You are here

Article Text

Article menu

Download PDFPDF

XML
Epidemiology/Health Services Research
Habitual snoring, adiposity measures and risk of type 2 diabetes in 0.5 million Chinese adults: a 10-year cohort
  1. Yuxia Wei1,
  2. Bang Zheng1,2,
  3. Junning Fan1,
  4. Jun Lv1,3,4,
  5. Yu Guo5,
  6. Zheng Bian5,
  7. Huaidong Du6,7,
  8. Ling Yang6,7,
  9. Yiping Chen6,7,
  10. Jianxin Chen8,
  11. Xunfu Zhong9,
  12. Junshi Chen10,
  13. Zhengming Chen7,
  14. Canqing Yu1,
  15. Liming Li1
  16. on behalf of the China Kadoorie Biobank Collaborative Group
    1. 1Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
    2. 2School of Public Health, Faculty of Medicine, Imperial College London, London, UK
    3. 3Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
    4. 4Peking University Institute of Environmental Medicine, Beijing, China
    5. 5Chinese Academy of Medical Sciences, Beijing, China
    6. 6Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
    7. 7Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
    8. 8Public Health Department, Pengzhou People’s Hospital, Pengzhou, China
    9. 9NCDs Prevention and Control Department, Pengzhou CDC, Pengzhou, China
    10. 10China National Center for Food Safety Risk Assessment, Beijing, China
    1. Correspondence to Dr Canqing Yu; yucanqing{at}pku.edu.cn; Professor Liming Li; lmlee{at}vip.163.com

    Abstract

    Objectives The present study aimed to examine whether habitual snoring was independently associated with risk of type 2 diabetes among Chinese adults, and to assess the role that adiposity measures play in the snoring–diabetes association, as well as to evaluate the joint influence of snoring and adiposity measures on diabetes.

    Research design and methods The China Kadoorie Biobank study recruited 512 715 adults aged 30–79 years from 10 regions in China during 2004 and 2008. Data from 482 413 participants without baseline diabetes were analyzed in the present study. Autoregressive cross-lagged panel analysis was used to assess the longitudinal relationship between adiposity measures and habitual snoring. Cox proportional hazards models were used to examine the association between habitual snoring and diabetes risk.

    Results Both higher body mass index and waist circumference were associated with higher risks of subsequent habitual snoring, whereas no reverse association was detected. A total of 16 479 type 2 diabetes cases were observed during a 10-year follow-up. Habitual snoring was independently associated with 12% (95% CI 6% to 18%) and 14% (95% CI 9% to 19%) higher risks of diabetes among men and women, respectively. Habitual snorers who had general obesity or central obesity were about twice as likely to develop diabetes as non-snorers at the lowest levels of adiposity measures.

    Conclusion Habitual snoring was independently associated with a higher risk of type 2 diabetes among Chinese adults. It is important to maintain both a healthy weight and a normal waist circumference to prevent or alleviate habitual snoring and ultimately prevent diabetes among Chinese adults.

    • sleep
    • adiposity
    • type 2 diabetes
    • Chinese
    http://creativecommons.org/licenses/by-nc/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/bmjdrc-2019-001015

    Statistics from Altmetric.com

      Request Permissions

      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

      View Full Text

      Footnotes

      • YW and BZ are joint first authors.

      • Collaborators The China Kadoorie Biobank Collaborative Group (group members were listed in the online supplementary material).

      • Contributors CY and LL conceived and designed the study. ZC and JunC, as the members of CKB steering committee, designed and supervised the conduct of the whole study, obtained funding, and together with JL, YG, ZB, HD, LY, YC, JiaC, and XZ acquired the data. YW and JF analyzed the data. BZ dealt with methodological issues. YW wrote the first draft of the manuscript. CY and LL contributed to the interpretation of the results and critical revision of the manuscript for valuable intellectual content. All authors reviewed the manuscript and revised it critically when necessary. All authors approved the final manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. CY and LL are the guarantors of the study.

      • Funding This work was supported by the National Key R&D Program of China (2016YFC0900500, 2016YFC0900501, 2016YFC0900504), the Natural Science Foundation of China (91846303), the UK Wellcome Trust (202922/Z/16/Z, 088158/Z/09/Z, 104085/Z/14/Z), and the Kadoorie Charitable Foundation in Hong Kong.

      • Disclaimer The funders had no role in the study design, data collection, data analysis and interpretation, writing of the report, or the decision to submit the article for publication.

      • Competing interests None declared.

      • Patient consent for publication Not required.

      • Ethics approval The CKB study was approved by the Ethical Review Committee of the Chinese Center for Disease Control and Prevention (Beijing, China) and the Oxford Tropical Research Ethics Committee, University of Oxford (UK).

      • Provenance and peer review Not commissioned; externally peer reviewed.

      • Data availability statement Data are available upon reasonable request. Details of how to access China Kadoorie Biobank data and details of the data release schedule are available on www.ckbiobank.org/site/Data+Access.