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鼾症对糖尿病患者卒中风险的影响。

Impact of snoring on the risk of stroke in patients with diabetes mellitus.

机构信息

Department of Medicine, Chonnam National University, Gwangju, Korea.

Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea.

出版信息

Sleep Breath. 2024 Dec;28(6):2675-2682. doi: 10.1007/s11325-024-03131-z. Epub 2024 Aug 16.

Abstract

BACKGROUND

The impact of snoring and diabetes on stroke risk is unclear. This study examined the association between snoring and stroke risk and how it varies with diabetes mellitus (DM) status.

METHODS

This research was conducted as a prospective cohort study. A total of 4,352 subjects were included in the analysis, with a mean follow-up time of 13.7 years. The study used snoring history obtained through interviews as the primary exposure variable and DM as the secondary exposure variable. The main outcome measured was the occurrence of stroke. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Additionally, a joint test was conducted to evaluate the combined effect of snoring and diabetes on the occurrence of stroke.

RESULTS

In our study of 4,352 subjects, 1,135 (26.1%) had a history of snoring, 233 (5.4%) had diabetes mellitus, and over the 18-year observation period, there were 168 cases of new-onset stroke. Snoring was not associated with an increased risk of stroke (HR: 0.95, 95% CI [0.68-1.33]), but DM significantly elevated the risk of stroke (3.02 [1.96-4.65]). In the interaction analysis of snoring and DM status on stroke risk, snoring was a significant risk factor for stroke only in the population with DM (2.89 [1.07-7.60]). Compared to non-snoring and non-DM, the multivariate HRs for stroke were 1.09 (0.76-1.57) for snoring and non-DM, 1.64 (0.83-2.82) for non-snoring and DM, and 2.95 (1.42-5.45) for snoring and DM.

CONCLUSION

Diabetes mellitus was associated with an increased risk of stroke, while a history of snoring was not. In a sub analysis, snoring appeared to be associated with an increased risk of stroke among subjects with diabetes mellitus.

摘要

背景

打鼾和糖尿病对中风风险的影响尚不清楚。本研究旨在探讨打鼾与中风风险之间的关联,以及这种关联如何随糖尿病(DM)状态而变化。

方法

本研究为前瞻性队列研究。共纳入 4352 例受试者,平均随访时间为 13.7 年。研究采用通过访谈获得的打鼾史作为主要暴露变量,DM 作为次要暴露变量。主要结局为中风的发生。采用 Cox 回归分析估计风险比(HRs)和 95%置信区间(CIs)。此外,还进行了联合检验,以评估打鼾和糖尿病对中风发生的综合影响。

结果

在纳入的 4352 例受试者中,1135 例(26.1%)有打鼾史,233 例(5.4%)患有糖尿病,在 18 年的观察期间,有 168 例新发中风。打鼾与中风风险增加无关(HR:0.95,95%CI [0.68-1.33]),但糖尿病显著增加了中风风险(3.02 [1.96-4.65])。在打鼾和 DM 状态对中风风险的交互分析中,只有在 DM 人群中,打鼾才是中风的显著危险因素(2.89 [1.07-7.60])。与非打鼾且非 DM 人群相比,DM 人群中,打鼾且非 DM 的中风多变量 HR 为 1.09(0.76-1.57),非打鼾且 DM 的 HR 为 1.64(0.83-2.82),而打鼾且 DM 的 HR 为 2.95(1.42-5.45)。

结论

糖尿病与中风风险增加相关,而打鼾史与中风风险无关。在亚组分析中,对于患有糖尿病的患者,打鼾似乎与中风风险增加相关。

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