Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Diabetes Metab Res Rev. 2018 Jan;34(1). doi: 10.1002/dmrr.2930. Epub 2017 Oct 4.
We investigated the risk of type 2 diabetes mellitus (T2DM) in patients with and without insomnia.
In this historical cohort study, we performed a secondary analysis of data from 2001 to 2010, which was obtained from Taiwan's National Health Insurance Database. We developed a Cox proportional hazard regression model to estimate the effects of insomnia on T2DM risk. Kaplan-Meier survival analysis was applied to compare the differences in the cumulative incidence of T2DM between the groups with and without insomnia.
During the follow-up period, the T2DM incidence rate of patients with insomnia was significantly higher than that of patients without insomnia (34.7 vs 24.3 per 1000 person-years). Overall, patients with insomnia had a higher risk of T2DM than did patients without insomnia (adjusted hazard ratio, 1.16; 95% confidence interval [CI], 1.10-1.19). Among patients aged younger than 40 years, those with insomnia had a higher risk of T2DM than did the comparison cohort (adjusted hazard ratio, 1.31; 95% CI, 1.14-1.55). Compared with patients without insomnia, the risk tended to increase with the duration of follow-up in patients with insomnia; when the insomnia duration was <4 years, 4 to 8 years, and >8 years, the risk of T2DM increased by 1.14, 1.38, and 1.51 times (95% CI, 1.03-1.17, 1.15-1.49, and 1.20-1.86), respectively. Patients with insomnia had a higher risk of T2DM, and this risk was particularly pronounced among the younger (≤40 years) population.
Chronic insomnia could be an important risk factor for T2DM.
本研究旨在探讨失眠与非失眠患者发生 2 型糖尿病（T2DM）的风险。
本回顾性队列研究利用台湾全民健康保险研究数据库的数据（2001 至 2010 年）进行二次分析。采用 Cox 比例风险回归模型评估失眠对 T2DM 风险的影响，Kaplan-Meier 生存分析比较两组患者 T2DM 的累积发病率差异。
在随访期间，失眠患者的 T2DM 发生率明显高于非失眠患者（34.7 比 24.3/1000 人年）。总体而言，失眠患者发生 T2DM 的风险高于非失眠患者（调整后的风险比 1.16，95%置信区间[CI]为 1.10-1.19）。在年龄<40 岁的患者中，失眠患者发生 T2DM 的风险高于对照组（调整后的风险比 1.31，95%CI 为 1.14-1.55）。与非失眠患者相比，失眠患者随着随访时间的延长，发生 T2DM 的风险呈上升趋势；当失眠持续时间<4 年、4-8 年和>8 年时，T2DM 的风险分别增加 1.14 倍、1.38 倍和 1.51 倍（95%CI 为 1.03-1.17、1.15-1.49 和 1.20-1.86）。失眠是 T2DM 的一个重要危险因素，在年轻（≤40 岁）人群中尤为明显。
慢性失眠可能是 T2DM 的一个重要危险因素。
