Social jetlag and metabolic control in non-communicable chronic diseases: a study addressing different obesity statuses

Abstract

Social jetlag – a measure of disruption of the circadian system – has been linked to obesity, but its association with metabolic complications in non-communicable chronic diseases (NCCDs) is unknown in the literature. We examined the associations between social jetlag and obesity status and metabolic parameters among individuals with NCCDs. Patients (n = 792) with NCCDs (obesity, systemic arterial hypertension, type 2 diabetes mellitus or dyslipidaemia) attended clinics of the public health service of the city of Uberlândia, Minas Gerais State, Brazil. They were classified in three obesity statuses: non-obese: BMI < 30 kg/m2; metabolically healthy obese (MHO): BMI ≥ 30 kg/m2 and less than three high-risk biomarkers for metabolic syndrome; and metabolically unhealthy obese (MUO): BMI ≥ 30 kg/m2 and with high-risk values on three or more biomarkers for metabolic syndrome. After adjustments for confounding variables, social jetlag was positively associated with fasting glucose levels among all subjects (β = 0.08, p = 0.03) and MUO subjects (β = 0.32, p < 0.001). Patients with social jetlag (>1 h) presented a significant odds ratio (OR) of being overweight (OR = 2.0, confidence interval (CI) = 1.2–3.6, p = 0.006) and MUO (OR = 1.8, CI = 1.1–2.8, p = 0.01). These results suggest that social jetlag is associated with a higher risk of overweight and related metabolic complications in individuals with NCCDs.

Social jetlag, sleep‐related parameters, and glycemic control in adults with type 1 diabetes: Results of a cross‐sectional study

“…The duration of SJL that has negative metabolic consequences is currently unknown. However, most studies reporting a metabolic effect of this circadian rhythm disruption have used ≥1 hour as the cut‐off value . The age of the study participants may be another explanation for the apparent discrepancies between studies.…”

“…Data on bedtime, sleep onset latency, and wake up time on weekdays and on weekends during the previous month were collected from all participants, as described previously . These data were collected on the basis of responses to the following questions: “During the past month, at what time did you usually go to bed at night on weekdays (Monday‐Thursday)” “During the past month, how long (in minutes) has it usually taken you to fall asleep on weekdays (Monday‐Thursday)” “During the past month, what time have you usually gotten up in the morning on weekdays (Monday‐Thursday)” “During the past month, at what time have you usually gone to bed at night on the weekend (Friday‐Sunday)?” “During the past month, how long (in minutes) has it taken you to fall asleep on the weekend (Friday‐Sunday)” “During the past month, what time have you usually gotten up in the morning on the weekend (Saturday and Sunday)” …”

Clocks in the clinic: circadian rhythms in health and disease

“…SJL has also been associated with higher BMI, triglycerides, fasting plasma insulin, insulin resistance and greater fat mass 77 78. For patients with non-communicable chronic disorders, SJL and fasting glucose were associated, most so in metabolically unhealthy obese (MUO) participants; SJL was also associated with higher risk of being obese and fitting the MUO category and thus risked metabolic complications 81. Chronotype is also associated with diabetes and obesity risk, with individuals with a later chronotype having an increased likelihood of T2DM compared with morning types with a 2.5 fold OR 82.…”

Night shifts: chronotype and social jetlag

“…It is the difference, in hours, between the midpoint of sleep on a work or duty day and the midpoint of sleep when a person is divested of all commitments 234. An “owl-ish” person, on a workday, may sleep at 10 pm and rise at 6 am.…”

“…This creates a social jetlag of 3.5 hours. Cumulative social jetlag is linked to declines in performance and adverse health 234. Owls tend to adapt better to working night shifts, as they accumulate a smaller social jetlag than early chronotypes, an effect shown in nurses 5…”