Obese people who sleep more are at higher risk of diabetes, Says Study

According to a study, obese people who wake up later have a higher risk of diabetes and cardiovascular disease

A study carried out by the Federico II University of Naples (Italy) has succeeded in verifying that people with obesity with the so-called ‘evening chronotype’ – a pattern that causes awakening later – have a higher risk of developing type 2 diabetes and cardiovascular diseases, than those with the earliest activity levels.

The research, presented at the European Congress on Obesity, compared people with obesity with morning chronotype (MC), evening chronotype (EC), and intermediate chronotype (IC). Previous studies have shown that people with EC have alterations in their body clock (known as circadian rhythm) that can alter their metabolic processes, due to the overactivation of the hypothalamic-pituitary-adrenal axis, which is a set of linked body systems that control our reaction to stress, digestion, the immune system and various other functions.

The aim of this study was to investigate whether EC contributes to the risk of developing diabetes and cardiovascular disease in people with obesity, beyond sleep disorders and other pathologies.

Study on 172 people with obesity

These hypotheses have been confirmed thanks to a study on 172 middle-aged adults (72 percent women; mean age 52 years; mean body mass index (BMI) 32 kg / m2) where they were consecutively enrolled during a campaign of obesity prevention called OPERA project (Obesity, Programmes of nutrition, Education, Research and Assessment of the best treatment) PREVENTION which was held in Naples from October 11 to 13, 2019.

Body measurements and personal data were collected in the study, and sleep quality was assessed using the Pittsburgh Index scoring system. The chronotype was assessed using a standard assessment called the Horne-Ostberg Morning-Speed Questionnaire. Based on their scores, individuals were classified as morning (score 59 to 86), non-morning (42 to 58), or evening (16 to 41).

The chronotype was classified as MC in 58 percent of the subjects, EC in 13 percent, and IC in 29 percent. The subjects with CE, compared to those with IC and MC, reported a tendency to follow an unhealthy lifestyle, engaging in less regular physical activity, and being smokers more frequently. Across the population, a lower chronotype score was associated with a higher BMI. All the results were statistically significant.

Increased occurrence of diabetes and cardiovascular disease

Although the subjects belonging to the MC, IC and DC categories had similar BMI values, the subjects with DC had a significantly higher prevalence of cardiovascular disease and diabetes compared to the other categories. For this reason, a statistical analysis was carried out to assess the associations of the chronotype with diabetes and cardiovascular disease.

After adjusting the analysis for age, sex, BMI, and quality of sleep, people with EC had a 6-fold higher risk of diabetes and a more than 4-fold higher risk of cardiovascular disease compared to MC.

Thus, EC also showed a 19 times higher risk of diabetes and a four times higher risk of cardiovascular disease compared to IC, and all the results were again statistically significant. However, no statistically significant differences were found in the risk of diabetes or cardivascular disease between MC and IC.

Our study has found that the nocturnal chronotype represents an independent risk factor for cardiometabolic diseases beyond sleep disorders, age, gender, and BMI. Therefore, chronotype evaluation should be considered in the treatment of obesity, since promoting an alignment of daily activities according to the body clock or “circadian rhythm” of people living with obesity could reduce their risk of developing metabolic diseases such as type 2 diabetes and cardiovascular disease.
the study authors stated.

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