Intestinal flora composition and fecal metabolic phenotype in elderly patients with sleep disorders combined with type 2 diabetes

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 ( n = 134) and a control group ( n = 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 ( n = 14), diabetes group ( n = 14), and elderly patients with sleep disorders combined with the T2D group (ESdD) ( n = 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 Barnesiella and Marvinbryantia , with 47 metabolites upregulated and 53 metabolites downregulated. The ESdD group showed a decrease in Lachnospiraceae_UCG_010 , 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.