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However, results from large population-based prospective cohort studies are rare. The main aim of the present study was to investigate the relative risk of 8-year incident type 2 diabetes in relation to OSA severity in a prospective cohort study of middle-aged and older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 2918 participants (mean age 59\u2005years) of the Korean Genome and Epidemiology Study (KoGES), who underwent home-based overnight polysomnography at baseline examination between 2011 and 2014, were followed up 4-yearly between 2015\u20132018 and 2019\u20132021. A total of 1697 participants were present in both follow-ups. After excluding participants who had diabetes at baseline (n=481), a total of 1216 participants were eligible for the analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>OSA at baseline was categorised by apnoea\u2013hypopnoea index levels as non-OSA (0\u20134.9\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>), mild OSA (5.0\u201314.9\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>) and moderate\u2013severe OSA (\u226515.0\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>). Incident type 2 diabetes was identified at each follow-up. Compared with non-OSA, participants with moderate\u2013severe OSA had 1.5 times higher risk of developing type 2 diabetes at the end of the 8-year follow-up after adjusting for potential covariates (relative risk 1.50, 95% CI 1.02\u20132.21). In the same analytical models for 4-year relative risk of incident type 2 diabetes, none of the OSA groups were at significantly higher risk compared with the non-OSA group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Moderate<jats:bold>\u2013<\/jats:bold>severe OSA, a modifiable risk factor, poses a higher risk of incident type 2 diabetes compared with non-OSA over an 8-year period in general middle-aged and older adults.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00401-2022","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T17:05:27Z","timestamp":1677171927000},"page":"00401-2022","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Obstructive sleep apnoea and long-term risk of incident diabetes in the middle-aged and older general population"],"prefix":"10.1183","volume":"9","author":[{"given":"Ali 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