title: Association between Self-Reported Habitual Snoring and Diabetes Mellitus: A Systemic Review and Meta-Analysis.
abstract: OBJECTIVE
  Several studies have reported an association between self-reported habitual snoring and diabetes mellitus (DM); however, the results are inconsistent.
  
  
  METHODS
  Electronic databases including PubMed and EMBASE were searched. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the association between snoring and DM using a random-effects model. Heterogeneity, subgroup, and sensitivity analyses were also evaluated. Begg's, Egger's tests and funnel plots were used to evaluate publication bias.
  
  
  RESULTS
  A total of eight studies (six cross sectional and two prospective cohort studies) pooling 101,246 participants were included. Of the six cross sectional studies, the summary OR and 95% CI of DM in individuals that snore compared with nonsnorers were 1.37 (95% CI: 1.20-1.57, p < 0.001). There was no heterogeneity across the included studies (I (2) = 2.9%, p = 0.408). When stratified by gender, the pooled OR (95% CI) was 1.59 (1.20-2.11) in females (n = 12298), and 0.89 (0.65-1.22) in males (n = 4276). Of the two prospective studies, the pooled RR was 1.65 (95% CI, 1.30-2.08).
  
  
  CONCLUSIONS
  Self-reported habitual snoring is statistically associated with DM in females, but not in males. This meta-analysis indicates a need to paying attention to the effect of snoring on the occurrence of DM in females.
authors.affiliation: Department of Endocrinology, Drum Tower Clinical Medical College of Nanjing Medical University, 53 North Zhongshan Road, Nanjing 210008, China.
authors.forename: Xiaolu
authors.initials: X
authors.lastname: Xiong
authors.affiliation: Department of Respiratory Diseases, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China.
authors.forename: Anyuan
authors.initials: A
authors.lastname: Zhong
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Huajun
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Geriatrics, Drum Tower Clinical Medical College of Nanjing Medical University, 53 North Zhongshan Road, Nanjing 210008, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017594:Publication Bias; D057566:Self Report; D012727:Sex Characteristics; D020181:Sleep Apnea, Obstructive / Q000150:complications; D012913:Snoring / Q000150:complications*