The association between rest–activity parameters and hemoglobin A1c in patients with prediabetes

ABSTRACT

Circadian abnormalities can adversely affect glucose metabolism. This study determined whether behavioral circadian parameters, as assessed by rest–activity rhythm, were predictors of glycemic control in patients with prediabetes. Seventy-nine patients with prediabetes participated. Nonparametric rest–activity rhythm parameters, sleep duration and efficiency were obtained from 7-d actigraphy recordings. Sleep-disordered breathing severity was assessed using a home sleep apnea test. Hemoglobin A1c (HbA1c) was obtained to evaluate glycemic control. The results revealed that shorter sleep duration, lower relative amplitude and higher L5 (average activity of the least active 5-h period) were associated with higher HbA1c, while other sleep variables were not related to HbA1c. Multiple stepwise regression analysis adjusting for age, sex, body mass index and sleep duration revealed that lower relative amplitude, but not L5, was independently associated with higher HbA1c (B = −0.027, p = 0.031). In summary, among patients with prediabetes, an abnormal circadian rhythm was associated with higher HbA1c, implying a greater risk of developing diabetes. These results support the role of circadian rhythmicity in glucose control among those with prediabetes.

KEYWORDS:

• Rest–activity parameters
• prediabetes
• relative amplitude
• sleep
• hemoglobin A1c
• glycemic control

Author contributorship

J.P. and B.S.G. analyzed data and reviewed/edited the manuscript. T.A. collected data and reviewed/edited the manuscript. N.C. reviewed/edited the manuscript. S.S. collected data and reviewed/edited the manuscript. S.R. conceptualized the study, collected data and reviewed/edited the manuscript.

Disclosure statement

S.R. received speaker fee from Eli Lilly, and supported by grant from the National Institute of Health (R01EY029782). All other authors disclose no conflict of interest.

Data availability statement

Data are available upon reasonable request to the corresponding author.

Additional information

Funding

This work was partly supported by the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (grant number CF_64009), and by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp, MSIP 0000-349. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp.