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.

Observation of the efficacy and safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation for patients with prediabetes

Objective:To observe the safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation in treating patients with prediabetes and its effects on blood glucose and lipid metabolism.Methods:One hundred and two patients with prediabetes were divided into a manipulation group and a control group according to the random number table method,with 51 cases in each group.All patients received the general behavioral intervention for prediabetes,with additional Song-Relaxing and Zhen-Vibrating abdomen manipulation in the manipulation group and oral metformin hydrochloride tablets in the control group.Both groups received the intervention for six months.Results:Fourteen patients dropped out during the treatment,and a total of 88 patients completed the trial,including 45 cases in the manipulation group and 43 cases in the control group.After the treatment,the prediabetes control rate was 93.3%in the manipulation group and 74.4%in the control group,and the difference between the two groups was statistically significant(P<0.05);no patient in the manipulation group progressed to diabetes,while the rate of conversion to diabetes in the control group was 6.9%,with a significant difference between the two groups(P<0.05).After the treatment,the body mass index(BMI),glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2-hour postload plasma glucose(2hPG)level during an oral glucose tolerance test(OGTT),fasting insulin(FINS),homeostasis model assessment-2 of insulin resistance(HOMA2-IR),total cholesterol(TC),and triglycerides(TG)decreased in both groups versus baseline,with significant differences within the groups;the levels of all indicators were lower in the manipulation group than in the control group(P<0.05),and the differences between the two groups were more prominent at the sixth month(P<0.01).At the sixth month,the high-density lipoprotein cholesterol(HDL-C)in the manipulation group was increased,while there was no significant change in the control group.In the control group,three patients reported mild gastrointestinal reactions at the initial dosing,which improved after medication adjustment.No other adverse events were observed in either group.Conclusion:Both metformin hydrochloride tablets and the Song-Relaxing and Zhen-Vibrating abdomen manipulation can improve blood glucose and lipid metabolism and reduce insulin resistance and clinical discomfort in patients with prediabetes,but the Song-Relaxing and Zhen-Vibrating abdomen manipulation has higher efficacy and safety.