Synergistic Effects of Incident Diabetes Between Snoring, Family History of Diabetes, and Obesity

Abstract

Objective: The general public recognizes the connections between obesity, family history of diabetes (FHD), and diabetes, but remains unaware of synergistic effects that occur due to their combination. In this study, we investigate the synergistic effects of event diabetes between snoring, FHD, and obesity. Materials and Methods: Study subjects were selected among participants in the Korean Genome and Epidemiology Study Ansan-Ansung cohort, an ongoing prospective population-based study. Ansan-Ansung cohort initiated in 2001 and 2002 and has been followed biennially. At baseline, the initial cohort of 10.030 subjects, aged 40 to 69 years. A total of 5.759 participants were included in this study. The relationships between diabetes and snoring, FHD, and obesity were estimated using Cox hazard regression models after adjusting for confounding factors. Snoring, obesity and FHD were significantly associated with diabetes in both males and females after adjustments for covariates. However, males were significantly more likely to have FHD and obesity. Results: A synergistic effect between these two risk factors showed that being female was associated with the all group after adjustment for covariates. Moreover, there was a high risk of having two risk factors among female patients, while males showed no such tendency. A significant synergistic effect between these three risk factors was seen in females. An exposure group with these three factors had higher diabetes risk than other groups [hazard ratio (HR): 6.27 (95% confidence interval (CI): 2.93-13.41] p<0.01, but this was not seen in males. Especially, premenopausal women was showed significant with FHD, obese, habitual snorer [HR=5.69 (95% CI: 2.31-14.02) p<0.01]. But postmenopausal women was showed significant with FHD and habitual snorer both non-obese and obese [HR=7.22 (95% CI: 1.68-30.99) p=0.01 and HR=7.85 (95% CI: 1.88-32.82) p<0.01, respectively]. Conclusion: The combination of obesity, FHD, and habitual snoring was associated with greater susceptibility to diabetes in female patients, while obesity and habitual snoring was associated with greater susceptibility to diabetes in males.