Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes

Background：Several previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes,but rare study has shown the association between snoring frequency and prediabetes,particularly in China.We hypothesized that individuals who snore might have a higher risk of prediabetes.This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population.Methods：A cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old.All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements.A 75 g oral glucose tolerance test was performed in individuals without diabetes.Blood samples of all participants were collected;blood glucose and blood fat levels were measured.Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes.Results：A total of 13,592 participants （female：66.56%;mean age：56.8 ＆#177; 7.9 years;mean body mass index：25.5 ± 3.4 kg/m2） were included in the final analysis.Of these,30.9% were diagnosed with prediabetes,while 41.3% and 25.4% had occasional and habitual snoring,respectively.Habitual snoring was associated with an increased risk of prediabetes （odds ratio [OR]：1.3,95% confidence interval [CI]：1.1-1.4,P 〈 0.001）,after adjusting for diabetes and sleep-related confounders in the multivariable models.Habitual snoring was also associated with isolated impaired fasting glucose （IFG;OR：1.3,95% CI：1.0-1.6;P 〈 0.001） and isolated impaired glucose tolerance （IGT;OR：1.3,95% CI：1.2-1.5;P 〈 0.001）,but not IFG ＋ IGT （OR：1.1,95% CI：0.9-1.4;P =0.281）.When stratified by total cholesterol （TC） levels,this association between habitual snoring and prediabetes was observed only in individuals with TC 〈5.6 mmol/L （OR：1.4,95% CI：1.2-1.6;P〈 0.001）.Conclusions：Habitual snoring is associated with prediabetes,but only in individuals with TC 〈5.6 mmol/L.Further prospective studies are needed to confirm this finding.

Evaluation of Basal Serum Adrenocorticotropic Hormone and Cortisol Levels and Their Relationship with Nonalcoholic Fatty Liver Disease in Male Patients with Idiopathic Hypogonadotropic Hypogonadism

Background： Prolonged gonadal hormone deficiency in patients with idiopathic hypogonadotropic hypogonadism （IHH） may produce adverse effects on the endocrine homeostasis and metabolism. This study aimed to compare basal serum adrenocorticotropic hormone （ACTH） and cortisol levels between male IHH patients and healthy controls. Moreover, this study compared the basal hypothalamic-pituitary-adrenal （HPA） axis in patients with and without nonalcoholic fatty liver disease （NAFLD）, and also evaluated the relationship between basal HPA axis and NAFLD in male IHH patients. Methods： This was a retrospective case-control study involving 75 Chinese male IHH patients （mean age 21.4 ± 3.8 years, range 17 30 years） and 135 healthy controls after matching tbr gender and age. All subjects underwent physical examination and blood testing for serum testosterone, luteinizing hormone, follicle-stimulating hormone. ACTH, and cortisol and biochemical tests. Results： Higher basal serum ACTH levels （8.25 ±3.78 pmol/L vs. 6.97 ±2.81 pmol/L） and lower cortisol levels （366.70 ±142.48 nmol/L vs. 452.82 ± 141.53 nmol/L） were observed ill male IHH patients than healthy subjects （all P 〈 0.05）. IHH patients also showed higher metabolism parameters and higher prevalence rate of NAFLD （34.9% vs. 4.4%） than the controls （all P 〈 0.05）. Basal serum ACTH （9.91 ±4.98 pmol/L vs. 7.60 ±2.96 pmol/L） and dehydroepiandrosterone sulfate （2123.7 ±925.8 μg/L vs. 1417.1 ±498.4 μg/L） levels were significantly higher in IHH patients with NAFLD than those without NAFLD （all P 〈 0.05）. We also found that basal serum ACTH levels were positively correlated with NAFLD （r = 0.289, P 〈 0.05） and triglyceride levels （r - 0.268, P 〈 0.05） in male IHH patients. Furthermore, NAFLD was independently associated with ACTH levels in male IHH patients by multiple linear regression analysis. Conclusions： The male IHH patients showed higher basal serum ACTH levels and lower cortisol levels than matched healthy controls. NAFLD was an independent associated factor for ACTH levels in male IHH patients. These preliminary findings provided evidence of the relationship between basal serum ACTH and NAFLD in male IHH patients.