title: Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  While poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship.
  
  
  METHODS
  The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated.
  
  
  RESULTS
  The mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors.
  
  
  CONCLUSIONS
  Our study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. Yu.osonoi@gmail.com.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Osonoi
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. tom-m@juntendo.ac.jp.|Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. tom-m@juntendo.ac.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Mita
authors.affiliation: Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan. t-osonoi@kensei-kai.com.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Osonoi
authors.affiliation: Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan. t-saitou@kensei-kai.com.
authors.forename: Miyoko
authors.initials: M
authors.lastname: Saito
authors.affiliation: Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan. a-tamasawa@kensei-kai.com.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Tamasawa
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. micshiho@yahoo.co.jp.
authors.forename: Shiho
authors.initials: S
authors.lastname: Nakayama
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. yksomeya@juntendo.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Someya
authors.affiliation: Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan. h-ishida@kensei-kai.com.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ishida
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. akana@juntendo.ac.jp.|Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. akana@juntendo.ac.jp.
authors.forename: Akio
authors.initials: A
authors.lastname: Kanazawa
authors.affiliation: Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, 305-8575, Ibaraki, Japan. robin_gosho@yahoo.co.jp.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Gosho
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. fujitani@juntendo.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Fujitani
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. hwatada@juntendo.ac.jp.|Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. hwatada@juntendo.ac.jp.|Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. hwatada@juntendo.ac.jp.|Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan. hwatada@juntendo.ac.jp.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Watada
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D000419:Albuminuria / Q000453:epidemiology; D055109:Ankle Brachial Index; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D063177:Pulse Wave Analysis; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D059289:Vascular Stiffness
chemical_list: D000410:Alanine Transaminase; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human