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在无2型糖尿病的普通人群中,自我报告的打鼾与糖化血红蛋白水平之间的性别特异性关联。

A Gender-Specific Association between Self-Reported Snoring and Hemoglobin A1c Levels in a General Population without Type 2 Diabetes Mellitus.

作者信息

Lee Young Hoon, Kweon Sun Seog, Choi Jin Su, Nam Hae Sung, Park Kyeong Soo, Choi Seong Woo, Oh Su Hyun, Kim Sun A, Shin Min Ho

机构信息

Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.

出版信息

Yonsei Med J. 2017 Nov;58(6):1152-1159. doi: 10.3349/ymj.2017.58.6.1152.

Abstract

PURPOSE

We explored whether a gender difference was evident in terms of the associations of snoring with hemoglobin A1c (HbA1c) and homeostatic model assessment-insulin resistance (HOMA-IR) levels in a healthy population without type 2 diabetes mellitus (DM).

MATERIALS AND METHODS

We analyzed 2706 males and 4080 females who participated in the baseline survey of the Namwon Study. In terms of self-reported snoring frequency, participants were classified as non-snorers or occasional (1-3 days/week), frequent (4-6 days/week), or constant (7 days/week) snorers. Participants with DM, defined as a fasting blood glucose level ≥126 mg/dL and/or use of insulin or hypoglycemic medication, were excluded from the analysis.

RESULTS

In females, the fully adjusted mean (95% confidence interval) HbA1c levels in non-snorers and in occasional, frequent, and constant snorers were 5.53% (5.47-5.59%), 5.53% (5.47-5.59%), 5.57% (5.49-5.64%), and 5.57% (5.51-5.64%), respectively, reflecting a dose-response relationship (p trend=0.004). Compared with female non-snorers, the risk of an elevated HbA1c level (top quintile, ≥5.9%) in constant snorers remained significant (odds ratio 1.30, 95% confidence interval 1.02-1.66) after full adjustment. In addition, in females, a significant linear trend in HbA1c level odds ratio by increased snoring frequency was apparent (p trend=0.019 in model 3). In contrast, no significant association between snoring frequency and HbA1c level was identified in males. No significant association between snoring frequency and HOMA-IR was detected in either gender.

CONCLUSION

We discovered a gender-specific association between snoring and HbA1c level in a healthy, community-dwelling population free of DM.

摘要

目的

我们探讨了在无2型糖尿病(DM)的健康人群中,打鼾与糖化血红蛋白(HbA1c)及稳态模型评估胰岛素抵抗(HOMA-IR)水平之间的关联是否存在性别差异。

材料与方法

我们分析了参与南原研究基线调查的2706名男性和4080名女性。根据自我报告的打鼾频率,参与者被分为非打鼾者或偶尔(每周1 - 3天)、频繁(每周4 - 6天)或持续(每周7天)打鼾者。将空腹血糖水平≥126 mg/dL和/或使用胰岛素或降糖药物定义为患有DM的参与者被排除在分析之外。

结果

在女性中,非打鼾者以及偶尔、频繁和持续打鼾者经完全调整后的平均(95%置信区间)HbA1c水平分别为5.53%(5.47 - 5.59%)、5.53%(5.47 - 5.59%)、5.57%(5.49 - 5.64%)和5.57%(5.51 - 5.64%),呈现出剂量反应关系(p趋势 = 0.004)。与女性非打鼾者相比,完全调整后,持续打鼾者HbA1c水平升高(最高五分位数,≥5.9%)的风险仍然显著(优势比1.30,95%置信区间1.02 - 1.66)。此外,在女性中,随着打鼾频率增加,HbA1c水平优势比存在显著的线性趋势(模型3中p趋势 = 0.019)。相比之下,在男性中未发现打鼾频率与HbA1c水平之间存在显著关联。在任何性别中均未检测到打鼾频率与HOMA-IR之间存在显著关联。

结论

我们在无DM的健康社区居住人群中发现了打鼾与HbA1c水平之间的性别特异性关联。

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