Sleep stability, weight, and glycemic control

睡眠稳定性、体重和血糖控制

• 批准号: 10363984
• 负责人: BLANDINE B LAFERRERE
• 金额: $ 32.4万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10363984
• 关键词: Address; Adipose tissue; Adult; Adverse effects; Affect; Age; Area Under Curve; Behavior; Behavior Therapy; Blood Pressure; Body Composition; Cause of Death; Chronic Disease; Clinical; Clinical Trials; Complications of Diabetes Mellitus; Conduct Clinical Trials; Data; Diabetes Mellitus; Diabetes prevention; Diagnosis; Diet; Disease; Drug or chemical Tissue Distribution; Fasting; Fatty acid glycerol esters; Fructosamine; Funding Opportunities; Glucose; Glycosylated hemoglobin A; Goals; Health; Heart; Individual; Insulin Resistance; Intervention; Intervention Studies; Lead; Life Style; Liver; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Maintenance; Measures; Mediating; Metabolic syndrome; Mission; Modeling; Monitor; Multi-Ethnic Study of Atherosclerosis; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; OGTT; Obesity; Participant; Patients; Physical activity; Plasma; Postmenopause; Prediabetes syndrome; Prevention; Public Health; Randomized; Recommendation; Research; Risk; Risk Factors; Sampling; Schedule; Sleep; Sleep Deprivation; System; Testing; Time; Treatment Efficacy; Visceral; Weight maintenance regimen; Woman; Wrist; actigraphy; base; blood glucose regulation; clinical practice; design; diabetes management; diet and exercise; disorder risk; fasting glucose; glucose monitor; glucose tolerance; glycemic control; improved; indexing; innovation; insulin sensitivity; men; modifiable behavior; novel; poor sleep; primary outcome; public health relevance; recruit; research study; secondary outcome; sleep behavior; sleep health; sleep pattern; sleep quality; subcutaneous

Lifestyle changes are at the heart of diabetes prevention and management. In addition to diet and physical activity, sleep has emerged as an important behavior associated with glucose control. Recent studies further show that timing of these behaviors may be as important as their quality and quantity. For example, timing of sleep, independent of sleep duration, has been associated with obesity and metabolic syndrome, particularly glucose concentrations. In support of our study goals, we have shown that reducing variability in bedtimes improves body composition, measured by magnetic resonance imaging, compared to maintaining or increasing bedtime variability in women. While prior sleep research has focused on elucidating adverse health effects of too little sleep or poor sleep quality, we propose an innovative project in which we will test whether improvements in sleep behaviors, namely bedtime stability, ameliorates glycemia. Our main goal is to conduct a pilot clinical intervention study that will test whether reducing bedtime variability improves weight and glycemic control in patients with pre-diabetes. We will recruit men and post-menopausal women, age ³50 y, who have variable bedtimes (VS; standard deviation of bedtimes, measured over 14 d, >60 min). Participants will be randomized to maintain their habitual sleep patterns (VS) or reduce bedtime variability by following a fixed sleep schedule (FS) for 12 wk. Sleep will be monitored nightly using wrist actigraphy. In Aim 1, body adipose tissue distribution will be measured by magnetic resonance imaging (primary outcomes=total, subcutaneous, and visceral adipose tissue) and magnetic resonance spectroscopy (secondary outcome=liver fat). In Aim 2, we will assess glucose tolerance and insulin sensitivity via an oral glucose tolerance test (OGTT) at baseline and endpoint (primary outcome=glucose area under the curve; secondary outcomes=disposition index). Fasting plasma samples at baseline and endpoint will determine long-term glycemia (secondary outcomes=fructosamine and hemoglobin A1c). Finally, in Aim 3, we will assess variability in glucose concentrations, an independent risk factor for diabetes complications, using continuous glucose monitoring system for 14 d prior to study onset and in the last 2 wk of the intervention (primary outcomes=mean amplitude of glycemic excursion and standard deviation of mean glucose; secondary outcome=24-h average glucose concentrations). Diet and physical activity measures will be obtained throughout the intervention. This project has the potential to lead to larger-scale research study to provide more definitive information on the impact of maintaining stable bedtimes as a means to improve the health of adults at risk of type 2 diabetes and improve glycemic control in those living with this disease. This proposal addresses a highly novel and important research question and the

生活方式的改变是预防糖尿病和管理的核心。除了饮食和身体 活性，睡眠已成为与葡萄糖控制相关的重要行为。最近的研究进一步 表明这些行为的时机可能与它们的质量和数量一样重要。例如，时间安排 睡眠，独立于睡眠时间，与肥胖和代谢综合征有关，尤其是 葡萄糖浓度。为了支持我们的学习目标，我们已经表明，降低了床位的变化 通过磁共振成像来改善人体成分，与维持或增加 女性就寝时间变异性。虽然先前的睡眠研究重点是阐明 睡眠太少或睡眠质量差，我们提出了一个创新的项目，我们将测试是否有改进 在睡眠行为中，即就寝时间稳定，可以改善血糖。我们的主要目标是进行飞行员临床 干预研究将测试降低就寝时间的可变性是否可以改善体重和血糖控制 糖尿病前的患者。我们将招募有变量的男性和绝经后妇女，年龄铭 床点时间（VS；床位的标准偏差，在14 d，> 60分钟内测量）。参与者将是随机的 通过遵循固定的睡眠时间表来维持其习惯睡眠方式（VS）或减少就寝时间的变化 （FS）12周。睡眠将使用手腕行为摄影每晚监控。在AIM 1中，身体脂肪组织分布 将通过磁共振成像（主要结果=总和，皮下和内脏脂肪来测量 组织）和磁共振光谱（次要结果=肝脏脂肪）。在AIM 2中，我们将评估葡萄糖 通过基线和终点的口服葡萄糖耐量测试（OGTT）的耐受性和胰岛素敏感性（主要 结果=曲线下的葡萄糖面积；次要结果=倾斜索引）。禁食等离子体样品 基线和终点将确定长期血糖（次要结果=果糖和血红蛋白 A1C）。最后，在AIM 3中，我们将评估葡萄糖浓度的可变性，这是一个独立的风险因素 糖尿病并发症，在研究开始之前使用连续的葡萄糖监测系统14 d 2 WK的干预措施（主要结果=血糖偏移的平均放大器和标准偏差 平均葡萄糖；次要结果= 24小时平均葡萄糖浓度）。饮食和体育锻炼措施 将在整个干预过程中获得。该项目有可能导致大规模研究 提供有关维持稳定床位的影响的更明确的信息，以改善 患有2型糖尿病风险的成年人的健康，并改善患有这种疾病患者的血糖控制。这 提案解决了一个高度新颖而重要的研究问题，