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Purpose: 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). Materials and Methods: 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. Results: 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, reflectinga 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 significantassociation between snoring frequency and HOMA-IR was detected in either gender. Conclusion: We discovered a gender-specific association between snoring and HbA1c level in a healthy, community-dwelling populationfree of DM.

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