Interaction of poor sleep quality, family history of type 2 diabetes, and abdominal obesity on impaired fasting glucose: a population-based cross-sectional survey in China

This study aims to explore the interaction of sleep quality, family history of type 2 diabetes, and obesity in relation to impaired fasting glucose in a Chinese population. A representative population-based cross-sectional study was conducted, and 15,145 residents aged between 18 and 75 years were selected from 11 districts of Xuzhou City, Jiangsu Province. The Pittsburgh Sleep Quality Index was used to evaluate sleep conditions, with categories of good and poor. Impaired fasting glucose (IFG) was assessed by fasting blood glucose. Interaction of sleep quality, obesity, and family history of diabetes (FHD) on IFG was analyzed by logistic regression. Relative excess risk due to interaction (RERI) and the synergy index (SI) were applied to evaluate the additive interaction between the two factors. Either poor sleep or positive FHD was independently associated with an increased odds ratio (OR) for IFG. Those with both poor sleep and positive FHD had a significantly increased risk compared with those without poor sleep and FHD (OR 20.6, 95 % confidence interval (CI) 16.4–29.0, P < 0.001). The corresponding RERI and SI was 14.6 (8.6–20.6) and 3.7 (1.4–5.1), respectively. Both abdominal obesity and FHD significantly increased the risk of being IFG. The synergistic effect of abdominal obesity and FHD on IFG was statistically significant (OR 40.1, 95 % CI 28.8–61.5). The results suggest that additive interactions exist between poor sleep quality, abdominal obesity, and family history of diabetes in relation to impaired fasting glucose.