Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA.
Chronobiol Int. 2011 Apr;28(3):258-66. doi: 10.3109/07420528.2011.553016.
Prior studies have suggested an increased risk of cardiovascular disease (CVD)-related mortality in older adults with disturbed circadian rest/activity rhythms (RARs). The objective goal of this study was to examine the association between disrupted RARs and risk of CVD events in older men. A total of 2968 men aged 67 yrs and older wore wrist actigraphs for 115 ± 18 consecutive hours. RAR parameters were computed from wrist actigraphy data and expressed as quartiles (Q). CVD events consisted of a composite outcome of coronary heart disease (CHD), stroke, and peripheral vascular disease (PVD) events. Secondary analyses examined associations between RARs and individual components of the composite outcome (CHD, stroke, and PVD). There were 490 CVD events over an average of 4.0 ± 1.2 yrs. Overall, reduced amplitude (HR = 1.31, 95% confidence interval [CI] 1.01-1.71 for Q2 vs. Q4) and greater minimum (HR = 1.33, 95% CI 1.01-1.73 for Q4 vs. Q1) were associated with an increased risk of CVD events in multivariable-adjusted models. In secondary analyses, there was an independent association between reduced amplitude (HR = 1.36, 95% CI 1.00-1.86) and greater minimum activity counts (HR = 1.39, 95% CI 1.02-1.91) with increased risk of CHD events. Reduced F value (HR = 2.88, 95% CI 1.41-5.87 for Q1 vs. Q4 and HR = 2.71, 95% CI 1.34-5.48 for Q2 vs. Q4) and later occurring acrophase of the RAR (HR = 1.65, 95% CI 1.04-2.63 for Q4 vs. Q2-3) were associated with an increased risk of PVD events. Results were similar in men without a history of CVD events. The findings revealed that among older men, measures of decreased circadian activity rhythm robustness (reduced amplitude and greater minimum activity) were associated with an increased risk of CVD events, primarily through increased risk of CHD or stroke events, whereas measures of reduced circadian activity rhythmicity were not associated with risk of CVD events overall, but were associated with an increased risk of PVD events. These results should be confirmed in other populations.
先前的研究表明，昼夜节律休息/活动节律（RAR）紊乱的老年人患心血管疾病（CVD）相关死亡的风险增加。本研究的目的是探讨老年人 RAR 紊乱与 CVD 事件风险之间的关系。共有 2968 名年龄在 67 岁及以上的男性佩戴腕动仪 115±18 小时。从腕动仪数据中计算 RAR 参数，并表示为四分位数（Q）。CVD 事件由冠心病（CHD）、中风和外周血管疾病（PVD）事件的复合结局组成。次要分析检查了 RAR 与复合结局的各个组成部分（CHD、中风和 PVD）之间的关联。平均随访 4.0±1.2 年后发生了 490 例 CVD 事件。总体而言，幅度降低（HR=1.31，95%置信区间[CI]为 Q2 与 Q4 相比为 1.01-1.71）和最小活动计数增加（HR=1.33，95%CI 为 Q4 与 Q1 相比为 1.01-1.73）与多变量调整模型中 CVD 事件风险增加相关。在次要分析中，幅度降低（HR=1.36，95%CI 为 1.00-1.86）和最小活动计数增加（HR=1.39，95%CI 为 1.02-1.91）与 CHD 事件风险增加独立相关。较低的 F 值（HR=2.88，95%CI 为 Q1 与 Q4 相比为 1.41-5.87，HR=2.71，95%CI 为 Q2 与 Q4 相比为 1.34-5.48）和 RAR 后期发生的峰值（HR=1.65，95%CI 为 Q4 与 Q2-3 相比为 1.04-2.63）与 PVD 事件风险增加相关。在没有 CVD 事件史的男性中，结果相似。研究结果表明，在老年男性中，昼夜活动节律稳健性降低（幅度降低和最小活动增加）的指标与 CVD 事件风险增加相关，主要是通过增加 CHD 或中风事件的风险，而昼夜活动节律性降低的指标与 CVD 事件风险总体上不相关，但与 PVD 事件的风险增加相关。这些结果应在其他人群中得到证实。
