title: Association between sleep duration and urinary albumin excretion in patients with type 2 diabetes: the Fukuoka diabetes registry.
abstract: OBJECTIVE
  Few studies have so far investigated the impact of sleep duration on chronic kidney disease in diabetic patients. The objective of the present study was to examine the relationship between sleep duration and albuminuria in type 2 diabetic patients.
  
  
  METHODS
  A total of 4,870 Japanese type 2 diabetic patients ≥20 years of age were divided into six groups according to self-reported sleep duration: less than 4.5 hours, 4.5-5.4 hours, 5.5-6.4 hours, 6.5-7.4 hours, 7.5-8.4 hours and more than 8.5 hours. The association between sleep duration and urinary albumin-creatinine ratio (UACR) was examined cross-sectionally.
  
  
  RESULTS
  Both short and long sleep durations were significantly associated with higher UACR levels and higher proportions of patients with albuminuria (≥30 mg/g) and macroalbuminuria (≥300 mg/g) compared with a sleep duration of 6.5-7.4 hours (P for quadratic trend <0.001). A U-shaped association between sleep duration and UACR remained significant even after adjustment for potential confounders, including age, sex, duration of diabetes, current smoking habits, former smoking habits, current drinking habits, regular exercise habits, total energy intake, total protein intake, hypnotic use and estimated glomerular filtration rate. Furthermore, the association remained substantially unchanged after additional adjustment for body mass index, hemoglobin A1c, systolic blood pressure, renin-angiotensin system inhibitor use and depressive symptoms.
  
  
  CONCLUSIONS
  Our findings suggest that sleep duration has a U-shaped association with the UACR levels in type 2 diabetic patients, independent of potential confounders.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ; Department of Internal Medicine, Fukuoka Dental College Medical and Dental Hospital, Fukuoka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ohkuma
authors.forename: Hiroki
authors.initials: H
authors.lastname: Fujii
authors.forename: Masanori
authors.initials: M
authors.lastname: Iwase
authors.forename: Shinako
authors.initials: S
authors.lastname: Ogata-Kaizu
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ide
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Idewaki
authors.forename: Tamaki
authors.initials: T
authors.lastname: Jodai
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hirakawa
authors.forename: Udai
authors.initials: U
authors.lastname: Nakamura
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications*; D003401:Creatine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000652:urine*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012042:Registries; D012044:Regression Analysis; D012890:Sleep; D013997:Time Factors
chemical_list: D003401:Creatine