Joint association of weekend catch-up sleep and triglyceride-glucose index on bone loss and all-cause mortality in employed U.S. adults aged 18–60 with diabetes

The increasing prevalence of younger-onset type 2 diabetes mellitus (T2DM) has resulted in an increased risk of bone loss and mortality among employed adults aged 18–60 years. Weekend catch-up sleep (WCS) index, reflecting irregularity in sleep duration, and triglyceride-glucose (TyG) index, reflecting glucolipid metabolism, may be interrelated in the assessment of diabetes pathophysiology. This study developed a composite WCS + TyG index to yield an incremental effect, improving predictive performance of bone loss risk and all-cause mortality in employed U.S. adults aged 18–60 years with T2DM. A cohort analysis included 4,185 employed adults aged 18–60 with T2DM from the NHANES database. Receiver operating characteristic (ROC) curves, logistic regression, and Cox models were used to evaluate predictive performance of the WCS + TyG combination on bone loss risk and all-cause mortality. Logistic regression and Cox models provided preliminary evidence that the WCS + TyG combination was an independent risk factor for bone loss and all-cause mortality; among patients with T2DM, those with high levels of both indices had the highest risk (full adjusted Model 3: bone loss risk OR = 1.480, 95% CI = 1.195–1.833, P < 0.001; all-cause mortality HR = 2.600, 95% CI = 1.957–3.454, P < 0.001). These findings suggest an association, but causal conclusions cannot be drawn, and further prospective research is needed to confirm these results. This study confirmed that the WCS + TyG combination can provide an incremental effect in predicting risk of bone loss and all-cause mortality in employed U.S. adults aged 18–60 with T2DM.