Yonsei Med J.  2017 Nov;58(6):1152-1159. 10.3349/ymj.2017.58.6.1152.

A Gender-Specific Association between Self-Reported Snoring and Hemoglobin A1c Levels in a General Population without Type 2 Diabetes Mellitus

  • 1Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
  • 2Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.
  • 3Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea. mhshinx@paran.com
  • 4Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 5Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
  • 6Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Korea.
  • 7Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea.
  • 8Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Korea.


We explored whether a gender difference was evident in terms of the associations of snoring with hemoglobin A1c (HbA1c) and homeostatic model assessment-insulin resistance (HOMA-IR) levels in a healthy population without type 2 diabetes mellitus (DM).
We analyzed 2706 males and 4080 females who participated in the baseline survey of the Namwon Study. In terms of self-reported snoring frequency, participants were classified as non-snorers or occasional (1-3 days/week), frequent (4-6 days/week), or constant (7 days/week) snorers. Participants with DM, defined as a fasting blood glucose level ≥126 mg/dL and/or use of insulin or hypoglycemic medication, were excluded from the analysis.
In females, the fully adjusted mean (95% confidence interval) HbA1c levels in non-snorers and in occasional, frequent, and constant snorers were 5.53% (5.47-5.59%), 5.53% (5.47-5.59%), 5.57% (5.49-5.64%), and 5.57% (5.51-5.64%), respectively, reflecting a dose-response relationship (p trend=0.004). Compared with female non-snorers, the risk of an elevated HbA1c level (top quintile, ≥5.9%) in constant snorers remained significant (odds ratio 1.30, 95% confidence interval 1.02-1.66) after full adjustment. In addition, in females, a significant linear trend in HbA1c level odds ratio by increased snoring frequency was apparent (p trend=0.019 in model 3). In contrast, no significant association between snoring frequency and HbA1c level was identified in males. No significant association between snoring frequency and HOMA-IR was detected in either gender.
We discovered a gender-specific association between snoring and HbA1c level in a healthy, community-dwelling population free of DM.


Snoring; hemoglobin A; glycosylated; insulin resistance; gender
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