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Association of Sleep Duration, Metabolic Markers, and Risk of All-Cause and Cause-Specific Mortality in China and the UK Cover

Association of Sleep Duration, Metabolic Markers, and Risk of All-Cause and Cause-Specific Mortality in China and the UK

Open Access
|Sep 2026

Figures & Tables

Graphical Abstract
Table 1

Baseline characteristics of participants from CKB and UKB by incidence of all-cause mortality.

CKBUKB
INCIDENT ALL-CAUSE MORTALITYINCIDENT ALL-CAUSE MORTALITY
CHARACTERISTICNOYESP VALUENOYESP VALUE
N5,0362,005253,55620,701
Age, mean (SD), years47.62 (9.08)55.04 (9.65)<0.00156.15 (8.06)61.67 (6.45)<0.001
Sex<0.001<0.001
    Male2,207 (43.8%)1,080 (53.9%)139,665 (55.1%)8,335 (40.3%)
    Female2,829 (56.2%)925 (46.1%)113,891 (44.9%)12,366 (59.7%)
Region0.010
    Rural3,231 (64.2%)1,351 (67.4%)
    Urban1,805 (35.8%)654 (32.6%)
Ethnicity<0.001
White239,660 (94.9%)19,931 (96.8%)
Non-white12,788 (5.1%)650 (3.2%)
Smoking status<0.001<0.001
    Never3,300 (65.5%)1,097 (54.7%)141,160 (55.9%)7,944 (38.7%)
    Former252 (5.0%)159 (7.9%)86,291 (34.2%)8,667 (42.2%)
    Current1,484 (29.5%)749 (37.4%)24,942 (9.9%)3,917 (19.1%)
Alcohol consumption status<0.001<0.001
    Never4,018 (79.8%)1,486 (74.1%)10,894 (4.3%)1,017 (4.9%)
    Former194 (3.9%)134 (6.7%)8431 (3.3%)1,358 (6.6%)
    Current824 (16.4%)385 (19.2%)233,655 (92.4%)18,258 (88.5%)
Self-rated health<0.001<0.001
    Excellent926 (18.4%)273 (13.6%)42,546 (16.9%)1,852 (9.0%)
    Good1,426 (28.3%)487 (24.3%)148,554 (58.9%)9,624 (47.0%)
    Fair2,198 (43.6%)872 (43.5%)51,364 (20.4%)6,273 (30.6%)
    Poor486 (9.7%)373 (18.6%)9,688 (3.8%)2,737 (13.4%)
Educationa<0.001<0.001
    Low2,289 (45.5%)1,186 (59.2%)110,489 (44.1%)11,100 (54.6%)
    Medium2,470 (49.0%)759 (37.9%)58,116 (23.2%)4,632 (22.8%)
    High277 (5.5%)60 (3.0%)82,112 (32.8%)4,616 (22.7%)
BMI, mean (SD), kg/m224.33 (3.51)23.97 (3.79)<0.00127.38 (4.72)28.37 (5.44)<0.001
Sleep duration, mean (SD), h/day7.55 (1.33)7.39 (1.50)<0.0017.15 (1.09)7.25 (1.34)<0.001
Hypertension<0.001<0.001
    No2,950 (58.6%)787 (39.3%)118,196 (46.6%)5,798 (28.0%)
    Yes2,086 (41.4%)1,218 (60.7%)135,360 (53.4%)14,903 (72.0%)
Diabetes<0.001<0.001
    No4,816 (95.6%)1,761 (87.8%)239,924 (94.6%)17,692 (85.5%)
    Yes220 (4.4%)244 (12.2%)13,632 (5.4%)3,009 (14.5%)

[i] SD, standard deviation; BMI, body mass index.

a In CKB, high, medium, and low level of education refers to college and above, secondary school, and primary school and below. In UKB, high, medium, and low level of education refers to college or university degree, A/AS levels or equivalent and O levels/GCSEs or equivalent, and none of the aforementioned.

Figure 1

Association of metabolic markers with sleep duration and all-cause and cause-specific mortality in the CKB.

Models were adjusted for age, sex, regions, levels of education, smoking status, alcohol consumption, and self-rated health status. P values are corrected for multiple testing using FDR adjustment. Significance: ***p < 0.0001, **P < 0.01, *P < 0.05, - P > 0.05.

HR, hazard ratio; CI, confidence interval; HDL, High-Density Lipoprotein; VLDL, Very-Low-Density Lipoprotein.

Figure 2

Association of metabolic markers with sleep duration and all-cause and cause-specific mortality in the UKB.

Models were adjusted for age, sex, ethnicity, levels of education, smoking status, alcohol consumption, and self-rated health status. P values are corrected for multiple testing using FDR adjustment. Significance: ***p < 0.0001, **P < 0.01, *P < 0.05, - P > 0.05.

HR, hazard ratio; CI, confidence interval; HDL, High-Density Lipoprotein; VLDL, Very-Low-Density Lipoprotein.

Figure 3

Association of metabolic markers with sleep duration and all-cause and cause-specific mortality in the CKB by sex (A, B) and age group (C, D).

This heatmap shows the metabolic markers and their β coefficient from multivariable-adjusted linear regression (sleep duration), and HRs from multivariable-adjusted Cox regressions (mortality). Results are adjusted for age, sex, regions, levels of education, smoking status, alcohol consumption, and self-rated health status. P values are corrected for multiple testing using FDR adjustment. Dark pink indicates a strong positive association and dark blue a strong negative association.

HDL, High-Density Lipoprotein; VLDL, Very-Low-Density Lipoprotein.

Figure 4

Association of metabolic markers with sleep duration and all-cause and cause-specific mortality in the UKB by sex (A, B) and age group (C, D).

This heatmap shows the metabolic markers and their β coefficient from multivariable-adjusted linear regression (sleep duration), and HRs from multivariable-adjusted Cox regressions (mortality). Results are adjusted for age, sex, regions, levels of education, smoking status, alcohol consumption, and self-rated health status. P values are corrected for multiple testing using FDR adjustment. Dark pink indicates a strong positive association and dark blue a strong negative association.

HDL, High-Density Lipoprotein; VLDL, Very-Low-Density Lipoprotein.

DOI: https://doi.org/10.5334/gh.1582 | Journal eISSN: 2211-8179
Language: English
Page range: 65 - 65
Submitted on: Apr 22, 2026
Accepted on: Aug 18, 2026
Published on: Sep 1, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services

© 2026 Guangyao Hua, Lijun Zhang, Cong Li, Yan Wang, Xue He, Chingyu Cheng, Lei Liu, Xiaohong Yang, Jinghua Jiao, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.