Sleep Quality and Its Determinants Among Type 2 Diabetes Patients with Comorbid Metabolic Syndrome

Figures & data

Table 1 Distribution of Participants’ General Characteristics According to Sleep Quality

Variable	Total	Good Sleep Quality (PSQI≤5)	Poor Sleep Quality (PSQI>5)	T/χ^2	P
Gender				0.65	0.422
Male	168 (59.80)	72 (42.90)	96 (57.10)
Female	113 (40.20)	43 (38.10)	70 (61.90)
Age	49.91±11.85	45.49±11.63	52.98±11.01	−5.48	<0.001
Marriage				3.27	0.195
Unmarried	16 (5.70)	10 (62.50)	6 (37.50)
Married with a spouse	255 (90.70)	101 (39.60)	154 (60.40)
Divorced or widowed	10 (3.60)	4 (40.00)	6 (60.00)
Education				14.13	0.001
Junior high school and below	116 (41.30)	33 (28.40)	83 (71.60)
High school or junior college	92 (32.70)	42 (45.70)	50 (54.30)
College and above	73 (26.00)	40 (54.80)	33 (45.20)
Monthly income (RMB)				6.20	0.045
<5000	97 (34.50)	30 (30.90)	67 (69.10)
5000–10,000	95 (33.80)	43 (45.30)	52 (54.70)
>10,000	89 (31.70)	42 (47.20)	47 (52.80)
Smoke				1.80	0.180
No	212 (75.40)	82 (38.70)	130 (61.30)
Yes	69 (24.60)	33 (47.80)	36 (52.20)
Drink				0.01	0.938
No	184 (65.50)	75 (40.80)	109 (59.20)
Yes	97 (34.50)	40 (41.20)	57 (58.80)
Treatment				10.38	0.006
Oral medicine	90 (32.00)	28 (31.10)	62 (68.90)
Oral medicine and insulin	35 (12.50)	10 (28.60)	25 (71.40)
Oral medicine and GLP-1RA	156 (55.50)	77 (49.40)	79 (50.60)
Years of diabetes				2.14	0.144
≤5	189 (66.50)	83 (43.90)	106 (56.10)
>5	92 (32.40)	32 (34.80)	60 (65.20)
Complications				8.21	0.004
No	215 (76.50)	98 (45.60)	117 (54.40)
Yes	66 (23.50)	17 (25.80)	49 (74.20)
Depression (Score)				13.14	<0.001
No	188 (66.90)	91 (48.40)	97 (51.60)
Yes	93 (33.10)	24 (25.80)	69 (74.20)
Anxiety (Score)				7.92	0.005
No	224 (79.70)	101 (45.10)	123 (54.90)
Yes	57 (20.30)	14 (24.60)	43 (75.40)
SF12 (Score)				13.84	<0.001
Good quality of life	179 (63.70)	88 (49.20)	91 (50.80)
Poor quality of life	102 (36.30)	27 (26.50)	75 (73.50)
PSQI (Score)	6.63±3.28	3.63±1.29	8.70±2.54	−21.97	<0.001
Subjective sleep quality (C1)	0.98±0.70	0.54±0.50	1.28±0.65	−10.33	<0.001
Sleep latency (C2)	0.89±1.13	0.21±0.50	1.36±1.21	−11.00	<0.001
Sleep duration (C3)	0.97±0.70	0.63±0.52	1.21±0.70	−7.59	<0.001
Habitual sleep efficiency (C4)	1.06±1.10	0.29±0.51	1.60±1.08	−13.68	<0.001
Sleep disturbances (C5)	1.18±0.50	0.93±0.41	1.35±0.48	−7.86	<0.001
Use of sleep medication (C6)	0.07±0.40	0.00±0.00	0.13±0.52	−3.14	0.002
Daytime dysfunction (C7)	1.47±0.93	1.03±0.79	1.78±0.89	−7.33	<0.001
Sleep latency (min)				42.29	<0.001
≤30	216 (76.90)	111 (51.40)	105 (48.60)
>30	65 (23.10)	4 (6.20)	61 (93.80)
Sleep duration (hour)				32.35	<0.001
≥6	233 (82.90)	113 (48.50)	120 (51.50)
<6	48 (17.10)	2 (4.20)	46 (95.80)
Sleep efficiency (%)				89.77	<0.001
≥85	114 (40.60)	85 (74.60)	29 (25.40)
<85	167 (59.40)	30 (18.00)	137 (82.00)
IPAQ (Score)				2.450	0.294
Low PA intensity	141 (50.20)	61 (43.30)	80 (56.70)
Medium PA intensity	123 (43.80)	50 (40.70)	73 (59.30)
High PA intensity	17 (6.00)	4 (23.50)	13 (76.50)
BMI (kg/m^2)				10.43	0.005
18.5–23.9	37 (13.20)	8 (21.60)	29 (78.40)
24–27.9	150 (53.40)	58 (38.70)	92 (61.30)
≥28	93 (33.10)	48 (51.60)	45 (48.40)
WC (cm)	93.74±7.75	94.26±7.58	93.37±7.86	0.94	0.346
HbA1c (%)				0.04	0.849
<7	147 (52.30)	60 (40.80)	87 (59.20)
≥7	131 (46.60)	52 (39.70)	79 (60.30)
SBP (mmHg)	137.56±16.82	136.24±15.95	138.46±17.38	−1.09	0.277
DBP (mmHg)	82.05±10.68	83.25±11.03	81.22±10.39	1.56	0.120
FPG (mmol/L)	8.22±3.34	8.17±2.79	8.25±3.66	−0.21	0.836
TG (mmol/L)	2.07±1.81	2.08±1.54	2.06±1.98	0.08	0.940
TC (mmol/L)	4.91±1.35	4.99±1.35	4.85±1.35	0.86	0.394
HDL-C (mmol/L)	1.18±0.25	1.18±0.26	1.17±0.24	0.47	0.642
LDL-C (mmol/L)	3.09±0.97	3.15±0.98	3.05±0.96	0.87	0.385

Note: Statistical test: Independent Two-sample t-test and Chi-square Test.

Abbreviations: GLP-1RA, Glp-1 receptor agonist; SF12, Short Form 12; PSQI, Pittsburgh Sleep Quality Index; BMI, Body mass index; WC, Waist circumference; SBP, Systolic blood pressure; DBP, Diastolic blood pressure; FPG, Fasting plasma glucose; TG, Triglycerides; TC, Total cholesterol; HDL-C, High-density lipoprotein cholesterol; LDL-C, Low-density lipoprotein cholesterol; RMB, Ren Min Bi; IPAQ, International Physical Activity Questionnaire; PA, Physical activity.

Table 2 Logistic Regression Analysis for Sleep Quality

Variable	Step 1			Step 2
	OR	95% CI	P	OR	95% CI	P
Treatment			0.188			0.494
Oral medicine	Ref			Ref
Oral medicine and insulin	0.74	(0.28,1.92)	0.532	0.69	(0.25,1.94)	0.480
Oral medicine and GLP-1RA	0.57	(0.31,1.04)	0.069	0.68	(0.35,1.31)	0.247
Complications
No	Ref			Ref
Yes	2.27	(1.15,4.48)	0.018	1.28	(0.61,2.69)	0.519
Depression (Score)
No	Ref			Ref
Yes	2.14	(1.05,4.37)	0.037	3.10	(1.38,6.96)	0.006
Anxiety (Score)
No	Ref			Ref
Yes	1.03	(0.41,2.58)	0.951	1.24	(0.45,3.43)	0.679
SF12 (Score)
Good QOL	Ref			Ref
Poor QOL	2.05	(1.10,3.83)	0.025	2.49	(1.24,4.99)	0.010
BMI (kg/m^2)			0.115			0.387
18.5–23.9	Ref			Ref
24–27.9	0.47	(0.19,1.16)	0.100	0.51	(0.19,1.39)	0.188
≥28	0.35	(0.13,0.94)	0.038	0.48	(0.16,1.43)	0.188
Age				1.07	(1.04,1.10)	<0.001
Education
Junior high school and below				Ref		0.153
High school or junior college				0.58	(0.28,1.18)	0.131
College and above				0.46	(0.20,1.04)	0.063
Monthly income (RMB)						0.870
<5000				Ref
5000–10,000				1.22	(0.59,2.52)	0.598
>10,000				1.14	(0.52,2.51)	0.736
R^2	0.179			0.305

Note: Statistical test: Multiple Logistic Regression Model.

Abbreviations: GLP-1RA, Glp-1 receptor agonist; SF12, Short Form 12; BMI, Body mass index; RMB, Ren Min Bi.

Table 3 Logistic Regression Analysis for Sleep Latency

Variable	Step 1			Step 2
	OR	95% CI	P	OR	95% CI	P
Treatment			0.107			0.114
Oral medicine	Ref			Ref
Oral medicine and insulin	0.62	(0.25,1.53)	0.296	0.53	(0.21,1.35)	0.181
Oral medicine and GLP-1RA	0.49	(0.25,0.96)	0.038	0.50	(0.25,1.01)	0.052
Depression (Score)
No	Ref			Ref
Yes	2.10	(1.15,3.85)	0.016	2.19	(1.15,4.16)	0.017
BMI (kg/m^2)			0.025			0.231
18.5–23.9	Ref			Ref
24–27.9	0.40	(0.18,0.91)	0.029	0.55	(0.23,1.32)	0.180
≥28	0.26	(0.10,0.70)	0.007	0.40	(0.14,1.15)	0.089
SBP (mmHg)
≤130	Ref			Ref
>130	1.89	(0.99,3.58)	0.052	1.71	(0.89,3.28)	0.110
Gender
Male				0.77	(0.38,1.58)	0.477
Female				Ref
Age				1.01	(0.98,1.04)	0.373
Education						0.487
Junior high school and below				Ref
High school or junior college				1.14	(0.54,2.44)	0.726
College and above				0.65	(0.24,1.77)	0.400
Monthly income (RMB)						0.455
<5000				Ref
5000–10,000				0.58	(0.24,1.38)	0.215
>10,000				0.65	(0.25,1.68)	0.375
R^2	0.141			0.185

Note: Statistical test: Multiple Logistic Regression Model.

Abbreviations: GLP-1RA, Glp-1 receptor agonist; BMI, Body mass index; SBP, Systolic blood pressure; RMB, Ren Min Bi.

Table 4 Logistic Regression Analysis for Sleep Duration

Variable	Step 1			Step 2
	OR	95% CI	P	OR	95% CI	P
Depression (Score)
No	Ref			Ref
Yes	2.18	(1.15,4.16)	0.018	2.56	(1.31,5.00)	0.006
BMI (kg/m^2)			0.037			0.289
18.5–23.9	Ref			Ref
24–27.9	0.59	(0.25,1.38)	0.226	0.76	(0.32,1.83)	0.540
≥28	0.27	(0.10,0.75)	0.012	0.44	(0.15,1.28)	0.134
Age				1.05	(1.02,1.08)	0.002
R^2	0.073			0.128

Note: Statistical test: Multiple Logistic Regression Model.

Abbreviation: BMI, Body mass index.

Table 5 Logistic Regression Analysis for Sleep Efficiency

Variable	Step 1			Step 2
	OR	95% CI	P	OR	95% CI	P
Treatment			0.214			0.293
Oral medicine	Ref			Ref
Oral medicine and insulin	0.76	(0.33,1.73)	0.508	0.65	(0.28,1.53)	0.323
Oral medicine and GLP-1RA	0.59	(0.33,1.06)	0.080	0.63	(0.34,1.15)	0.129
BMI (kg/m^2)			0.056			0.320
18.5–23.9	Ref			Ref
24–27.9	0.62	(0.27,1.44)	0.267	0.79	(0.33,1.91)	0.606
≥28	0.37	(0.15,0.92)	0.032	0.54	(0.21,1.42)	0.212
Age				1.03	(1.01,1.06)	0.019
Education						0.685
Junior high school and below				Ref
High school or junior college				0.75	(0.39,1.45)	0.387
College and above				0.81	(0.39,1.71)	0.583
Monthly income (RMB)						0.388
<5000				Ref
5000–10,000				0.78	(0.39,1.54)	0.476
>10,000				0.60	(0.29,1.24)	0.171
R^2	0.064			0.129

Note: Statistical test: Multiple Logistic Regression Model.

Abbreviations: GLP-1RA, Glp-1 receptor agonist; BMI, Body mass index; RMB, Ren Min Bi.