Normal sleep is characterized by increased glycogen stores and reduced glucose turnover by metabolically active tissues, thus it is a state of decreased metabolism. It has been reported that reduced sleep quality is associated with disrupted glucose metabolism. However, the relationship between Sleep Metabolic Rate (SMR) and prediabetes defined by the presence of IFG and/or IGT, during 75-g OGTT, has not been clarified.

The aim of this study was to investigate the role of SMR in the association between sleep quality and prediabetes.

A total of 226 individuals [women 72.1%; mean (DS) age 50.46 (±13.1) years; BMI 33.4 (±8.41) Kg/m2] undergoing the OGTT, were also asked to wear a metabolic holter (Armband) for 3-days, to assess their daily energy expenditure (DEE). The Armband was also capable of measuring the SMR, the Total Sleep Time (TST) and Sleep Efficiency (SE). The SMR has been adjusted for Free Fat Mass (FFM) to reduce the overweight/obesity influence on energy expenditure (SMR/FFM).

A total of 78 subjects were identified as prediabetic. No difference in TST, SE, and DEE was observed between NGT and prediabetics. The SMR/FFM was significantly higher in patients with prediabetes (p<.004). Using multivariate logistic regression, with prediabetes status as dependent variable and sleep efficiency, age, fat mass, gender and SMR/FFM as independent variables, the latter resulted an independent marker of prediabetes (OR 1.52, 95% CI 1.03-2.24) p .034, Nagelkerke’s r2: 0.12.

The SMR/FFM increase in prediabetic overweight/obese subjects may be explained through several mechanisms such as the increased nocturnal gluconeogenesis and the possible shift towards other substrates utilization (e.g., cori and glucose-alanine cycle).


D. Tuccinardi: None. G. Rossini: None. E. Maddaloni: Speaker's Bureau; Self; Merck & Co., Inc., Pikdare. D. Maggi: None. L. Monte: None. E. Fioriti: None. S. Kyanvash: None. P. Pozzilli: None. S. Manfrini: None.

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