In the first study of its kind, researchers found that people who reported trouble sleeping were on average more likely to have indicators of poor cardiometabolic health — inflammatory markers, cholesterol and body weight — which can contribute to type 2 diabetes.

In Australia, almost one million adults have type 2 diabetes. Globally, type 2 diabetes affects more than 422 million people.

UniSA researcher Dr Lisa Matricciani says different aspects of sleep are associated with risk factors for diabetes.

“Everyone knows that sleep is important. But when we think about sleep, we mainly focus on how many hours of sleep we get, when we should also be looking at our sleep experience as a whole,” Dr Matricciani says.

“How soundly we sleep, when we go to bed and get up, and how regular our sleep habits are, may be just as important as sleep duration.”

“In this study, we examined the association of different aspects of sleep, and risk factors for diabetes, and found a connection between those who had troubled sleep and those who were at risk of type 2 diabetes.”

The study assessed more than 1000 Australian adults* with a median age of 44.8 years. Researchers examined a range of sleep characteristics: self-report trouble sleeping, duration, timing, efficiency, and day-to-day sleep length variability.

“People who reported having trouble sleeping were also more likely to have a higher body mass index, as well as blood markers of cholesterol and inflammation,” Dr Matricciani says.

“When it comes down to the crunch, we know we must prioritise our sleep to help stay in good health. More research is needed, but as this study shows, it’s important to think about sleep as a whole, not just as one aspect.”

Notes

• *Most participants (87 per cent) were mothers.
• Approximately half of all participants (48 per cent) reported that they never had troubled sleep.

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Materials provided by University of South Australia. Note: Content may be edited for style and length.

Led by researchers from Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, this is the largest study worldwide to examine whether air pollution exposure is linked with the occurrence of multiple long-term health conditions.

Multimorbidity is defined as having two or more physical or mental health conditions and affects 27 per cent of adults in UK primary care. It increases the use of healthcare services and the costs of primary and secondary care, but its association with air pollution has not been studied in the UK until now.

Published in Frontiers in Public Health the study showed that high levels of traffic-related air pollution — fine particulate matter 2.5 (PM_2.5) and nitrogen dioxide (NO₂) — were associated with an increased risk of having at least two long term health conditions. The strongest associations were observed for co-occurring neurological, respiratory, cardiovascular and common mental health conditions such as depression and anxiety.

This research was funded by National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre and NIHR Applied Research Collaboration (ARC) South London.

Dr Amy Ronaldson, Research Associate at Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London and first author on the study said: “People with more than one long-term health condition have a lower quality of life and greater dependence on the healthcare system. Our NIHR funded research has indicated that those people that live in areas of higher traffic-related air pollution are at greater risk of having multiple health conditions. The study does not prove that air pollution causes multimorbidity, but it does warrant further research in this area. It could be that simple measures to reduce traffic levels could potentially improve lives and lessen the pressure on our healthcare systems.”

Researchers analysed data from UK Biobank — a large-scale biomedical database and research resource containing anonymised genetic, lifestyle and health information from half a million UK participants. aged between 40 and 69 years. Participants were assessed for 36 physical and five mental health chronic conditions. Multimorbidity was defined as having two or more of these conditions.

Physical and mental health data from UK Biobank in 2010 were linked with the estimated concentration of air pollution at the residential address of the participants.

The study found that those participants exposed to higher concentrations (above 10µg/m³) of fine particulate matter had a 21 per cent increased risk of two or more co-occurring conditions compared to those exposed to concentrations below 10µg/m³.

For participants exposed to above 30µg/m³ of NO₂ the research showed a 20 per cent increased risk of having two or more co-occurring conditions compared to those participants that were exposed to concentrations of NO₂ below 20µg/m³.

Amongst those with multiple conditions, increased exposure to both PM_2.5 and NO₂ was linked to a greater severity of the co-occurring conditions.

Dr Ioannis Bakolis, Reader at IoPPN, King’s College London and senior author on the study said: “How air pollution affects multiple organs and systems at the same time is not yet fully understood, but there is some evidence that mechanisms such as inflammation, oxidative stress and immune activation could be triggered by air particulates, which can cause damage to the brain, heart, blood, lungs and gut.

“Our study suggests that it could be through shared mechanisms that air pollution negatively impacts several body systems and increases the likelihood of people developing multiple long term health conditions. More research is needed to understand just how air pollution affects the different bodily systems, but it may be that tackling air pollution could help prevent and alleviate the debilitating impact of multiple long-term health conditions.”

Researchers identified several patterns in the associations: the strongest links were primarily between conditions relating to the respiratory system (asthma, chronic obstructive pulmonary disease) as well as the cardiovascular system (atrial fibrillation, coronary heart disease, heart failure) but also to neurological and common mental conditions (stroke, substance abuse, depression, anxiety).

The study, ‘Associations between air pollution and multimorbidity in the UK Biobank: A cross-sectional study’ was published in Frontiers in Public Health.

This study has been funded by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London and the NIHR Applied Research Collaboration South London.

Now a follow-up study by the same group, published in Science Translational Medicine, has found that the 2-dose vaccines still provide protection against lung disease in rhesus macaques one year after they had been vaccinated as infants.

The co-senior authors of the paper are Kristina De Paris, PhD, professor of microbiology and immunology at the UNC School of Medicine, Sallie Permar, MD, PhD, chair of the Department of Pediatrics at Weill Cornell Medicine, and Koen K.A. Van Rompay, DVM, PhD, leader of the Infectious Disease Unit at the California National Primate Research at the University of California, Davis. Co-first authors are Emma C. Milligan at the Children’s Research Institute in the UNC School of Medicine and Katherine Olstad at the California National Primate Research Center.

To evaluate SARS-CoV-2 infant vaccination, the researchers immunized two groups of eight infant rhesus macaques at the California National Primate Research Center at 2 months of age and again four weeks later. Each animal received one of two vaccine types: a preclinical version of the Moderna mRNA vaccine or a vaccine combining a protein developed by the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health with a potent adjuvant formulation. Consisting of 3M’s molecular adjuvant 3M-052 formulated in a squalene emulsion by the Access to Advanced Health Institute (AAHI), the adjuvant formulation stimulates immune responses by engaging receptors on immune cells.

“Following up on our SARS-CoV-2 infant rhesus macaque study, we gave the animals a high-dose challenge with a SARS-CoV-2 variant one year later to assess durability of vaccine-induced immune responses and their efficacy,” Dr. De Paris said. “We found that both vaccines protected against lung disease, despite the fact that the challenge SARS-CoV-2 variants acquired numerous mutations in their spike protein that differed from the vaccine immunogen.”

Overall, the adjuvanted protein vaccine candidate maintained higher levels of neutralizing antibodies and provided superior protection compared to the mRNA vaccine, Dr. De Paris said. These data imply that these vaccines are safe and highly effective when given to young infant macaques. Furthermore, the results inform the optimization and development of SARS-CoV-2 vaccines in a way that may reduce the need for frequent boosters and protect special populations that don’t have fully developed immune systems, such as young children.

“With COVID-19, young infants are one of the most vulnerable pediatric populations. This fall, we are seeing a sharp rise in hospitalizations due to respiratory virus disease in infants as the result of a confluence of SARS-CoV-2, flu, and RSV circulation,” said Dr. Permar, who is also the Nancy C. Paduano Professor in Pediatrics at Weill Cornell Medicine and pediatrician-in-chief at NewYork-Presbyterian Komansky Children’s Hospital. “We should take every opportunity to provide safe and effective vaccine immunity to our youngest patients, including considering COVID-19 vaccination earlier than the currently recommended 6 months of age.”

“This study emphasizes the need to get human infants immunized against SARS-CoV-2 as much as possible, as the benefits are clear and long-lasting. It also highlights the value of animal models in infectious disease research,” Dr. Van Rompay said. “The lessons we learned and the resources and tools that were developed in the current study will be very valuable for future pandemic preparedness, to more effectively combat outbreaks with novel coronaviruses or other respiratory viruses in pediatric populations.”

This research was funded through grants from the National Institutes of Health (P01AI117915-06S1), (U54 CA260543), (P510D11107), (UM1 AI068618-15: HVTN/HPTN, CoVPN), (P30AI050410: UNC Center for AIDS Research), and (P30 CA016086: UNC-LCCC Flow Cytometry Core Facility).

Other authors are Caitlin A. Williams, Michael Mallory, Patricia Cano, Kaitlyn A. Cross, Jennifer E. Munt, Carolina Garrido, Lisa Lindesmith, Jennifer Watanabe, Jodie L. Usachenko, Lincoln Hopkins, Ramya Immareddy, Yashavanth Shaan Lakshmanappa, Sonny R. Elizaldi, Jamin W. Roh, Rebecca L. Sammak, JoAnn L. Yee, Savannah Herbek, Trover Scobey, Dieter Miehlke, Genevieve Fouda, Guido Ferrari, Hongmei Gao, Xiaoying Shen, Pamela A. Kozlowski, David Montefiori, Michael Hudgens, Darin K. Edwards, Andrea Carfi, Kizzmekia S. Corbett, Barney S. Graham, Christopher B. Fox, Mark Tomai, Smita S. Iyer, Ralph Baric, Rachel Reader, and Dirk P. Dittmer.