ArticleJournal of diabetes investigation2026
Combined sleep behaviors, mediating biomarkers, and incident vascular complications among individuals with type 2 diabetes: A prospective study in UK Biobank.
Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsTo 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.
methodsA 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.
resultsOver 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 (P
conclusionsA 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.
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