Diabetes & Metabolism Journal

Original Articles

Complications
Association of Snoring with Prediabetes and Type 2 Diabetes Mellitus: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort: So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim; Diabetes Metab J. 2020;44(5):687-698. Published online April 16, 2020; DOI: https://doi.org/10.4093/dmj.2019.0128

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Background

Evidence suggests that habitual snoring is an independent risk factor for poor glycemic health. We examined the associations between snoring with prediabetes and diabetes in Korean population.

Methods

Self-reported snoring characteristics were collected from 3,948 middle-aged adults without prior cardiovascular diseases. Multivariable linear regression assessed the association of snoring intensity, frequency, disruptiveness, and disrupted breathing with fasting glucose and glycosylated hemoglobin (HbA1c) level. Then, multinomial regression evaluated how increasing snoring symptoms are associated with the risk for prediabetes and diabetes, adjusting for socioeconomic and behavioral risk factors of diabetes, obesity, hypertension, and other sleep variables.

Results

Higher snoring intensity and frequency were positively associated with fasting glucose and HbA1c levels. Participants presenting the most severe snoring were at 1.84 times higher risk (95% confidence interval [CI], 1.09 to 2.29) for prediabetes and 2.24 times higher risk (95% CI, 1.84 to 2.95) for diabetes, compared to non-snorers. Such graded association was also observed amongst the most frequent snorers with higher risk for prediabetes (odds ratio [OR], 1.78; 95% CI, 1.29 to 2.22) and diabetes (OR, 2.03; 95% CI, 1.45 to 2.85). Disruptive snoring (OR, 1.60; 95% CI, 1.12 to 2.28) and near-daily disruptive breathing (OR, 2.18; 95% CI, 1.02 to 4.19) were associated with higher odds for diabetes. Such findings remained robust after additional adjustment for sleep duration, excessive daytime sleepiness, unwakefulness, and sleep-deprived driving.

Conclusion

Snoring is associated with impaired glucose metabolism even in otherwise metabolically healthy adults. Habitual snorers may require lifestyle modifications and pharmacological treatment to improve glycemic profile.

Citations

Citations to this article as recorded by

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Mei-Hsiang Lin, Ping-Ru Hsiao, Ning-Hung Chen, Chao-Chung Ho, Hsiu-Chin Hsu
Biological Research For Nursing.2026;[Epub] CrossRef
Classification and identification of risk factors for type 2 diabetes
Shan-Shan Tang, Xue-Fei Zhao, Xue-Dong An, Wen-Jie Sun, Xiao-Min Kang, Yu-Ting Sun, Lin-Lin Jiang, Qing Gao, Ze-Hua Li, Hang-Yu Ji, Feng-Mei Lian
World Journal of Diabetes.2025;[Epub] CrossRef
Prediabetes and sleep patterns: Linking poor sleep to adverse outcomes through metabolic syndrome
Zixuan Huang, Jie Deng, Hang Li, Shubin Fang, Yi Wei, Wenbin Lei, Weiping Wen, Lin Chen
Diabetes Research and Clinical Practice.2025; 221: 112044. CrossRef
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Journal of Diabetes & Metabolic Disorders.2025;[Epub] CrossRef
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Yong-Mi Kim, Chie Noyori-Corbett
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Exploring the Link Between Obstructive Sleep Apnea and Diabetes Mellitus: A Retrospective Single-Center Analysis
Mara Andreea Vultur, Dragoș Huțanu, Edith Simona Ianoși, Hédi-Katalin Sárközi, Corina Eugenia Budin, Maria Beatrice Ianoși, Mioara Szathmáry, Gabriela Jimborean
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BMC Public Health.2025;[Epub] CrossRef
Does seasonality affect snoring? A study based on international data from the past decade
Ping Wang, Cai Chen, Xingwei Wang, Ningling Zhang, Danyang Lv, Wei Li, Fulai Peng, Xiuli Wang
Sleep and Breathing.2023; 27(4): 1297. CrossRef
Association Between Snoring and Diabetes Among Pre- and Postmenopausal Women
Yun Yuan, Fan Zhang, Jingfu Qiu, Liling Chen, Meng Xiao, Wenge Tang, Qinwen Luo, Xianbin Ding, Xiaojun Tang
International Journal of General Medicine.2022; Volume 15: 2491. CrossRef
Elevated fasting insulin results in snoring: A view emerged from causal evaluation of glycemic traits and snoring
Minhan Yi, Quanming Fei, Kun Liu, Wangcheng Zhao, Ziliang Chen, Yuan Zhang
European Journal of Clinical Investigation.2022;[Epub] CrossRef
Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar
Hiba Bawadi, Asma Al Sada, Noof Al Mansoori, Sharifa Al Mannai, Aya Hamdan, Zumin Shi, Abdelhamid Kerkadi
International Journal of Environmental Research and Public Health.2021; 18(8): 4017. CrossRef
Changes in creatinine‐to‐cystatin C ratio over 4 years, risk of diabetes, and cardiometabolic control: The China Health and Retirement Longitudinal Study
Shanhu Qiu, Xue Cai, Yang Yuan, Bo Xie, Zilin Sun, Tongzhi Wu
Journal of Diabetes.2021; 13(12): 1025. CrossRef
Association Between Self-Reported Snoring and Metabolic Syndrome: A Systematic Review and Meta-Analysis
Jinsha Ma, Huifang Zhang, Hui Wang, Qian Gao, Heli Sun, Simin He, Lingxian Meng, Tong Wang
Frontiers in Neurology.2020;[Epub] CrossRef
Early Development of Bidirectional Associations between Sleep Disturbance and Diabetes
Yongin Cho
Diabetes & Metabolism Journal.2020; 44(5): 668. CrossRef

Metabolic Risk/Epidemiology
Sex-, Age-, and Metabolic Disorder-Dependent Distributions of Selected Inflammatory Biomarkers among Community-Dwelling Adults: So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim; Diabetes Metab J. 2020;44(5):711-725. Published online April 16, 2020; DOI: https://doi.org/10.4093/dmj.2019.0119

11,644 View
93 Download
7 Web of Science
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Abstract PDF Supplementary Material PubReader ePub

Background

Inflammatory cytokines are increasingly utilized to detect high-risk individuals for cardiometabolic diseases. However, with large population and assay methodological heterogeneity, no clear reference currently exists.

Methods

Among participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort, of community-dwelling adults aged 30 to 64 without overt cardiovascular diseases, we presented distributions of tumor necrosis factor (TNF)-α and -β, interleukin (IL)-1α, -1β, and 6, monocyte chemoattractant protein (MCP)-1 and -3 and high sensitivity C-reactive protein (hsCRP) with and without non-detectable (ND) measurements using multiplex enzyme-linked immunosorbent assay. Then, we compared each markers by sex, age, and prevalence of type 2 diabetes mellitus, hypertension, and dyslipidemia, using the Wilcoxon Rank-Sum Test.

Results

In general, there were inconsistencies in direction and magnitude of differences in distributions by sex, age, and prevalence of cardiometabolic disorders. Overall, the median and the 99th percentiles were higher in men than in women. Older participants had higher TNF-α, high sensitivity IL-6 (hsIL-6), MCP-1, hsCRP, TNF-β, and MCP-3 median, after excluding the NDs. Participants with type 2 diabetes mellitus had higher median for all assayed biomarkers, except for TNF-β, IL-1α, and MCP-3, in which the medians for both groups were 0.00 due to predominant NDs. Compared to normotensive group, participants with hypertension had higher TNF-α, hsIL-6, MCP-1, and hsCRP median. When stratifying by dyslipidemia prevalence, the comparison varied significantly depending on the treatment of NDs.

Conclusion

Our findings provide sex-, age-, and disease-specific reference values to improve risk prediction and diagnostic performance for inflammatory diseases in both population- and clinic-based settings.

Citations

Citations to this article as recorded by

Impact of Sex on Plasma Biomarkers in ob/ob Mice
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Anna Lena Huber, Angelika Bauer, Julius Beirer, Katharina Frede, Katharina Kirchmair, Reinhard Angermann, Matus Rehak, Claus Zehetner, Yvonne Nowosielski
Graefe's Archive for Clinical and Experimental Ophthalmology.2025; 263(5): 1259. CrossRef
Immune regulation mechanism of polysaccharide from Dendrobium officinale Kimura et Migo on intestinal lamina propria cells
Jia Li, Xiaoli Yang, Ziying Zheng, Shuang Song, Yang Tian, Zhongbin Bai
Food Bioscience.2025; 71: 107410. CrossRef
Characterizing CD8+ TEMRA Cells in CP/CPPS Patients: Insights from Targeted Single-Cell Transcriptomic and Functional Investigations
Fei Zhang, Qintao Ge, Jialin Meng, Jia Chen, Chaozhao Liang, Meng Zhang
ImmunoTargets and Therapy.2024; Volume 13: 111. CrossRef
Within-subject variation of C-reactive protein and high-sensitivity C-reactive protein: A systematic review and meta-analysis
Alex Gough, Alice Sitch, Erica Ferris, Tom Marshall, Andreas Zirlik
PLOS ONE.2024; 19(11): e0304961. CrossRef
Association between physical activity and inflammatory markers in community-dwelling, middle-aged adults
So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Justin Y. Jeon, Hyeon Chang Kim
Applied Physiology, Nutrition, and Metabolism.2021; 46(7): 828. CrossRef
The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges
Thomas S. Buttle, Claire Y. Hummerstone, Thippeswamy Billahalli, Richard J. B. Ward, Korina E. Barnes, Natalie J. Marshall, Viktoria C. Spong, Graham H. Bothamley, Selvakumar Subbian
PLOS ONE.2021; 16(8): e0247745. CrossRef

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