| Title: | Combined sleep behaviors, mediating biomarkers, and incident vascular complications among individuals with type 2 diabetes: A prospective study in UK Biobank |
| Journal: | Journal of Diabetes Investigation |
| Published: | 22 Jul 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42484390/ |
| DOI: | https://doi.org/10.1111/jdi.70396 |
Publication 21482
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Abstract
AIMS: To prospectively examine how combined sleep behaviors affect vascular complications in type 2 diabetes, whether these associations are modified by disease severity, as well as the mediating roles of clinical biomarkers.</p>
METHODS: A total of 12,456 participants with type 2 diabetes from the UK Biobank were included. A sleep score was defined by: sleep duration, chronotype, insomnia, snoring, and daytime sleepiness. Cox regression models were used to examine the association between healthy sleep score and risk of vascular complications.</p>
RESULTS: Over 13.5 years, 1,878 macrovascular and 3,066 microvascular complications occurred. Compared with a healthy sleep score of 0-1, the multivariable-adjusted HRs (95% CIs) of the score 4-5 were 0.75 (0.63, 0.89) for macrovascular complications [coronary artery disease 0.72 (0.57, 0.91), stroke 0.92 (0.66, 1.28), peripheral artery disease 0.79 (0.56, 1.10)]; 0.86 (0.75, 0.99) for microvascular complications [neuropathy 0.62 (0.47, 0.83), nephropathy 1.01 (0.84, 1.21), retinopathy 0.84 (0.68, 1.03)]. The aggregated diabetes severity score (Pinteraction = 0.037) significantly modified the association with microvascular complications. Total cholesterol, LDL-C, triglycerides, apolipoprotein B, and CRP collectively explained 11.34% (4.24%, 37.70%) of macrovascular associations [including 11.14% (2.85%, 43.03%) for coronary artery disease], while total bilirubin explained 3.57% (0.43%, 20.63%) of microvascular associations, collectively with triglycerides, GGT, and CRP mediating 9.33% (3.95%, 27.58%) for diabetic neuropathy.</p>
CONCLUSIONS: A healthy sleep pattern is associated with lower risks of vascular complications in type 2 diabetes, independent of traditional risk factors, and the association with microvascular complications is modified by diabetes severity. Lipid profiles and inflammatory factors partly mediate the favorable association.</p>
19 Authors
- Yanqiu Zou
- Xia Jiang
- Jinyu Zhou
- Tao Han
- Sirui Zheng
- Mingshuang Tang
- Yutong Wang
- Lin Chen
- Lingli Qiu
- Xuan Wu
- Zhixin Tan
- Yunjie Liu
- Bowen Lei
- Xiaofeng Ma
- Di Zhang
- Jiaqiang Liao
- Jiayuan Li
- Ben Zhang
- Mengyu Fan
1 Application
| Application ID | Title |
|---|---|
| 99713 | Using genetic and phenotypic data to understand putative causal pathways leading to major human noncommunicable diseases. |
Enabling scientific discoveries that improve human health