The impact of sleep quality and duration on leptin, appetite, and obesity indices in adults
BACKGROUND Poor sleep duration and quality were previously reported to increase the risk of obesity. This study was aimed to evaluate the impact of sleep quality and duration on leptin, appetite, and adiposity in Indonesian adults.
METHODS This cross-sectional study recruited adults in Yogyakarta, Indonesia, in 2016. Sleep quality was assessed using the Pittsburgh sleep quality index, appetite was evaluated using the community nutrition appetite questionnaire, and dietary intake was assessed by interviews using the semi-quantitative food frequency questionnaire. Sleep duration was also asked. Obesity indices were measured using the body mass index (BMI), waist-hip circumference, and percentage of body fat. Leptin was analyzed using the enzyme-linked immunosorbent assay. A Spearman analysis was done to evaluate the correlation between sleep quality, sleep duration, anthropometric measures, dietary intake, appetite, and leptin.
RESULTS 244 adults participated in this study. This study showed that lower sleep quality and duration was significantly correlated with higher body weight (r = 0.129, p = 0.043 and r = −0.228, p<0.001), BMI (r = 0.176, p = 0.006 and r = −0.202, p = 0.001), and waist circumference (r = 0.179, p = 0.005 and r = −0.254, p<0.001). There was a correlation between poor sleep quality and higher leptin concentration (r = 0.186, p = 0.004). Sleep quality and duration were not associated with appetite (r = 0.109, p = 0.109 and r = −0.043, p = 0.500).
CONCLUSIONS This study found that lower sleep quality was correlated with higher BMI, higher leptin concentration, but not appetite.
Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-3. https://doi.org/10.1016/j.sleh.2014.12.010
Hoyos C, Glozier N, Marshall NS. Recent evidence on worldwide trends on sleep duration. Curr Sleep Med Rep. 2015;1:195-204. https://doi.org/10.1007/s40675-015-0024-x
Ryu JY, Lee JS, Hong HC, Choi HY, Yoo HJ, Seo JA, et al. Association between body size phenotype and sleep duration: Korean National Health and Nutrition Examination Survey V (KNHANES V). Metab Clin Exp. 2015;64(3):460-6. https://doi.org/10.1016/j.metabol.2014.12.001
Sun W, Huang Y, Wang Z, Yu Y, Lau A, Ali G, et al. Sleep duration associated with body mass index among Chinese adults. Sleep Med. 2015;16(5):612-6. https://doi.org/10.1016/j.sleep.2014.12.011
Gonnissen HK, Adam TC, Hursel R, Rutters F, Verhoef SP, Westerterp-Plantenga MS. Sleep duration, sleep quality and body weight: parallel developments. Physiol Behav. 2013;121:112-6. https://doi.org/10.1016/j.physbeh.2013.04.007
McNeil J, Doucet E, Chaput JP. Inadequate sleep as a contributor to obesity and type 2 diabetes. Can J Diabetes. 2013;37(2):103-8. https://doi.org/10.1016/j.jcjd.2013.02.060
Golem DL, Martin-Biggers JT, Koenings MM, Davis KF, Byrd-Bredbenner C. An integrative review of sleep for nutrition professionals. Adv Nutr. 2014;5(6):742-59. https://doi.org/10.3945/an.114.006809
Rahe C, Czira ME, Teismann H, Berger K. Associations between poor sleep quality and different measures of obesity. Sleep Med. 2015;16(10):1225-8. https://doi.org/10.1016/j.sleep.2015.05.023
GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13-27. https://doi.org/10.1056/NEJMoa1614362
Tremmel M, Gerdtham UG, Nilsson PM, Saha S. Economic burden of obesity: a systematic literature review. Int J Environ Res Public Health. 2017;14(4):435. https://doi.org/10.3390/ijerph14040435
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index (PSQI): a new instrument for psychiatric research and practice. Psychiatry Res. 1989;28(2):193-213. https://doi.org/10.1016/0165-1781(89)90047-4
Hinz A, Glaesmer H, Brähler E, Löffler M, Engel C, Enzenbach C, et al. Sleep quality in the general population: psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people. Sleep Med. 2017;30:57-63. https://doi.org/10.1016/j.sleep.2016.03.008
Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr. 2005;82(5):1074-81. https://doi.org/10.1093/ajcn/82.5.1074
Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care. 2011;14(4):402-12. https://doi.org/10.1097/MCO.0b013e3283479109
Greer SM, Goldstein AN, Walker MP. The impact of sleep deprivation on food desire in the human brain. Nat Commun. 2013;4:2259. https://doi.org/10.1038/ncomms3259
Hirota T, Morioka T, Yoda K, Toi N, Hayashi N, Maruo S, et al. Positive association of plasma leptin with sleep quality in obese type 2 diabetic patients. J Diabetes Investig. 2018;9(5):1100-5. https://doi.org/10.1111/jdi.12826
Knutson KL, Galli G, Zhao X, Mattingly M, Cizza G, NIDDK Sleep Extension Study. No association between leptin levels and sleep duration or quality in obese adults. Obesity (Silver Spring). 2011;19(12):2433-5. https://doi.org/10.1038/oby.2011.248
Van Leeuwen WMA, Hublin C, Sallinen M, Härmä M, Hirvonen A, Porkka-Heiskanen T. Prolonged sleep restriction affects glucose metabolism in healthy young men. Int J Endocrinol. 2010;2010:108641. https://doi.org/10.1155/2010/108641
Charles LE, Gu JK, Andrew ME, Violanti JM, Fekedulegn D, Burchfiel CM. Sleep duration and biomarkers of metabolic function among police officers. J Occup Environ Med. 2011;53(8):831-7. https://doi.org/10.1097/JOM.0b013e31821f5ece
Reynolds AC, Dorrian J, Liu PY, Van Dongen HP, Wittert GA, Harmer LJ, et al. Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men. PLoS One. 2012;7(7):e41218. https://doi.org/10.1371/journal.pone.0041218
Simpson NS, Banks S, Dinges DF. Sleep restriction is associated with increased morning plasma leptin concentrations, especially in women. Biol Res Nurs. 2010;12(1):47-53. https://doi.org/10.1177/1099800410366301
Hou N, Luo JD. Leptin and cardiovascular diseases. Clin Exp Pharmacol Physiol. 2011;38(12):905-13. https://doi.org/10.1111/j.1440-1681.2011.05619.x
Zhu B, Shi C, Park CG, Zhao X, Reutrakul S. Effects of sleep restriction on metabolism-related parameters in healthy adults: a comprehensive review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2019;45:18-30. https://doi.org/10.1016/j.smrv.2019.02.002
Pan W, Kastin AJ. Leptin: a biomarker for sleep disorders? Sleep Med Rev. 2014;18(3):283-90. https://doi.org/10.1016/j.smrv.2013.07.003
Copyright (c) 2020 Harry Freitag Luglio Muhammad, Satwika Arya Pratama, Dian Caturini Sulistyoningrum, Maya Nurfitriani Hartono, Emy Huriyati, Yi Y Lee, Wan Abdul Manan Wan Muda
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.