title: Poor Sleep Quality Is Associated with Dawn Phenomenon and Impaired Circadian Clock Gene Expression in Subjects with Type 2 Diabetes Mellitus.
abstract: Aims. We investigated whether poor sleep quality is associated with both dawn phenomenon and impaired circadian clock gene expression in subjects with diabetes.Methods. 81 subjects with diabetes on continuous glucose monitoring were divided into two groups according to the Pittsburgh Sleep Quality Index. The magnitude of dawn phenomenon was quantified by its increment from nocturnal nadir to prebreakfast. Peripheral leucocytes were sampled from 81 subjects with diabetes and 28 normal controls at 09:00. Transcript levels of circadian clock genes (BMAL1,PER1,PER2, andPER3) were determined by real-time quantitative polymerase chain reaction.Results.The levels of HbA1c and fasting glucose and the magnitude of dawn phenomenon were significantly higher in the diabetes group with poor sleep quality than that with good sleep quality. Peripheral leucocytes from subjects with poor sleep quality expressed significantly lower transcript levels ofBMAL1andPER1compared with those with good sleep quality. Poor sleep quality was significantly correlated with magnitude of dawn phenomenon. Multiple linear regression showed that sleep quality andPER1were significantly independently correlated with dawn phenomenon.Conclusions. Dawn phenomenon is associated with sleep quality. Furthermore, mRNA expression of circadian clock genes is dampened in peripheral leucocytes of subjects with poor sleep quality.
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China; Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
authors.forename: Yuxin
authors.identifier: 0000-0003-3056-4168
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China; Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
authors.forename: Haidong
authors.identifier: 0000-0002-1833-2586
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China; Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China; Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Tao
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 Yananxi Road, Shanghai 200040, China; Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
authors.forename: Jiao
authors.identifier: 0000-0001-8464-9947
authors.initials: J
authors.lastname: Sun