Abstract
Purpose: This study aimed to determine whether insomnia is associated with hypertension (HBP) and coronary artery disease (CAD) in a hospital-based sample of patients with type 2 diabetes mellitus (T2DM).Methods: Our present study included 354 patients with T2DM. According to the diagnostic criteria of insomnia, the participants were assigned to three groups based on the duration of T2DM and insomnia diagnosis. Patients with T2DM alone were placed in group A; patients with T2DM longer than insomnia were placed in group B; and patients with insomnia longer than T2DM were placed in group C. Medical history was collected from all the patients in detail. Besides, the participants underwent thorough physical examinations and laboratory measurements. Propensity score matching (PSM) was applied to evaluate the associations of insomnia with HBP and CAD. The univariate and multivariate logistic regression analysis was used to explore whether insomnia was a risk factor for HBP and CAD in patients with T2DM.Results: Of 354 patients, 225 patients were included in group A, 62 patients were included in group B, and 67 patients were included in group C. Compared with groups B and C, group A showed a lower prevalence of HBP and CAD (p < 0.05). In addition, compared with group B, group C showed no difference in the prevalence of HBP and CAD (p > 0.05). After PSM was performed, groups B and C had a higher prevalence of HBP and CAD (p < 0.05) than group A with no significant difference between groups B and C (p > 0.05). In the univariate and multivariate logistic regression analysis, insomnia was a risk factor for HBP [univariate: odds ratio (OR) = 3.376, 95% CI 2.290–6.093, p < 0.001; multivariate: OR = 2.832, 95% CI 1.373–5.841, p = 0.005] and CAD (univariate: OR = 5.019, 95% CI 3.148–8.001, p < 0.001; multivariate: OR = 5.289, 95% CI 2.579–10.850, p < 0.001).Conclusion: T2DM combined with insomnia was related to HBP and CAD and insomnia was a risk factor for HBP and CAD in patients with T2DM. However, larger, prospective studies are required to confirm our findings.
Highlights
Diabetes mellitus influences more than 463 million people worldwide and is one of the most important public health issues [1]
The patients were divided into three groups: patients with type 2 diabetes mellitus (T2DM) only were assigned to group A; if the duration of T2DM was longer than insomnia, the patients were assigned to group B (T2DM combined with insomnia group); and if the duration of insomnia was longer than T2DM, the patients were assigned to group C
225 patients were divided into group A (T2DMalone group), 62 patients were assigned to group B (T2DM combined with insomnia), and 67 patients were assigned to group C
Summary
Diabetes mellitus influences more than 463 million people worldwide and is one of the most important public health issues [1]. The number may well-increase on account of the rising obesity rate, which is a major cause of the increase in the global incidence of type 2 diabetes mellitus (T2DM) [2]. It is well-established that T2DM deeply compromises the cardiovascular system, kidneys, nerves, and eyes and is strongly associated with a series of complications. Cardiovascular events, heart failure, and atherosclerosis are mainly caused by damage to the macrovasculature These complications are the primary cause of morbidity and mortality risks in patients with T2DM. Low subjective sleep quality and increased subjective insomnia symptoms [8] have been associated with higher glycosylated hemoglobin A1c (HbA1c) in patients with T2DM
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