Intestinal Flora Composition and Fecal Metabolic Phenotype in Elderly Patients with Sleep Disorders Combined with Type 2 Diabetes

Overview

Journal Aging Med (Milton)

Date 2025 Jan 8

PMID 39777104

Authors

Zhuohao Yin

Huaze Xie

Fuyuan Liu

Xue Kong

Wei Chen

Yangfan Gong

Wei Ge

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aimed to determine whether type 2 diabetes (T2D) is an independent risk factor for sleep disorders in the elderly and explore the possible intestinal flora factors of sleep disorders combined with T2D in this population.

Methods: All hospitalized patients with sleep disorders aged ≥65 years between June and November 2023 were retrospectively analyzed, and they were divided into a sleep disorder group ( = 134) and a control group ( = 109). The logistic regression method was utilized to clarify the causal relationship between T2D and sleep disorders. For stool analyses, 42 patients were randomly extracted, which included the control group ( = 14), diabetes group ( = 14), and elderly patients with sleep disorders combined with the T2D group (ESdD) ( = 14). The composition feature of intestinal flora and metabolomics in the ESdD group was described through high-throughput 16S rDNA sequencing and nontargeted analysis based on liquid chromatography-mass spectrometry.

Results: Gender, body mass index (BMI), T2D, intestinal discomfort, and anxiety depression were independent risk factors for sleep disorders in the elderly. Notably, older individuals with T2D were 3.3 times more likely to experience sleep disorders than normal individuals. Compared with the control group, the ESdD group had decreased relative abundance of and , with 47 metabolites upregulated and 53 metabolites downregulated. The ESdD group showed a decrease in , with 62 metabolites upregulated and 43 metabolites downregulated, compared with the diabetes group.

Conclusions: Diabetes is an independent risk factor for sleep disorders in the elderly patients. Variations in intestinal flora and metabolism significantly influence the onset and progression of the ESdD group.

References

Meyer K, Lulla A, Debroy K, Shikany J, Yaffe K, Meirelles O . Association of the Gut Microbiota With Cognitive Function in Midlife. JAMA Netw Open. 2022; 5(2):e2143941. PMC: 8826173. DOI: 10.1001/jamanetworkopen.2021.43941. View

Irwin M, Vitiello M . Implications of sleep disturbance and inflammation for Alzheimer's disease dementia. Lancet Neurol. 2019; 18(3):296-306. DOI: 10.1016/S1474-4422(18)30450-2. View

Wang Z, Wang Z, Lu T, Chen W, Yan W, Yuan K . The microbiota-gut-brain axis in sleep disorders. Sleep Med Rev. 2022; 65:101691. DOI: 10.1016/j.smrv.2022.101691. View

Kuo C, Lu S, Huang C, Liao W, Lee M . Sleep Quality and Associated Factors in Adults with Type 2 Diabetes: A Retrospective Cohort Study. Int J Environ Res Public Health. 2021; 18(6). PMC: 7999598. DOI: 10.3390/ijerph18063025. View

Kim J, Choi P, Park Y, Kim T, Ham J, Kim J . The Cannabinoids, CBDA and THCA, Rescue Memory Deficits and Reduce Amyloid-Beta and Tau Pathology in an Alzheimer's Disease-like Mouse Model. Int J Mol Sci. 2023; 24(7). PMC: 10095267. DOI: 10.3390/ijms24076827. View

Adhikari P, Pradhan A, Zele A, Feigl B . Supplemental light exposure improves sleep architecture in people with type 2 diabetes. Acta Diabetol. 2021; 58(9):1201-1208. DOI: 10.1007/s00592-021-01712-y. View

Frigerio F, Pasqualini G, Craparotta I, Marchini S, van Vliet E, Foerch P . n-3 Docosapentaenoic acid-derived protectin D1 promotes resolution of neuroinflammation and arrests epileptogenesis. Brain. 2018; 141(11):3130-3143. PMC: 6202571. DOI: 10.1093/brain/awy247. View

Ho Y, Tsai Y, Kuo T, Yang C . Effects of PS128 on Depressive Symptoms and Sleep Quality in Self-Reported Insomniacs: A Randomized, Double-Blind, Placebo-Controlled Pilot Trial. Nutrients. 2021; 13(8). PMC: 8402034. DOI: 10.3390/nu13082820. View

Xiao M, Lin L, Chen H, Ge X, Huang Y, Zheng Z . Anti-fatigue property of the oyster polypeptide fraction and its effect on gut microbiota in mice. Food Funct. 2020; 11(10):8659-8669. DOI: 10.1039/d0fo01713b. View

10.

Bhatt P, Pathak S, Kumar V, Panda B . Attenuation of neurobehavioral and neurochemical abnormalities in animal model of cognitive deficits of Alzheimer's disease by fermented soybean nanonutraceutical. Inflammopharmacology. 2017; 26(1):105-118. DOI: 10.1007/s10787-017-0381-9. View

11.

Pravalika K, Sarmah D, Kaur H, Vats K, Saraf J, Wanve M . Trigonelline therapy confers neuroprotection by reduced glutathione mediated myeloperoxidase expression in animal model of ischemic stroke. Life Sci. 2018; 216:49-58. DOI: 10.1016/j.lfs.2018.11.014. View

12.

Qiao T, Wang Y, Liang K, Zheng B, Ma J, Li F . Effects of the Radix Ginseng and Semen Ziziphi Spinosae drug pair on the GLU/GABA-GLN metabolic cycle and the intestinal microflora of insomniac rats based on the brain-gut axis. Front Pharmacol. 2023; 13:1094507. PMC: 9811267. DOI: 10.3389/fphar.2022.1094507. View

13.

Gonzalez-Mercado V, Sarkar A, Penedo F, Perez-Santiago J, McMillan S, Marrero S . Gut microbiota perturbation is associated with acute sleep disturbance among rectal cancer patients. J Sleep Res. 2019; 29(3):e12915. PMC: 7644135. DOI: 10.1111/jsr.12915. View

14.

Shamshirgaran S, Ataei J, Malek A, Iranparvar-Alamdari M, Aminisani N . Quality of sleep and its determinants among people with type 2 diabetes mellitus in Northwest of Iran. World J Diabetes. 2017; 8(7):358-364. PMC: 5507833. DOI: 10.4239/wjd.v8.i7.358. View

15.

Jiang Z, Wang X, Zhang H, Yin J, Zhao P, Yin Q . Ketogenic diet protects MPTP-induced mouse model of Parkinson's disease via altering gut microbiota and metabolites. MedComm (2020). 2023; 4(3):e268. PMC: 10186339. DOI: 10.1002/mco2.268. View

16.

Matenchuk B, Mandhane P, Kozyrskyj A . Sleep, circadian rhythm, and gut microbiota. Sleep Med Rev. 2020; 53:101340. DOI: 10.1016/j.smrv.2020.101340. View

17.

Magzal F, Even C, Haimov I, Agmon M, Asraf K, Shochat T . Associations between fecal short-chain fatty acids and sleep continuity in older adults with insomnia symptoms. Sci Rep. 2021; 11(1):4052. PMC: 7893161. DOI: 10.1038/s41598-021-83389-5. View

18.

Gore M, Brandenburg N, Dukes E, Hoffman D, Tai K, Stacey B . Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage. 2005; 30(4):374-85. DOI: 10.1016/j.jpainsymman.2005.04.009. View

19.

Namted S, Poungpong K, Loongyai W, Rakangthong C, Bunchasak C . Dietary autolysed yeast modulates blood profiles, small intestinal morphology and caecal microbiota of weaning pigs. Animal. 2022; 16(11):100660. DOI: 10.1016/j.animal.2022.100660. View

20.

Zhou Z, Zheng Z, Xiong X, Chen X, Peng J, Yao H . Gut Microbiota Composition and Fecal Metabolic Profiling in Patients With Diabetic Retinopathy. Front Cell Dev Biol. 2021; 9:732204. PMC: 8554156. DOI: 10.3389/fcell.2021.732204. View