Sleep disturbance linked to CVD, mortality risk in people with type 2 diabetes
medwireNews: Sleep disturbance is associated with a significantly increased risk for cardiovascular disease (CVD) and all-cause mortality among people with new-onset type 2 diabetes, South Korean researchers report.
Young Choi (Catholic University of Pusan, Busan) and Jae Woo Choi (Yonsei University, Incheon) used the Korean National Health Insurance Service–Health Screening Cohort to investigate the outcomes of 36,058 people aged at least 40 years with type 2 diabetes diagnosed between 2004 and 2007. In all, 2.4% of the cohort had sleep disturbance according to ICD-10 codes.
The researchers report in Cardiovascular Diabetology that 203 CVD events (coronary heart disease or stroke) occurred among the 870 individuals with sleep disturbance over an average follow-up of 7 years, compared with 6694 events among the 35,188 people without sleep disturbance.
These results translated into incidence rates of 400.0 versus 269.9 per 10,000 person–years and a significant 24% increased risk for CVD among people with sleep disturbance.
When analyzing the CVD events separately, the risk for coronary heart disease was a significant 24% higher among people with versus without sleep disturbance. Rates of stroke were numerically higher in the sleep disturbance group but the difference did not reach statistical significance.
The study authors also found that people with sleep disturbance had a significant 47% higher mortality risk than those without after adjustment for confounders, at incidence rates of 240.4 versus 111.6 per 10,000 person–years.
Discussing the potential mechanisms behind these associations, Choi and Choi suggest: “Sleep disturbance could activate the autonomic nervous system and promote the secretion of catecholamine, which is a well-known risk factor for CVD,” as well as activating pro-inflammatory cell signaling cascades leading to endothelial dysfunction, which “considerably influences CVD incidence.”
They conclude that their findings point to “the need for a more scrupulous investigation and appropriate management of sleep disturbance in the patients with type 2 diabetes to [help] prevent the incidence of CVD events and premature mortality.”
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