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Objective To examine the mediating effect of obesity indicators on the association between daytime napping and type 2 diabetes mellitus (T2DM) qualitatively and quantitatively using baseline data from the Guangzhou Biobank Cohort Study. Methods Twenty-nine thousand three hundred fifty-five participants aged 50+ years were included in this cross-sectional study. Mediation analysis was used to assess the mediating effect of body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) on the association between daytime napping and T2DM after adjustment for sex, age, education, occupation, smoking status, alcohol use and physical activity. Results The mean (standard deviation) age of participants was 61.5 ( 7.1) years. The prevalence of T2DM and daytime napping was 12.5% and 65.2%, respectively. After adjustment for potential confounders, WC, WHR and WHtR showed partial mediating effects on the association between daytime napping and T2DM, with the proportion (95% confidence interval) of mediation effect being 10.17% (8.14–14.43%), 14.91% (11.95–21.24%) and 9.36% (7.49–13.29%), respectively. No mediating effect of BMI or HC on the association between daytime napping and T2DM was found. Conclusions Our results showed significant mediating effects of WC, WHR and WHtR on the association between daytime napping and T2DM, suggesting that waist circumference management could be important in daytime nappers.

Obesity indicators as mediators of association between daytime napping and type 2 diabetes mellitus: the Guangzhou Biobank Cohort Study