Association of circadian rest-activity rhythms with cardiovascular disease and mortality in type 2 diabetes

Feng, Hongliang; Chen, Jie; Wing, Yun Kwok; Tan, Xiao; Zhang, Jihui

doi:10.1016/j.diabres.2023.110262

Cited by 11 publications

(4 citation statements)

References 39 publications

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“…Fast circadian rhythm aging exhibits stronger associations with outcomes compared to fast physical activity aging. These findings align with the recent studies that emphasize the pivotal role of circadian timing in cardiovascular incidence, extending its relevance to both the general population and diabetic patients 29 , 30 . In these investigations, researchers have demonstrated that circadian abnormalities, characterized by reduced amplitude, delayed acrophase, low MESOR, and low rhythm stability, correlated with elevated risks of CVD, atrial fibrillation, as well as all-cause and CVD mortalities.…”

Section: Discussionsupporting

confidence: 90%

Circadian rhythm analysis using wearable-based accelerometry as a digital biomarker of aging and healthspan

Shim,

Fleisch,

Barata

2024

npj Digit. Med.

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Recognizing the pivotal role of circadian rhythm in the human aging process and its scalability through wearables, we introduce CosinorAge, a digital biomarker of aging developed from wearable-derived circadian rhythmicity from 80,000 midlife and older adults in the UK and US. A one-year increase in CosinorAge corresponded to 8–12% higher all-cause and cause-specific mortality risks and 3–14% increased prospective incidences of age-related diseases. CosinorAge also captured a non-linear decline in resilience and physical functioning, evidenced by an 8–33% reduction in self-rated health and a 3–23% decline in health-related quality of life score, adjusting for covariates and multiple testing. The associations were robust in sensitivity analyses and external validation using an independent cohort from a disparate geographical region using a different wearable device. Moreover, we illustrated a heterogeneous impact of circadian parameters associated with biological aging, with young (<45 years) and fast agers experiencing a substantially delayed acrophase with a 25-minute difference in peak timing compared to slow agers, diminishing to a 7-minute difference in older adults (>65 years). We demonstrated a significant enhancement in the predictive performance when integrating circadian rhythmicity in the estimation of biological aging over physical activity. Our findings underscore CosinorAge’s potential as a scalable, economic, and digital solution for promoting healthy longevity, elucidating the critical and multifaceted circadian rhythmicity in aging processes. Consequently, our research contributes to advancing preventive measures in digital medicine.

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Section: Discussionsupporting

confidence: 90%

Circadian rhythm analysis using wearable-based accelerometry as a digital biomarker of aging and healthspan

Shim,

Fleisch,

Barata

2024

npj Digit. Med.

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“…As the circadian system also affects cardiovascular physiology, kidney function, and glycemic status [ 144 ], the clinical impact of circadian disruption on the risk of complications in diabetes is an interesting subject for researchers. Recently, patients with both diabetes and disrupted rest-activity rhythms exhibited a higher risk of developing cardiovascular diseases and mortality in an analysis of the United States Biobank database [ 145 ].…”

Section: Future Directionsmentioning

confidence: 99%

Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes

Lee,

Jung,

Park

et al. 2024

Diabetes Metab J

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Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a “central clock” in the suprachiasmatic nucleus and “peripheral clocks” in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.

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“…Prolonged circadian misalignment is associated with increased blood pressure, diminished sleep quality, and an overall increased risk of cardiovascular disease [ 13 ]. Specifically, healthy circadian rhythms in adults are independent of physical activity and associated with lower cardiometabolic risk, cardiovascular disease, and mortality [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the relationship between 24-h rest–activity rhythms and CRF remains unknown. Based on the results of previous studies [ 1 , 12 , 14 , 15 ], we formulated two hypotheses: (1) workers who maintain a regular workday exhibit higher CRF and (2) workers who are more physically active on the workday demonstrate higher CRF.…”

Section: Introductionmentioning

confidence: 99%

Relationship between rest–activity rhythms and cardiorespiratory fitness in middle-aged workers: a cross-sectional study with non-parametric analysis using accelerometers worn on the thigh

Seol,

So,

Murai

et al. 2024

BMC Public Health

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Background Rest–activity rhythms are directly related to health risks, but there are limited objective methods to assess them. This study aimed to investigate the relationship between rest–activity rhythms and cardiorespiratory fitness (CRF) in middle-aged workers. Methods Peak oxygen uptake was measured on a treadmill to assess CRF in 254 middle-aged workers who were divided into low, medium, and high-CRF groups based on tertiles. Participants were asked to wear an accelerometer (activPAL) on their thighs for 1 week, and the logarithmically transformed acceleration data were used for the analysis of a 24-hour rest–activity rhythm. Sex, age, body mass index, occupation, smoking status, and alcohol consumption were used as covariates in Model 1, with Model 2 also including walking count on non-workdays. Repeated measures analysis of variance was used to compare time course of rest–activity rhythms changes on workdays between groups, and post-hoc tests were conducted using Bonferroni’s correlation. Results Higher CRF correlated with increased physical activity. In model 1, higher CRF showed improved interdaily stability, but the significant difference disappeared in model 2 after adjusting for non-workday walking counts. A time-course group comparison showed that the high group had significantly higher activity levels than those of the low group from 6:00 to 8:59 and 17:00 to 17:59 and the medium group from 6:00 to 7:59 and 19:00 to 19:59. Conclusions Workers who have better rest–activity rhythms and engage in higher levels of physical activity on workdays tend to have higher CRF levels. Regular daily routines, influenced by physical activity during holidays, can positively impact cardiopulmonary endurance.

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Association of circadian rest-activity rhythms with cardiovascular disease and mortality in type 2 diabetes

Cited by 11 publications

References 39 publications

Circadian rhythm analysis using wearable-based accelerometry as a digital biomarker of aging and healthspan

Circadian rhythm analysis using wearable-based accelerometry as a digital biomarker of aging and healthspan

Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes

Relationship between rest–activity rhythms and cardiorespiratory fitness in middle-aged workers: a cross-sectional study with non-parametric analysis using accelerometers worn on the thigh

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