Unraveling the causal role of sleep traits in development of diabetic retinopathy: A UK Biobank observational study and Mendelian randomization

AimsTo evaluate the potential causal role of sleep traits (STs) on diabetic retinopathy (DR).MethodsThe cross-sectional study included 23,851 patients with type 2 diabetes from the UK Biobank and used multivariate logistic models to investigate the observational association between STs and DR. Genetic correlation analysis and two-sample Mendelian randomization (MR) were conducted using ST data from the UK Biobank and DR data from the FinnGen consortium to investigate the genetic and causal associations between STs and DR.ResultsPatients who experienced daytime sleepiness often/all of the time had a higher risk for DR (OR: 1.40; 95% CI, 1.09-1.79; p = .008) compared with those who sometimes/never/rarely experienced daytime sleepiness. Genetic correlations between several STs and DR were detected by cross-trait linkage disequilibrium score regression. MR suggested a causal effect of self-reported daytime sleepiness (OR: 4.08; 95% CI, 1.44-11.61; p = .008), and accelerator-derived sleep duration (OR: 0.73; 95% CI, 0.54-0.98; p = .036) and sleep efficiency (OR: 0.54; 95% CI, 0.36-0.80; p = .002) on DR.ConclusionsSTs may have a potential causal role for DR. Attention should be paid to the STs of patients for better prevention and treatment of DR.