Hu Yonghui, Yan Zhiyue, Fu Zhenrui, Pan Congqing
National Health Commission (NHC), Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
Department of Urology, Affiliated Zhongda Hospital of Southeast University, Southeast University, Nanjing, China.
Front Cardiovasc Med. 2021 Nov 19;8:730654. doi: 10.3389/fcvm.2021.730654. eCollection 2021.
This study aimed to determine whether insomnia is associated with hypertension (HBP) and coronary artery disease (CAD) in a hospital-based sample of patients with type 2 diabetes mellitus (T2DM). Our present study included 354 patients with T2DM. According to the diagnostic criteria of insomnia, the participants were assigned to three groups based on the duration of T2DM and insomnia diagnosis. Patients with T2DM alone were placed in group A; patients with T2DM longer than insomnia were placed in group B; and patients with insomnia longer than T2DM were placed in group C. Medical history was collected from all the patients in detail. Besides, the participants underwent thorough physical examinations and laboratory measurements. Propensity score matching (PSM) was applied to evaluate the associations of insomnia with HBP and CAD. The univariate and multivariate logistic regression analysis was used to explore whether insomnia was a risk factor for HBP and CAD in patients with T2DM. Of 354 patients, 225 patients were included in group A, 62 patients were included in group B, and 67 patients were included in group C. Compared with groups B and C, group A showed a lower prevalence of HBP and CAD ( < 0.05). In addition, compared with group B, group C showed no difference in the prevalence of HBP and CAD ( > 0.05). After PSM was performed, groups B and C had a higher prevalence of HBP and CAD ( < 0.05) than group A with no significant difference between groups B and C ( > 0.05). In the univariate and multivariate logistic regression analysis, insomnia was a risk factor for HBP [univariate: odds ratio (OR) = 3.376, 95% CI 2.290-6.093, < 0.001; multivariate: OR = 2.832, 95% CI 1.373-5.841, = 0.005] and CAD (univariate: OR = 5.019, 95% CI 3.148-8.001, < 0.001; multivariate: OR = 5.289, 95% CI 2.579-10.850, < 0.001). T2DM combined with insomnia was related to HBP and CAD and insomnia was a risk factor for HBP and CAD in patients with T2DM. However, larger, prospective studies are required to confirm our findings.
本研究旨在确定在以医院为基础的2型糖尿病（T2DM）患者样本中，失眠是否与高血压（HBP）和冠状动脉疾病（CAD）相关。我们目前的研究纳入了354例T2DM患者。根据失眠的诊断标准，参与者根据T2DM病程和失眠诊断被分为三组。单纯T2DM患者被归入A组；T2DM病程长于失眠的患者被归入B组；失眠病程长于T2DM的患者被归入C组。详细收集了所有患者的病史。此外，参与者还接受了全面的体格检查和实验室检测。采用倾向得分匹配（PSM）来评估失眠与HBP和CAD的关联。使用单因素和多因素逻辑回归分析来探讨失眠是否为T2DM患者发生HBP和CAD的危险因素。在354例患者中，A组纳入225例患者，B组纳入62例患者，C组纳入67例患者。与B组和C组相比，A组的HBP和CAD患病率较低（<0.05）。此外，与B组相比，C组的HBP和CAD患病率无差异（>0.05）。进行PSM后，B组和C组的HBP和CAD患病率高于A组（<0.05），B组和C组之间无显著差异（>0.05）。在单因素和多因素逻辑回归分析中，失眠是HBP的危险因素[单因素：比值比（OR）=3.376，95%可信区间（CI）2.290 - 6.093，<0.001；多因素：OR = 2.832，95%CI 1.373 - 5.841，=0.005]和CAD的危险因素（单因素：OR = 5.019，95%CI 3.148 - 8.001，<0.001；多因素：OR = 5.289，95%CI 2.579 - 10.850，<0.001）。T2DM合并失眠与HBP和CAD相关，且失眠是T2DM患者发生HBP和CAD的危险因素。然而，需要更大规模的前瞻性研究来证实我们的发现。
