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【medical-news】非裔美国人糖尿病患者的血糖控制
Insufficient Sleep Associated With Poorer Blood Glucose Control In Diabetic African Americans
非裔美国人糖尿病患者的血糖控制不佳与睡眠不充足有关
Getting fewer hours of sleep or lower-quality sleep may be associated with poorer blood glucose control among African-Americans with diabetes, according to an article in the September 18 issue of Archives of Internal Medicine, a Theme issue on sleep.
据《内科学档案》9月18日睡眠主题刊上的一篇文章报道，非裔美国人糖尿病患者的血糖控制不佳与睡眠时间短和睡眠质量差相关。
Many individuals in modern society experience a chronic lack of adequate sleep, either because they voluntarily stay up late or because they have difficulty sleeping, according to background information in the article. Accumulating evidence suggests that restricting sleep may affect the ability of the body to process sugar (glucose) into energy, thereby increasing risk for the development of diabetes. Additional studies indicate that the reverse may be true, and that type 2 diabetes--which occurs when the body loses the ability to respond to the insulin that converts glucose into energy--may contribute to sleep problems.
据论文的背景知识介绍，现代社会许多人都经历着长期的睡眠不足，不是因为他们自己需要熬夜就是因为他们患有睡眠障碍。累积的证据显示睡眠受限可能影响机体将糖（葡萄糖）转化成能量的能力，从而增加了发展成糖尿病的风险。另外的研究却显示恰好相反，即当机体接受胰岛素刺激后将葡萄糖转化为能量的能力丧失时发生的2型糖尿病可能导致睡眠问题。
Kristen L. Knutson, Ph.D., of the University of Chicago, and colleagues conducted a study of 161 African-Americans with type 2 diabetes, including 42 men and 119 women who had an average age of 57.3. During a 30- to 45-minute interview, participants answered questions about sleep quality and quantity, their diabetes and any complications, and whether or not they took insulin. Their waist-hip ratio was measured, and the patients reported their height and weight, from which body mass index (BMI) was calculated. Each individual was given a sleep quality score that ranged from zero to 21, with scores of greater than five indicating poor sleep quality. In addition, the researchers calculated a perceived sleep debt for each individual, described as the difference between the number of hours of sleep participants said they got on a typical weekday and the amount of sleep they said they wanted to get. Hemoglobin A1c (HbA1c) levels, which measure the control of blood glucose over time, were obtained from patients' medical charts. A level of 7 percent or lower is the recommended optimal level for HbA1c.
芝加哥大学的Kristen L. Knutson博士和他的同事做了一个实验，选用161名非裔美国人2型糖尿病患者，包括42名男性和119名女性，平均年龄为57.3岁。在30－45分钟的会诊期间，参与者回答了他们的睡眠质量和数量的问题，他们的糖尿病病情即一切并发症，以及他们是否注射胰岛素。测量了他们的腰臀围比值，体重指数用他们提供的身高与体重计算出。给定每人一个睡眠质量从0到21的评分，评分在5以上表明睡眠质量差。研究人员为每个人计算了可被感知的睡眠负债来描述参与者在典型工作日的睡眠时间与他们想要的睡眠时间之间的差异。用来衡量过去血糖控制情况的糖化血红蛋白(HbA1c)水平从病人的医疗图表中获取。糖化血红蛋白等于或低于7％被推荐为最佳水平。
The individuals in the study reported that they slept an average of six hours per night--22 percent averaged at least seven hours and only 6 percent at least eight hours. About 71 percent had sleep quality ratings of greater than five, indicating poor sleep quality. The average HbA1c level was 8.3 percent; 26 percent had a level below the recommended 7 percent.
实验受试者说他们每晚平均睡眠6小时，22％受试者平均至少睡眠7小时，仅6％的受试者睡眠时间最少8小时。大约71％的人睡眠质量评分在5以上，表明睡眠质量差。平均血红蛋白水平在8.3％，26％的受试者在推荐水平即7%以下。
Thirty-nine patients reported that their sleep was frequently disrupted by pain; these individuals were excluded from further analyses. Among the remaining 35 men and 87 women, 67 percent had poor sleep quality. Higher HbA1c levels were associated with lower sleep quality, less sleep and a larger perceived sleep debt, even after researchers controlled for sex, age, BMI, complications and use of insulin. Participants were then classified based on whether or not they had complications from diabetes and whether or not they used insulin. "In patients without complications, perceived sleep debt but not subjective sleep quality was associated with lnHbA1c levels," authors write. "In contrast, in patients with at least one complication, [sleep quality] score, but not perceived sleep debt, was a significant predictor after controlling for covariates."
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作者:admin@医学,生命科学 2010-12-25 17:11
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