title: [Association between retinopathy and sleep disorder in patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  To explore the association between retinopathy and sleep disorder in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  A total of 440 patients with T2DM treated from July 2011 to July 2013 in Metabolic Disease Hospital of Tianjin Medical University were divided into 2 groups according to Pittsburgh Sleep Quality Index: non-sleep disorder group (258 cases) and sleep disorder group (182 cases). Biochemical parameters including hepatorenal function, blood lipids, glycosylated hemoglobin (HbA1c), fructosamine and hemorrheology were detected. Oral glucose tolerance test, insulin releasing test and glucagon releasing test were performed to detect the inteR-group differences of α-cell and β-cell function after fasting and glucose-load management. The logistic regression analysis was performed to identify the factors relevant to retinopathy.
  
  
  RESULTS
  The ratio of retinopathy was 42.9% in sleep disorder group, which was higher compared to those in non-sleep disorder group (32.6%), P=0.027. The levels of fasting plasma glucose, postprandial blood glucose, HbA1c, fructosamine, systolic blood pressure, diastolic blood pressure and the indicators of hemorrheology (plasma viscosity, erythrocyte aggregation index, erythrocyte rigidity index, fibrinogen) were significantly higher in patients with sleep disorder compared to those without sleep disorder, while the erythrocyte defomation index was significantly lower in sleep disorder group (all P<0.05). The levels of glucagon and glucagon/insulin ratio at each time point as well as area under curve of glucagon were significantly higher in sleep disorder group (all P<0.05). The levels of fasting insulin, homeostasis model assessment for insulin resistance index (HOMA-IR) and area under curve of insulin were significantly higher in patients with sleep disorder compared to those without sleep disorder, while insulin sensitivity index was lower in patients with sleep disorder (all P<0.05). Logistic regression analysis showed that retinopathy was positively related to HbA1c (OR: 1.744-3.249), fibrinogen (OR: 1.687-2.998), systolic blood pressure (OR: 1.152-2.013), HOMA-IR (OR: 1.006-1.389) and sleep disorder (OR: 1.144-2.426), and negatively related to insulin sensitivity index (OR: 0.107-0.784) (all P<0.05).
  
  
  CONCLUSIONS
  Sleep disorders may be associated with retinopathy through multiple mechanisms in patients with T2DM.
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Huizhu
authors.initials: H
authors.lastname: Ren
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Yanguang
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Baocheng
authors.initials: B
authors.lastname: Chang
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Juhong
authors.initials: J
authors.lastname: Yang
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Miaoyan
authors.initials: M
authors.lastname: Zheng
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Jingli
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China; Email: chunyanshan@hotmail.com.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Shan
mesh_terms: D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2; D005934:Glucagon; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin; D006801:Humans; D007328:Insulin; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells; D019518:Postprandial Period; D012893:Sleep Wake Disorders
chemical_list: D001786:Blood Glucose; D005934:Glucagon; D006442:Glycated Hemoglobin; D007328:Insulin