The impact of sleep status on lipid profiles and incident type 2 diabetes mellitus: a mediation analysis in a Chinese population cohort.

AIMS: This study aimed to examine the association between sleep status and T2DM incidence, and explore the potential mediating role of lipid profiles.

METHODS

A cohort study of 69,116 participants aged 20-74 in Shanghai (2016-2019) tracked new T2DM cases until 2024. Sleep status was assessed using the Pittsburgh Sleep Quality Index (PSQI). Cox and logistic regression models evaluated the associations between sleep, lipid profiles, and T2DM. Mediation analysis was conducted to explore the effects of lipid profiles, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), dyslipidemia, and the Chinese Visceral Adiposity Index (CVAI).

RESULTS

Among 49,734 eligible participants, 4,126 new T2DM cases were diagnosed. Poor overall sleep quality (HR: 1.087, 95 % CI: 1.016, 1.162), subjective sleep quality (HR: 1.097, 95 % CI: 1.007, 1.194), and sleep disturbances (HR: 1.118, 95 % CI: 1.038, 1.204) were associated with a higher risk of T2DM. Mediation analysis revealed that dyslipidemia, TC, and CVAI played a major mediating role in the association between sleep disorders and T2DM.

CONCLUSIONS

Sleep disorders are linked to a higher T2DM risk, with lipid profiles mediating the relationship. Managing lipid metabolism and assessing T2DM risk in those with sleep disorders is key for prevention.