Misalignment Between Circadian Preference and Accelerometer-Derived Sleep-Wake Cycle With Increased Risk of Cardiometabolic Diseases

Yue Chen, MSc; Tingting Geng, MD, PhD; Xinming Xu, B.S.; Zhicheng Zhang, MSc; Lili Huang, PhD; Haiyang Dong, BS; Huan Yu, MD, PhD; Xiang Gao, MD, PhD; Liang Sun, MD, PhD

JACC: Advances (Dec 2024)

Misalignment Between Circadian Preference and Accelerometer-Derived Sleep-Wake Cycle With Increased Risk of Cardiometabolic Diseases

Yue Chen, MSc,
Tingting Geng, MD, PhD,
Xinming Xu, B.S.,
Zhicheng Zhang, MSc,
Lili Huang, PhD,
Haiyang Dong, BS,
Huan Yu, MD, PhD,
Xiang Gao, MD, PhD,
Liang Sun, MD, PhD

Affiliations

Yue Chen, MSc: Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China
Tingting Geng, MD, PhD: Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
Xinming Xu, B.S.: Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China
Zhicheng Zhang, MSc: Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China
Lili Huang, PhD: Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China
Haiyang Dong, BS: Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China
Huan Yu, MD, PhD: Sleep and Wake Disorders Center, Fudan University, Shanghai, China; Department of Neurology, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China; National Center for Neurological Disorders, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China
Xiang Gao, MD, PhD: Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China; Dr Xiang Gao, Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, 130 Dongan Road, Shanghai 200032, China.
Liang Sun, MD, PhD: Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China; Address for correspondence: Dr Liang Sun, Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Clinical Research Unit, Institute of Clinical Medicine, Zhongshan Hospital, Fudan University, 130 Dongan Road, Shanghai 200032, China

Journal volume & issue: Vol. 3, no. 12
p. 101406

Abstract

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Background: The relationship of circadian misalignment, sleep-wake cycle, and cardiometabolic diseases (CMDs) remains unclear. Objectives: This prospective study investigated the associations between circadian misalignment and CMDs, including type 2 diabetes (T2D), coronary heart disease (CHD), and stroke, and explored potential mechanisms. Methods: Data from 60,965 participants without pre-existing CMDs from the UK Biobank study and followed for an average of 7.9 years were analyzed. Circadian misalignment was determined by comparing self-reported chronotype and accelerometer-derived sleep timing. Incident CMDs were documented via multiple medical registries and self-reported information. Cox proportional hazards models were applied to estimate HRs and 95% CIs for these associations. Results: A U-shaped relationship between circadian misalignment and both T2D and CHD was observed. Compared to individuals with aligned midsleep and circadian preferences (the third quintile, Q3), those with advanced and delayed circadian misalignment had higher risks of T2D (HR: 1.22 [95% CI: 1.03-1.45] for Q1 and 1.39 [95% CI: 1.18-1.62] for Q5). Delayed circadian misalignment also associated with higher CHD risk (HR: 1.15 [95% CI: 1.01-1.31] for Q4 and 1.16 [95% CI: 1.02-1.33] for Q5). The association between delayed circadian misalignment and CMDs was greater in women (T2D, Pinteraction = 0.03) and younger adults (CHD, Pinteraction = 0.02). Early (HR: 1.19 [95% CI: 1.06-1.34]), rather than late, chronotype was associated with an increased T2D risk. Conclusions: Both advanced and delayed circadian misalignment were associated with an increased CMD risk, highlighting the potential health benefits of aligning sleep-wake cycles with individual circadian preferences.

Published in JACC: Advances

ISSN: 2772-963X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://www.sciencedirect.com/journal/jacc-advances

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