Associations of Insomnia With Hypertension and Coronary Artery Disease Among Patients With Type 2 Diabetes Mellitus

Yonghui Hu; Zhiyue Yan; Zhenrui Fu; Congqing Pan

doi:10.3389/fcvm.2021.730654

Associations of Insomnia With Hypertension and Coronary Artery Disease Among Patients With Type 2 Diabetes Mellitus

Front Cardiovasc Med. 2021 Nov 19:8:730654. doi: 10.3389/fcvm.2021.730654. eCollection 2021.

Authors

Yonghui Hu¹, Zhiyue Yan¹, Zhenrui Fu², Congqing Pan¹

Affiliations

¹ National Health Commission (NHC), Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
² Department of Urology, Affiliated Zhongda Hospital of Southeast University, Southeast University, Nanjing, China.

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.

Keywords: coronary artery disease; hypertension; insomnia; propensity score matching; type 2 diabetes mellitus.