - Jonathon L Maguire
- 3 The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,10 Department of Pediatrics, St. Michael's Hospital , Toronto, Ontario, Canada
| | - Catherine S Birken
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,9 Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children , Toronto, Ontario, Canada
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Inadequate sleep as a contributor to type 2 diabetes in children and adolescents. Nutr Diabetes 2017; 7:e266. [PMID: 28481337 PMCID: PMC5518801 DOI: 10.1038/nutd.2017.19] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/04/2017] [Accepted: 03/20/2017] [Indexed: 12/17/2022] Open
Abstract
Lack of sleep is a modifiable risk factor for adverse health in humans. Short sleep duration and poor sleep quality are common in the pediatric population; the largest decline in sleep duration over the past decades has been seen in children and adolescents. The objective of the present narrative review was to provide for the first time an overview of the literature on sleep and its association with type 2 diabetes mellitus (T2D) biomarkers in children and adolescents. For this narrative review, 23 studies were retained (21 observational and 2 experimental studies). Notwithstanding the conflicting results found in these studies and despite being attenuated by adiposity level, maturity, sex and age, there is still some compelling evidence for an association between sleep duration (for both objective or subjective measurements of duration) and architecture with one or more T2D biomarkers in children and adolescents. The majority of the studies reviewed did focus on sleep duration and one or more T2D biomarkers in children and adolescents, but sleep architecture, more precisely the suppression of slow wave sleep and rapid eye movement sleep, has also been shown to be associated with insulin resistance. Only two studies looked at sleep quality, and the association between sleep quality and insulin resistance was not independent of level of adiposity. Future experimental studies will help to better understand the mechanisms linking insufficient sleep with T2D. Work also needs to be carried out on finding novel and effective strategies aimed at improving sleep hygiene and health outcomes of children and adolescents.
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19
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Alodhayani AA, Alshaikh OM, Ghomraoui FA, AlShaibani TJ, Algadheeb AS, Bendahmash AW, Baqays AA. Correlation between obesity and sleep disturbance in Saudi medical students. J Phys Ther Sci 2017; 29:181-186. [PMID: 28265135 PMCID: PMC5332966 DOI: 10.1589/jpts.29.181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/09/2016] [Indexed: 01/08/2023] Open
Abstract
[Purpose] The aim of the present study was to investigate the association between sleep duration, quality and obesity in the medical students of Saudi population. [Subjects and Methods] This is a cross-sectional study carried out in 408 medical students from King Khalid University Hospitals, Riyadh, Saudi Arabia, based on well-designed questionnaire study and consent form. [Results] The results of this study revealed 39.9% of subjects perform the exercise on regular basis and 61.5% of them reduced their weight, which may be due to diet plan (52.9%) also. Only 68.6% of the subjects were affected with the weight. The maximum number of subjects was lying down after the lunch (88.2%), sitting and reading (80.1%) are prone to develop obesity in future. [Conclusion] Our study confirms sleep disturbance has affected the weight gain and the maximum number of subjects was lying down after the lunch and sitting and reading will be prone to develop obesity in future.
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Affiliation(s)
- Abdulaziz A Alodhayani
- Family Medicine and Community Department, College of Medicine, King Saud University, Saudi Arabia
| | - Omalkhaire M Alshaikh
- Department of Internal Medicine, Al-Imam Mohammed Ibn Saud Islamic University, Saudi Arabia
| | | | - Tahani Jathab AlShaibani
- Family Medicine and Community Department, College of Medicine, King Saud University, Saudi Arabia
| | | | | | - Abdullah Ali Baqays
- Family Medicine and Community Department, College of Medicine, King Saud University, Saudi Arabia
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Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. J Clin Sleep Med 2016; 12:1549-1561. [PMID: 27707447 DOI: 10.5664/jcsm.6288] [Citation(s) in RCA: 381] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 12/13/2022]
Abstract
ABSTRACT Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. COMMENTARY A commentary on this article apears in this issue on page 1439.
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Affiliation(s)
| | - Lee J Brooks
- Children's Hospital of Philadelphia, Philadelphia, PA.,Liaison for the American Academy of Pediatrics
| | | | - Wendy A Hall
- University of British Columbia School of Nursing, Vancouver, BC
| | | | | | - Beth A Malow
- Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | | | | | - Merrill S Wise
- Methodist Healthcare Sleep Disorders Center, Memphis, TN
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Al-Abri MA, Jaju D, Al-Sinani S, Al-Mamari A, Albarwani S, Al-Resadi K, Bayoumi R, Hassan M, Al-Hashmi K. Habitual Sleep Deprivation is Associated with
Type 2 Diabetes: A Case-Control Study. Oman Med J 2016; 31:399-403. [PMID: 27974953 DOI: 10.5001/omj.2016.81] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES It is suggested that a minimum of eight hours of sleep per night is needed for metabolism to work normally. The aim of the study was to determine the association of habitual sleep deprivation and type 2 diabetes mellitus (T2DM). METHODS We conducted a case-control study comparing patients with T2DM with age and sex matched healthy controls. Standard sleep questionnaires (the Berlin and Epworth Sleepiness Scale) and a weekly diary were used by patients to self-report habitual sleep. RESULTS A total of 172 diabetics and 188 healthy controls were enrolled in the study. There was a significant difference between T2DM and healthy controls in nocturnal sleep duration (p = 0.033). There was a significant association between nocturnal sleep duration of fewer than six hours and T2DM (χ2 = 14.0; p = 0.0001). There was no significant difference in daytime sleepiness and daytime naps between the T2DM and control groups (p = 0.452; p = 0.581, respectively). CONCLUSIONS A nocturnal sleep duration < 6 hours is associated with T2DM.
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Affiliation(s)
- Mohammed A Al-Abri
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Deepali Jaju
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sawsan Al-Sinani
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ali Al-Mamari
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sulayma Albarwani
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khalid Al-Resadi
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Riyadh Bayoumi
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Mohammed Hassan
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khamis Al-Hashmi
- Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
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22
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Quist JS, Sjödin A, Chaput JP, Hjorth MF. Sleep and cardiometabolic risk in children and adolescents. Sleep Med Rev 2016; 29:76-100. [DOI: 10.1016/j.smrv.2015.09.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 12/22/2022]
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Abstract
Emerging evidence has assigned an important role to sleep as a modulator of metabolic homeostasis. The impact of variations in sleep duration, sleep-disordered breathing, and chronotype to cardiometabolic function encompasses a wide array of perturbations spanning from obesity, insulin resistance, type 2 diabetes, the metabolic syndrome, and cardiovascular disease risk and mortality in both adults and children. Here, we critically and extensively review the published literature on such important issues and provide a comprehensive overview of the most salient pathophysiologic pathways underlying the links between sleep, sleep disorders, and cardiometabolic functioning.
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Affiliation(s)
- Dorit Koren
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, Department of Medicine
- Section of Pediatric Sleep Medicine
| | - Magdalena Dumin
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, Department of Medicine
| | - David Gozal
- Section of Pediatric Sleep Medicine
- Section of Pulmonology, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA
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24
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Sayin FK, Buyukinan M. Sleep Duration and Media Time Have a Major Impact on Insulin Resistance and Metabolic Risk Factors in Obese Children and Adolescents. Child Obes 2016; 12:272-8. [PMID: 26978730 DOI: 10.1089/chi.2015.0126] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Lifestyle factors sleep duration and media time during childhood differ between countries. This study examined whether sleep duration and media time affect metabolic risk factors insulin resistance (IR), blood lipid profile, and liver enzymes, and whether there is a relationship between sleep time and media time in Turkish obese children and adolescents. METHODS Subjects included 108 obese children and adolescents (aged 10-15 years) whose lifestyle factors were assessed using a survey containing questions about sleep durations, television viewing, media use, and demographic factors. Metabolic risk factors were compared among groups categorized according to sleep and media duration. RESULTS Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and triglyceride (TG) levels and homeostasis model assessment of insulin resistance (HOMA-IR) values were higher in subjects who spent >5 hours/day on media. Children 10-13 years old who slept <9 hours/day were more likely to have higher insulin and HOMA-IR (p < 0.05) levels and lower high-density lipoprotein cholesterol (HDL-C) levels compared with subjects who slept 9-10 hours/day and >10 hours/day. Correlation analysis revealed a negative relationship between sleep time and media time (r = -0.471, p = 0.000). CONCLUSIONS Short sleep duration was associated with IR and an elevated plasma lipoprotein profile in children and adolescents. Our results suggest that insufficient sleep and excessive media exposure may contribute to metabolic risk in the context of obesity, and therefore, working to improve sleep duration and limit media time could help reduce metabolic risk in obese children and adolescents.
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Affiliation(s)
- Fatma Kubra Sayin
- 1 Department of Nutrition and Dietetics, Faculty of Health Sciences, Necmettin Erbakan University , Konya, Turkey
| | - Muammer Buyukinan
- 2 Department of Paediatric Endocrinology, Konya Training and Research Hospital , Konya, Turkey
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25
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Shaw ND, McHill AW, Schiavon M, Kangarloo T, Mankowski PW, Cobelli C, Klerman EB, Hall JE. Effect of Slow Wave Sleep Disruption on Metabolic Parameters in Adolescents. Sleep 2016; 39:1591-9. [PMID: 27166229 DOI: 10.5665/sleep.6028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 03/28/2016] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Cross-sectional studies report a correlation between slow wave sleep (SWS) duration and insulin sensitivity (SI) in children and adults. Suppression of SWS causes insulin resistance in adults but effects in children are unknown. This study was designed to determine the effect of SWS fragmentation on SI in children. METHODS Fourteen pubertal children (11.3-14.1 y, body mass index 29(th) to 97(th) percentile) were randomized to sleep studies and mixed meal (MM) tolerance tests with and without SWS disruption. Beta-cell responsiveness (Φ) and SI were determined using oral minimal modeling. RESULTS During the disruption night, auditory stimuli (68.1 ± 10.7/night; mean ± standard error) decreased SWS by 40.0 ± 8.0%. SWS fragmentation did not affect fasting glucose (non-disrupted 76.9 ± 2.3 versus disrupted 80.6 ± 2.1 mg/dL), insulin (9.2 ± 1.6 versus 10.4 ± 2.0 μIU/mL), or C-peptide (1.9 ± 0.2 versus 1.9 ± 0.1 ng/mL) levels and did not impair SI (12.9 ± 2.3 versus 10.1 ± 1.6 10(-4) dL/kg/min per μIU/mL) or Φ (73.4 ± 7.8 versus 74.4 ± 8.4 10(-9) min(-1)) to a MM challenge. Only the subjects in the most insulin-sensitive tertile demonstrated a consistent decrease in SI after SWS disruption. CONCLUSION Pubertal children across a range of body mass indices may be resistant to the adverse metabolic effects of acute SWS disruption. Only those subjects with high SI (i.e., having the greatest "metabolic reserve") demonstrated a consistent decrease in SI. These results suggest that adolescents may have a unique ability to adapt to metabolic stressors, such as acute SWS disruption, to maintain euglycemia. Additional studies are necessary to confirm that this resiliency is maintained in settings of chronic SWS disruption.
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Affiliation(s)
- Natalie D Shaw
- Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.,Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC
| | - Andrew W McHill
- Division of Sleep and Circadian Disorders, The Brigham and Women's Hospital, Boston MA.,Division of Sleep Medicine, Harvard Medical School, Boston MA
| | - Michele Schiavon
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Tairmae Kangarloo
- Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Piotr W Mankowski
- Division of Sleep and Circadian Disorders, The Brigham and Women's Hospital, Boston MA.,Division of Sleep Medicine, Harvard Medical School, Boston MA
| | - Claudio Cobelli
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, The Brigham and Women's Hospital, Boston MA.,Division of Sleep Medicine, Harvard Medical School, Boston MA
| | - Janet E Hall
- Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.,Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC
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26
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Roane BM, Seifer R, Sharkey KM, Van Reen E, Bond TLY, Raffray T, Carskadon MA. What Role Does Sleep Play in Weight Gain in the First Semester of University? Behav Sleep Med 2016; 13:491-505. [PMID: 25115969 PMCID: PMC4892182 DOI: 10.1080/15402002.2014.940109] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We hypothesized that shorter sleep durations and greater variability in sleep patterns are associated with weight gain in the first semester of university. Students (N = 132) completed daily sleep diaries for 9 weeks, completed the MEQ (chronotype) and CES-D (depressed mood) at week 9, and self-reported weight/height (weeks 1 & 9). Mean and variability scores were calculated for sleep duration (TST, TSTv), bedtime (BT, BTv), and wake time (WT, WTv). An initial hierarchical regression evaluated (block 1) sex, ethnicity; (block 2) depressed mood, chronotype; (block 3) TST; (block 4) BT, WT; and (block 5; R(2) change = 0.09, p = 0.005) TSTv, BTv, WTv with weight change. A sex-by-TSTv interaction was found. A final model showed that ethnicity, TST, TSTv, and BTv accounted for 31% of the variance in weight change for males; TSTv was the most significant contributor (R(2) change = 0.21, p < 0.001). Daily variability in sleep duration contributes to males' weight gain. Further investigation needs to examine sex-specific outcomes for sleep and weight.
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Affiliation(s)
- Brandy M Roane
- a Department of Internal Medicine University of North Texas Health Science Center , Fort Worth.,b Department of Psychiatry and Human Behavior Alpert Medical School of Brown University.,c Sleep for Science Research Laboratory Brown University
| | - Ronald Seifer
- b Department of Psychiatry and Human Behavior Alpert Medical School of Brown University.,d E. P. Bradley Hospital , Providence
| | - Katherine M Sharkey
- c Sleep for Science Research Laboratory Brown University.,e Department of Medicine , Alpert Medical School of Brown University
| | - Eliza Van Reen
- b Department of Psychiatry and Human Behavior Alpert Medical School of Brown University.,c Sleep for Science Research Laboratory Brown University.,d E. P. Bradley Hospital , Providence
| | | | - Tifenn Raffray
- b Department of Psychiatry and Human Behavior Alpert Medical School of Brown University.,c Sleep for Science Research Laboratory Brown University.,f Psychiatry Department and Center for Investigation and Research in Sleep Lausanne University Hospital
| | - Mary A Carskadon
- b Department of Psychiatry and Human Behavior Alpert Medical School of Brown University.,c Sleep for Science Research Laboratory Brown University.,d E. P. Bradley Hospital , Providence.,g Centre for Sleep Research, Department of Psychology, Social Work, and Social Policy University of South Australia
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27
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Matthews KA, Pantesco EJM. Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review. Sleep Med 2015; 18:36-49. [PMID: 26459685 DOI: 10.1016/j.sleep.2015.06.004] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 04/23/2015] [Accepted: 06/01/2015] [Indexed: 01/10/2023]
Abstract
Cardiovascular risk factors develop in childhood and adolescence. This enumerative review addresses whether sleep characteristics, including sleep duration, continuity, quality, and daytime sleepiness, are associated with cardiovascular risk factors in young people. Thirty-nine studies were identified, which examined the following risk factors: metabolic syndrome, glucose and insulin, lipids, blood pressure, and cardiovascular responses to psychological stressors. Due to the availability of other reviews, 16 longitudinal studies of obesity published in 2011 and later were also included in this report. Excluded from the review were studies of participants with suspected or diagnosed sleep disorders and reports from sleep deprivation experiments. Combining studies, evidence was strongest for obesity, followed by glucose, insulin, blood pressure (especially ambulatory blood pressure), and parasympathetic responses to psychological stressors. There was little evidence for metabolic syndrome cluster, lipids, and blood pressure responses to psychological stressors. The more positive associations were obtained for studies that incorporated objective measures of sleep and that included adolescents. The foundational evidence is almost entirely cross-sectional, except for work on obesity. In summary, available evidence suggests that the associations between sleep characteristics and cardiovascular risk vary by risk factor. It is time to conduct studies to determine antecedent and consequent relationships, and to expand risk factors to include markers of inflammation.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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28
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Cespedes EM, Rifas-Shiman SL, Redline S, Gillman MW, Peña MM, Taveras EM. Longitudinal associations of sleep curtailment with metabolic risk in mid-childhood. Obesity (Silver Spring) 2014; 22:2586-92. [PMID: 25234485 PMCID: PMC4236242 DOI: 10.1002/oby.20894] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 08/18/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine associations of chronic insufficient sleep with mid-childhood cardiometabolic health. METHODS At 6 months and yearly from 1 to 7 years, mothers participating in the Project Viva cohort reported children's 24-h sleep duration. The main exposure was a sleep curtailment score, ranging from 0 (maximal curtailment) to 13 (never having curtailed sleep). The main outcome was a mid-childhood metabolic risk score, derived as the mean of five sex- and cohort-specific z scores for waist circumference, systolic blood pressure, HDL cholesterol (scaled inversely), and log-transformed triglycerides and HOMA-IR; higher scores indicate higher risk. RESULTS The mean (SD) sleep score was 10.0 (2.8); 5.1% scored 0-4, 13.9% scored 5-7, 14.1% scored 8-9, 28.7% scored 10-11, and 38.3% scored 12-13. Mean (SD, range) metabolic risk score was -0.03 (0.6, -1.8 to 2.6). In multivariable models, the metabolic risk score difference for children with most versus least curtailed sleep was 0.29 units (95% confidence interval [CI]: 0.02, 0.57). Further adjustment for mid-childhood BMI z score attenuated this difference to 0.08 units (95% CI: -0.14, 0.30). CONCLUSIONS Chronic insufficient sleep from infancy to school-age was associated with higher mid-childhood metabolic risk. This association was explained by sleep duration's influence on mid-childhood adiposity.
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Affiliation(s)
- Elizabeth M. Cespedes
- Department of Nutrition, Harvard School of Public Health, Boston, MA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Sheryl L. Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA
| | - Matthew W. Gillman
- Department of Nutrition, Harvard School of Public Health, Boston, MA
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Michelle-Marie Peña
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
- Harvard Medical School, Boston, MA
| | - Elsie M. Taveras
- Department of Nutrition, Harvard School of Public Health, Boston, MA
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
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29
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Fadzlina AA, Harun F, Nurul Haniza MY, Al Sadat N, Murray L, Cantwell MM, Su TT, Majid HA, Jalaludin MY. Metabolic syndrome among 13 year old adolescents: prevalence and risk factors. BMC Public Health 2014; 14 Suppl 3:S7. [PMID: 25437226 PMCID: PMC4251137 DOI: 10.1186/1471-2458-14-s3-s7] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Obesity and metabolic syndrome is prevalent among Malaysian adolescents and has been associated with certain behavioural factors such as duration of sleep, screen time and physical activity. The aim of the study is to report the prevalence of overweight/obesity, metabolic syndrome and its risk factors among adolescents. Methods A multi-staged cluster sampling method was used to select participants from urban and rural schools in Selangor, Perak and Wilayah Persekutuan Kuala Lumpur. Participants underwent anthropometric measurement and physical examination including blood pressure measurement. Blood samples were taken for fasting glucose and lipids and participants answered a self-administered questionnaire. Overweight and obesity was defined using the extrapolated adult body mass index (BMI) cut-offs of >25 kg/m2 and >30 kg/m2, according to the International Obesity Task Force (IOTF) criteria. Metabolic syndrome was defined based on International Diabetes Federation (IDF) 2007 criteria. Results Data were collected from 1361 participants. After excluding incomplete data and missing values for the variables, we analysed a sample of 1014 participants. Prevalence of overweight and obesity in this population was 25.4% (N = 258). The prevalence of metabolic syndrome was 2.6% in the population and 10% among the overweight and obese adolescents. Participants who slept between 7 and 9 hours a day has a lower risk of developing metabolic syndrome OR 0.38(0.15-0.94). Conclusion Our results provide the prevalence of metabolic syndrome in Malaysian adolescents. Adequate sleep between 7 and 9 hours per day reduces the risk of developing metabolic syndrome.
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30
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Hjorth MF, Chaput JP, Damsgaard CT, Dalskov SM, Andersen R, Astrup A, Michaelsen KF, Tetens I, Ritz C, Sjödin A. Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk profile: a longitudinal study in 8-11 year old Danish children. PLoS One 2014; 9:e104677. [PMID: 25102157 PMCID: PMC4125285 DOI: 10.1371/journal.pone.0104677] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 07/16/2014] [Indexed: 01/02/2023] Open
Abstract
Background As cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity, sedentary behavior and sleep) and cardio-metabolic risk in childhood may aid in preventing metabolic syndrome (MetS) in adulthood. Objective To examine independent and combined cross-sectional and longitudinal associations between movement behaviors and the MetS score in 8-11 year old Danish children. Design Physical activity, sedentary time and sleep duration (seven days and eight nights) were assessed by accelerometer and fat mass index (fat mass/height2) was assessed using Dual-energy X-ray absorptiometry. The MetS-score was based on z-scores of waist circumference, mean arterial blood pressure, homeostatic model assessment of insulin resistance, triglycerides and high density lipoprotein cholesterol. All measurements were taken at three time points separated by 100 days. Average of the three measurements was used as habitual behavior in the cross-sectional analysis and changes from first to third measurement was used in the longitudinal analysis. Results 723 children were included. In the cross-sectional analysis, physical activity was negatively associated with the MetS-score (P<0.03). In the longitudinal analysis, low physical activity and high sedentary time were associated with an increased MetS-score (all P<0.005); however, after mutual adjustments for movement behaviors, physical activity and sleep duration, but not sedentary time, were associated with the MetS-score (all P<0.03). Further adjusting for fat mass index while removing waist circumference from the MetS-score rendered the associations no longer statistically significant (all P>0.17). Children in the most favorable tertiles of changes in moderate-to-vigorous physical activity, sleep duration and sedentary time during the 200-day follow-up period had an improved MetS-score relative to children in the opposite tertiles (P = 0.005). Conclusion The present findings indicate that physical activity, sedentary time and sleep duration should all be targeted to improve cardio-metabolic risk markers in childhood; this is possibly mediated by adiposity.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Stine-Mathilde Dalskov
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Andersen
- National Food Institute, Division of Nutrition, Technical University of Denmark, Søborg, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Inge Tetens
- National Food Institute, Division of Nutrition, Technical University of Denmark, Søborg, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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31
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Iglayreger HB, Peterson MD, Liu D, Parker CA, Woolford SJ, Sallinen Gafka BJ, Hassan F, Gordon PM. Sleep duration predicts cardiometabolic risk in obese adolescents. J Pediatr 2014; 164:1085-1090.e1. [PMID: 24612904 PMCID: PMC4121116 DOI: 10.1016/j.jpeds.2014.01.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/08/2013] [Accepted: 01/16/2014] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine the independent contributions of objectively measured sleep duration and fragmentation on cardiometabolic risk accumulation in free-living obese adolescents. STUDY DESIGN Characteristics of metabolic syndrome (waist circumference, mean arterial pressure, fasting high-density lipoprotein cholesterol, triglycerides, glucose) were measured in obese adolescents and standardized residuals (z-scores) were summed (inverse high-density lipoprotein cholesterol) to create a continuous cardiometabolic risk score (cMetScore), adjusted for age, sex, and race. Sleep and physical activity were objectively measured in habitual, free-living conditions for 7 days (SenseWear Pro3, BodyMedia, Pittsburgh, Pennsylvania; n = 37; 54% female, ages 11-17 years). Associations between sleep duration and cMetScore were assessed via multiple linear regression. RESULTS Body mass index, total sleep time, and sleep session length were each correlated with cMetScore (P < .05 all). Total sleep time was inversely and independently associated with cMetScore (r = -0.535, P = .001) and was the best independent predictor of metabolic risk. CONCLUSIONS Sleep duration inversely predicts cardiometabolic risk in obese adolescents, even when we controlled for various measures of physical activity, anthropometry, and adiposity. Further research should investigate the biological mechanism of this relationship and the potential treatment effect of sleep intervention in decreasing cardiometabolic risk in this population.
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Affiliation(s)
- Heidi B Iglayreger
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Mark D Peterson
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Dongmei Liu
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Christine A Parker
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Susan J Woolford
- Child Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Bethany J Sallinen Gafka
- Division of Child Behavioral Health, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Fauziya Hassan
- Division of Pediatric Pulmonology, University of Michigan, Ann Arbor, MI; Michael S. Aldrich Sleep Disorders Center, University of Michigan, Ann Arbor, MI
| | - Paul M Gordon
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI; Department of Health, Human Performance and Recreation, Baylor University, Waco, TX.
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32
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Lee JA, Park HS. Relation between sleep duration, overweight, and metabolic syndrome in Korean adolescents. Nutr Metab Cardiovasc Dis 2014; 24:65-71. [PMID: 24188647 DOI: 10.1016/j.numecd.2013.06.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 06/11/2013] [Accepted: 06/11/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS The increasing prevalence of obesity has been paralleled by a trend of reduced sleep duration. Sleep is considered a modulator of neuroendocrine function. The aim of this study was to determine the relation between sleep duration, overweight, and metabolic syndrome in Korean adolescents. METHODS AND RESULTS This study was based on data from the Korean National Health and Nutrition Examination Survey (KNHANES) IV. Data from 1187 adolescents aged 12-18 years were included in the analysis. Subjects were classified according to self-reported sleep duration: ≤ 5 h, 6-7 h, 8-9 h, and ≥ 10 h. We analysed the association between sleep duration, overweight, and metabolic syndrome after adjustment for potential confounding variables. Body mass index (BMI), waist circumference (WC), and diastolic blood pressure (DBP) were higher in subjects who slept ≤ 5 h, and triglyceride level was higher in subjects who slept ≥ 10 h. According to logistic regression analysis, subjects who slept ≤ 5 h had a higher risk of overweight (odds ratio (OR) 2.04, 95% confidence interval (CI) 1.17-3.57) and elevated blood pressure (BP) (OR 2.11, 95% CI 1.22-3.65). We did not find any association between sleep duration and metabolic syndrome. Subjects who slept ≥ 10 h had a higher risk of hypertriglyceridemia (OR 2.17, 95% CI 1.14-4.13). CONCLUSION Short sleep duration was associated with overweight in adolescents. Although there was no association between sleep duration and metabolic syndrome, short sleep duration was associated with elevated BP and long sleep duration was associated with hypertriglyceridemia.
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Affiliation(s)
- J A Lee
- Department of Family Medicine, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - H S Park
- Department of Family Medicine, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul 138-736, Republic of Korea.
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Azadbakht L, Kelishadi R, Khodarahmi M, Qorbani M, Heshmat R, Motlagh ME, Taslimi M, Ardalan G. The association of sleep duration and cardiometabolic risk factors in a national sample of children and adolescents: The CASPIAN III Study. Nutrition 2013; 29:1133-41. [DOI: 10.1016/j.nut.2013.03.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 02/18/2013] [Accepted: 03/05/2013] [Indexed: 12/21/2022]
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Sleep Duration, Physical Activity, and Metabolic Syndrome for Adolescents. Ann Behav Med 2013; 46:401-2. [DOI: 10.1007/s12160-013-9531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Xi B, He D, Zhang M, Xue J, Zhou D. Short sleep duration predicts risk of metabolic syndrome: a systematic review and meta-analysis. Sleep Med Rev 2013; 18:293-7. [PMID: 23890470 DOI: 10.1016/j.smrv.2013.06.001] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 06/13/2013] [Accepted: 06/17/2013] [Indexed: 11/26/2022]
Abstract
Sleep duration has been suggested to play a key role in the development of metabolic syndrome (MS). However, the results have been inconsistent. The objective of this study was to clarify the association between sleep duration and MS risk. PubMed and Embase databases were searched for eligible publications. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using random- or fixed-model. A total of 12 studies (18,720 MS cases and 70,833 controls) were included in the meta-analysis. Short sleep duration was significantly associated with increased risk of MS (OR = 1.27, 95%CI = 1.09-1.47, p = 0.002). Long sleep duration was not associated with increased risk of MS (OR = 1.07, 95%CI = 0.87-1.32, p = 0.535). Similar results were found in both men and women. The sensitivity analysis confirmed the stability of the results and no publication bias was detected. The present meta-analysis suggests that short rather than long sleep duration is significantly associated with risk of MS. Large-scale well-design prospective studies are required to further investigate the association between sleep duration and MS risk.
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Affiliation(s)
- Bo Xi
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, People's Republic of China.
| | - Dan He
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, People's Republic of China
| | - Min Zhang
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, People's Republic of China
| | - Jian Xue
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, People's Republic of China
| | - Donghao Zhou
- Department of Endocrinology, Linyi People's Hospital, Linyi, People's Republic of China
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Kawada T. Sleep duration, obesity, and insulin resistance for children. Eur J Pediatr 2013; 172:571. [PMID: 23263166 DOI: 10.1007/s00431-012-1916-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 12/05/2012] [Accepted: 12/07/2012] [Indexed: 10/27/2022]
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Matthews KA, Dahl RE, Owens JF, Lee L, Hall M. Sleep duration and insulin resistance in healthy black and white adolescents. Sleep 2012; 35:1353-8. [PMID: 23024433 PMCID: PMC3443761 DOI: 10.5665/sleep.2112] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Poor sleep may play a role in insulin resistance and diabetes risk. Yet few studies of sleep and insulin resistance have focused on the important developmental period of adolescence. To address this gap, we examined the association of sleep and insulin resistance in healthy adolescents. DESIGN Cross-sectional. SETTING Community setting in one high school. PARTICIPANTS 245 (137 African Americans, 116 males) high school students. MEASUREMENTS AND RESULTS Participants provided a fasting blood draw and kept a sleep log and wore a wrist actigraph for one week during the school year. Participants' families were from low to middle class based on family Hollingshead scores. Total sleep time across the week averaged 7.4 h by diary and 6.4 h by actigraph; homeostatic model assessment of insulin resistance ([HOMA-IR] unadjusted) averaged 4.13. Linear regression analyses adjusted for age, race, gender, body mass index, and waist circumference showed that the shorter the sleep, the higher the HOMA-IR, primarily due to sleep duration during the week. No evidence was found for long sleep being associated with elevated HOMA-IR. Fragmented sleep was not associated with HOMA-IR but was associated with glucose levels. CONCLUSIONS Reduced sleep duration is associated with HOMA-IR in adolescence. Long sleep duration is not associated. Interventions to extend sleep duration may reduce diabetes risk in youth.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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Abstract
PURPOSE OF REVIEW Sleep disorders in children and adolescents often present with various medical comorbidities. The aim of this review is to present the recent literature findings on this issue. RECENT FINDINGS The major medical comorbid conditions that accompany insomnia or short sleep duration in children and adolescents are obesity and metabolic syndrome, growth hormone deficiency, allergic conditions, various disorders accompanied by chronic pain, neoplasms and blood malignancies, and genetic and congenital disorders. Hypersomnia is mainly related to malignancies. Children and adolescents with obstructive sleep apnoea syndrome or sleep-disordered breathing may suffer from obesity and metabolic syndrome, polycystic ovaries, hypothyroidism, asthma, epilepsy, various ear nose throat disorders, congenital malformations or genetic conditions. Parasomnias may be comorbid with some medical conditions, but the main challenge in their evaluation is the differential diagnosis from nocturnal epileptic seizures. SUMMARY The co-occurrence of sleep disorders and medical conditions in childhood and adolescence is quite frequent and has an impact on general health and quality of life.
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Abstract
Fine-tuning and integration between social rhythms and biological rhythms should be a priority for all, especially for children. As such, the opportunity to sleep should fit the evolving needs for sleep in a child. Unfortunately, children today are highly unlikely to obtain sufficient sleep or live under stable and regular schedules. Poor or dysregulated sleep affects the regulation of homeostatic and hormonal systems underlying somatic and intellectual growth, maturation, and bioenergetics. Therefore, in the prevention and management of childhood obesity, assessments of the “obesogenic” lifestyle, such as dietary and physical activity patterns, need to be coupled with accurate evaluation of the quality and quantity of sleep and with the potential co-existence of sleep-disordered breathing or other sleep disorders. Incorporation of sleep as an integral component of many childhood research studies on obesity should be done a priori rather than as an afterthought. Although parents and health professionals have meticulously delineated,observed, and quantified normal patterns of activities such as eating or playing, the absence of reliable sleep health data in children is all the more puzzling considering that young children engage in sleeping activities more than in any other activity during the 24-hour cycle. Therefore, the most forgotten, overlooked, or even actively ignored behavior of this century is undoubtedly childhood sleep. Trends aiming to reduce sleep in children have emerged, and regrettably continue to gain momentum. In parallel with such undesirable consequences, leading to the blatant disregard of sleep as a vital function rather than a commodity, a reciprocal increase in obesity rates has emerged. The mechanistic links between sleep and metabolism are now emerging, and should prompt incorporation of measures aiming to align sleep with any other antiobesity campaign. To paraphrase a well-known dictum “Somni sano in corpore sano” (healthy sleep in healthy bodies).
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Affiliation(s)
- Karen Spruyt
- Department of Pediatrics and Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL
| | - David Gozal
- Department of Pediatrics and Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL
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