ヒト成長ホルモンの膵内分泌、消化管グルカゴン、ソマトスタチン分泌および肝インスリン取込みに与える影響

取得学位 : 博士（医学）, 学位授与番号 : 医博乙第1276号,学位授与年月日：平成6年2月16日,学位授与年：199

Association of usual sleep quality and glycemic control in type 2 diabetes in Japanese: A cross sectional study. Sleep and Food Registry in Kanagawa (SOREKA).

Excessively short and long sleep durations are associated with type 2 diabetes, but there is limited information about the association between sleep quality and diabetes. Accordingly, the present study was performed to investigate this relationship.The subjects were 3249 patients with type 2 diabetes aged 20 years or older. Sleep quality was assessed by using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates worse sleep quality, and a global PSQI score >5 differentiates poor sleepers from good sleepers.The mean global PSQI score was 5.94 ± 3.33, and 47.6% of the patients had a score of 6 or higher. Regarding the components of the PSQI, the score was highest for sleep duration, followed by subjective sleep quality and then sleep latency in decreasing order. When the patients were assigned to HbA1c quartiles (≤ 6.5%, 6.6-7.0%, 7.1-7.8%, and ≥ 7.9%), the top quartile had a significantly higher global PSQI score than the other quartiles. The top HbA1c quartile had a sleep duration of only 6.23 ± 1.42 hours, which was significantly shorter than in the other quartiles. Also, sleep latency was 25.3 ± 31.8 minutes in the top quartile, which was significantly longer (by approximately 20 minutes) than in the other quartiles. When analysis was performed with adjustment for age, gender, BMI, smoking, and other confounders, the global PSQI score was still significantly higher and sleep duration was shorter in the top HbA1c quartile (HbA1c ≥ 7.9%).Japanese patients with type 2 diabetes were found to have poor subjective sleep quality independently of potential confounders, especially those with inadequate glycemic control. Impairment of sleep quality was associated with both increased sleep latency and a shorter duration of sleep

Distribution of sleep duration according to HbA1c.

<p>Distribution of sleep duration according to HbA1c.</p

Univariate and multivariate linear regression analyses of clinical variables and sleep duration.

<p>Univariate and multivariate linear regression analyses of clinical variables and sleep duration.</p

The clinical characteristics and the global PSQI score according to HbA1c.

<p>The clinical characteristics and the global PSQI score according to HbA1c.</p

The distribution of C1-C7 according to HbA1c.

<p>The distribution of C1-C7 according to HbA1c.</p

Baseline characteristics.

<p>Baseline characteristics.</p