Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University, Maastricht, Netherlands.
Am J Clin Nutr. 2012 Oct;96(4):689-97. doi: 10.3945/ajcn.112.037192. Epub 2012 Aug 22.
The disruption of the circadian system has been associated with the development of obesity.
We examined the effects of circadian misalignment on sleep, energy expenditure, substrate oxidation, appetite, and related hormones.
Thirteen subjects [aged 24.3 ± 2.5 (mean ± SD) y; BMI (in kg/m²): 23.6 ± 1.7 (mean ± SD)] completed a randomized crossover study. For each condition, subjects stayed time blinded in the respiration chamber during 3 light-entrained circadian cycles that resulted in a phase advance (3 × 21 h) and a phase delay (3 × 27 h) compared with during a 24-h cycle. Sleep, energy expenditure, substrate oxidation, and appetite were quantified. Blood and saliva samples were taken to determine melatonin, glucose, insulin, ghrelin, leptin, glucagon-like peptide 1 (GLP-1), and cortisol concentrations.
Circadian misalignment, either phase advanced or phase delayed, did not result in any changes in appetite or energy expenditure, whereas meal-related blood variables (glucose, insulin, ghrelin, leptin, and GLP-1) followed the new meal patterns. However, phase-advanced misalignment caused flattening of the cortisol-secretion pattern (P < 0.001), increased insulin concentrations (P = 0.04), and increased carbohydrate oxidation (P = 0.03) and decreased protein oxidation (P = 0.001). Phase-delayed misalignment increased rapid eye movement sleep (P < 0.001) and the sleeping metabolic rate (P = 0.02), increased glucose (P = 0.02) and decreased GLP-1 (P = 0.02) concentrations, and increased carbohydrate oxidation (P = 0.01) and decreased protein oxidation (P = 0.003).
The main effect of circadian misalignment, either phase advanced or phase delayed, is a concomitant disturbance of the glucose-insulin metabolism and substrate oxidation, whereas the energy balance or sleep is not largely affected. Chronically eating and sleeping at unusual circadian times may create a health risk through a metabolic disturbance. This trial was registered at the International Clinical Trials Registry Platform (http://apps.who.int/trialsearch/) as NTR2926.
昼夜节律系统的紊乱与肥胖的发生有关。
我们研究了昼夜节律失调对睡眠、能量消耗、底物氧化、食欲和相关激素的影响。
13 名受试者[年龄 24.3±2.5（均值±标准差）岁；BMI（kg/m²）：23.6±1.7（均值±标准差）]完成了一项随机交叉研究。在每个条件下，受试者在呼吸室内进行 3 次光照诱导的昼夜节律周期的时间盲法，导致相位提前（3×21 小时）和相位延迟（3×27 小时），与 24 小时周期相比。量化睡眠、能量消耗、底物氧化和食欲。采集血液和唾液样本以确定褪黑素、葡萄糖、胰岛素、胃饥饿素、瘦素、胰高血糖素样肽 1（GLP-1）和皮质醇浓度。
无论相位提前还是延迟，昼夜节律失调都不会导致食欲或能量消耗发生任何变化，而与进餐相关的血液变量（葡萄糖、胰岛素、胃饥饿素、瘦素和 GLP-1）则遵循新的进餐模式。然而，相位提前的昼夜节律失调导致皮质醇分泌模式变平（P＜0.001）、胰岛素浓度升高（P=0.04）、碳水化合物氧化增加（P=0.03）和蛋白质氧化减少（P=0.001）。相位延迟的昼夜节律失调增加快速眼动睡眠（P＜0.001）和睡眠代谢率（P=0.02），增加葡萄糖（P=0.02）和降低 GLP-1（P=0.02）浓度，增加碳水化合物氧化（P=0.01）和减少蛋白质氧化（P=0.003）。
昼夜节律失调的主要影响，无论是相位提前还是延迟，都会导致葡萄糖-胰岛素代谢和底物氧化的同时紊乱，而能量平衡或睡眠则不会受到太大影响。长期在不寻常的昼夜节律时间进食和睡眠可能会通过代谢紊乱带来健康风险。该试验在国际临床试验注册平台（http://apps.who.int/trialsearch/）上注册为 NTR2926。
