Um Yoo Hyun, Kim Tae-Won, Jeong Jong-Hyun, Hong Seung-Chul, Seo Ho-Jun, Han Kyung-Do
Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
Front Endocrinol (Lausanne). 2022 Jul 14;13:939251. doi: 10.3389/fendo.2022.939251. eCollection 2022.
Previous studies have suggested a close link between sleep disturbances and diabetic retinopathy (DR). However, to date, no confirmatory findings have been reported. We aimed to explore the risk of insomnia in DR by considering demographic factors and diabetes mellitus (DM)-related variables.
A nationwide population-based cohort of 2,206,619 patients with type 2 diabetes from the Korean National Insurance Service Database was followed up for insomnia incidence. DR, non-proliferative DR (NPDR), and proliferative DR (PDR) were defined according to ICD-10 codes. The interactive effects of sex, age, and DM-related variables were analyzed to evaluate their impact on insomnia risk in DR.
Compared with the non-DR group, insomnia risk was increased in the DR [(adjusted hazard ratio (aHR): 1.125, 95% confidence interval (CI):1.108-1.142), NPDR (aHR:1.117, 95% CI:1.099-1.134), and PDR (aHR:1.205, 95% CI: 1.156-1.256), even after controlling for comorbidities, lifestyle factors, and DM-related variables. The men and youngest age groups (<40 years) were most vulnerable to insomnia risk. Sex, age, DM duration, and chronic kidney disease (CKD) status exerted interactive effects with DR status in increasing the insomnia risk. In the PDR group, sex, age, DM duration, insulin therapy status, and CKD status exerted interactive effects that increased the risk of insomnia.
Insomnia risk is significantly higher in patients with DR, and clinical attention is warranted.
先前的研究表明睡眠障碍与糖尿病视网膜病变（DR）之间存在密切联系。然而，迄今为止，尚无确凿的研究结果报道。我们旨在通过考虑人口统计学因素和糖尿病（DM）相关变量来探讨DR患者发生失眠的风险。
基于韩国国民保险服务数据库中2206619例2型糖尿病患者的全国性队列，对失眠发病率进行随访。根据国际疾病分类第10版（ICD - 10）编码定义DR、非增殖性DR（NPDR）和增殖性DR（PDR）。分析性别、年龄和DM相关变量的交互作用，以评估它们对DR患者失眠风险的影响。
与非DR组相比，即使在控制了合并症、生活方式因素和DM相关变量后，DR组（调整后风险比（aHR）：1.125，95%置信区间（CI）：1.108 - 1.142）、NPDR组（aHR：1.117，95% CI：1.099 - 1.134）和PDR组（aHR：1.205，95% CI：1.156 - 1.256）的失眠风险均增加。男性和最年轻年龄组（<40岁）最易发生失眠风险。性别、年龄、DM病程和慢性肾脏病（CKD）状态与DR状态在增加失眠风险方面存在交互作用。在PDR组中，性别、年龄、DM病程、胰岛素治疗状态和CKD状态存在交互作用，增加了失眠风险。
DR患者的失眠风险显著更高，值得临床关注。
