Associations Between Sleep And Smoking And Metabolic Diseases In Chinese Community Population

BackgroundThe relationship between non-alcoholic fatty liver disease(NAFLD)and type 2 diabetes mellitus(T2DM)is bidirectional.These two metabolic diseases have become an emerging epidemic in recent decades,which impose great burden on the public health to our society.Furthermore,more than half of the patients with diabetes have poor glycemic control.Lifestyle factors are closely related to metabolic diseases,and the findings are inconsistent.Study design and methods 1.This study was performed on community-based population aged ?40 years in Shanghai.Sleep habits were self-reported using a standardized questionnaire;NAFLD was diagnosed by ultrasonography.The baseline non-NAFLD population was followed up 4 years later,a total of 8559 participants were included in the baseline cross-sectional analysis and a total of 3557 participants were included in the prospective analysis.Multiple logistic regression models were used to investigate the association between sleep habits and NAFLD after adjusting for potential confounders.2.Based on the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal(REACTION)study,we investigated the relationship between smoking and glycemic control in 10 551 men and 15 297 women with diabetes.Poor glycemic control was defined as HbA1 c ?7.0%.Three years later,the baseline non-diabetic population was followed up,we then evaluated the relationship between smoking and incident diabetes by multiple logistic regression models among 57722 participants.Results 1.The overall prevalence of NAFLD was 30.4%.Cross-sectional study found that nightly sleep duration was negatively correlated with the risk of prevalent NAFLD,while daytime nap duration was positively correlated with the risk of prevalent NAFLD.In prospective analysis,the risk of incident NAFLD increased by 10% for per 1 hour of sleep reduction.The risk of incident NAFLD across decreasing sleep duration categories(8.1-9,7.1-8,6.1-7,and ?6 h)were increased by 56%,83%,121% and 59%,respectively(P for trend=0.0005),compared with participants with >9 h sleep per night.No statistical significant association was found between daytime nap and the risk of incident NAFLD.2.Among patients with diabetes,56.1% had poor glycemic control.Current smokers have an increased risk of poor glycemic control.Further analysis demonstrated a dose-dependent relationship between current smoking and the risk of poor glycemic control in men.Former smokers who quit smoking for <10 years remained at increased risk of poor glycemic control,with the risk leveling off after 10 years of smoking cessation compared with nonsmokers.After controlling for possible confounders,current smokers had a higher risk of incident diabetes compared with the never-smokers.No statistical significant association was observed between former smokers and the risk of incident diabetes.ConclusionNightly sleep duration was negatively associated with the risk of incident NAFLD in Chinese middle-aged and elderly population.Active smoking was a modifiable risk factor for poor glycemic control in diabetic patients,and incident diabetes in Chinese middle-aged and elderly population.A healthy lifestyle should be encouraged as an effective measure for the prevention of metabolic diseases.