title: Short sleep duration is associated with insulin resistance independent of adiposity in Chinese adult twins.
abstract: OBJECTIVE
  To investigate the association between sleep duration and insulin resistance in rural Chinese adults and examine whether any such associations are independent of adiposity.
  
  
  METHODS
  This is a cross-sectional analysis of 854 men and 640 women aged 20 to 70 years from the Anqing Twin Cohort. The following measures were obtained for each subject: Body mass index (BMI) and percentage of trunk fat (%TF), fasting plasma glucose, homeostatic model assessment of insulin resistance index (HOMA-IR), self-reported sleep duration and measures of snoring and sleep disturbance from the Pittsburgh Sleep Quality Indices (PSQI) questionnaire were modified for a Chinese population. Multivariate linear regressions were applied to examine the association of sleep duration with HOMA-IR, with and without adjustment for adiposity variables, along with other relevant covariates.
  
  
  RESULTS
  In this sample of relatively lean rural Chinese adults, short sleep duration was associated with HOMA-IR in women but not in men. In women, short (≤ 7 h/night) sleep duration was associated with a higher HOMA-IR (p=0.003) compared with normal sleep duration (>7 to ≤ 8 h/night) after adjustment for all the covariates except adiposity. Further adjustment for BMI or %TF attenuated the sleep-HOMA-IR association, but the association remained significant upon adjustment for BMI (p=0.013); and upon adjustment for %TF (p=0.026). Long sleep duration (> 8 h/night) was not significantly associated with HOMA-IR.
  
  
  CONCLUSIONS
  In this rural Chinese cohort, short sleep duration is independently associated with increased insulin resistance among women only, even after adjusting for adiposity and other potential confounders.
authors.affiliation: Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA.
authors.forename: Rong
authors.initials: R
authors.lastname: Liu
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Zee
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Chervin
authors.forename: Lester M
authors.initials: LM
authors.lastname: Arguelles
authors.forename: Jennafer
authors.initials: J
authors.lastname: Birne
authors.forename: Shanchun
authors.initials: S
authors.lastname: Zhang
authors.forename: Katherine Kaufer
authors.initials: KK
authors.lastname: Christoffel
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Brickman
authors.forename: Donald
authors.initials: D
authors.lastname: Zimmerman
authors.forename: Binyan
authors.initials: B
authors.lastname: Wang
authors.forename: Guoying
authors.initials: G
authors.lastname: Wang
authors.forename: Xiping
authors.initials: X
authors.lastname: Xu
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D001835:Body Weight; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012892:Sleep Deprivation / Q000208:ethnology*; D014427:Twins / Q000706:statistics & numerical data*; D055815:Young Adult