Associations of BMI, sleep quality, and sleep duration trajectories with new-onset diabetes mellitus in the elderly

Abstract

Objective: Our objective was to investigate the relationships between BMI, sleep quality, and sleep duration trajectories and new-onset diabetes mellitus (NODM) in the elderly. Methods: We analyzed 2648 diabetes-free participants aged ≥60 years from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2014. Using Cox proportional hazards models, we examined the associations of BMI, self-reported sleep quality, and sleep duration trajectories (categorized as persistent short, persistent normal, persistent long, low-increasing, normal-decreasing, normal-increasing, and long-decreasing) with NODM risk over 4 years. Diabetes diagnosis was self-reported. Results: Over 4 years, 94 participants developed NODM. Obesity was associated with the highest risk (adjusted hazard ratio [HR] 2.247 [CI: 1.212–4.168]). Compared with individuals with good sleep quality, those with poor sleep quality showed an increased risk of NODM, but this association was not statistically significant (HR 1.570 [0.903–2.731]). Additionally, persistent short, normal-decreasing, and long-decreasing sleep trajectories were associated with elevated NODM risk (adjusted HR values 11.662 [CI: 1.565–86.896], 8.403 [CI: 1.023–69.010], and 9.474 [CI: 1.269–70.700]). Conclusions: BMI, sleep quality, and sleep duration trajectories are associated with NODM risk. Individuals with higher BMI values, poor sleep quality, or persistent short or decreasing sleep duration may be at higher risk for NODM, warranting further attention.