Marinac Catherine R, Natarajan Loki, Sears Dorothy D, Gallo Linda C, Hartman Sheri J, Arredondo Elva, Patterson Ruth E
Moores UCSD Cancer Center, University of California, San Diego, La Jolla, California. Graduate School of Public Health, San Diego State University, San Diego, California.
Moores UCSD Cancer Center, University of California, San Diego, La Jolla, California. Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California.
Cancer Epidemiol Biomarkers Prev. 2015 May;24(5):783-9. doi: 10.1158/1055-9965.EPI-14-1292. Epub 2015 Apr 20.
A novel line of research has emerged, suggesting that daily feeding-fasting schedules that are synchronized with sleep-wake cycles have metabolic implications that are highly relevant to breast cancer. We examined associations of nighttime fasting duration with biomarkers of breast cancer risk among women in the 2009-2010 U.S. National Health and Nutrition Examination Survey.
Dietary, anthropometric, and HbA1c data were available for 2,212 women, and 2-hour postprandial glucose concentrations were available for 1,066 women. Nighttime fasting duration was calculated using 24-hour food records. Separate linear regression models examined associations of nighttime fasting with HbA1c and 2-hour glucose concentrations. Logistic regression modeled associations of nighttime fasting with elevated HbA1c (HbA1c ≥ 39 mmol/mol or 5.7%) and elevated 2-hour glucose (glucose ≥ 140 mg/dL). All models adjusted for age, education, race/ethnicity, body mass index, total kcal intake, evening kcal intake, and the number of eating episodes per day.
Each 3-hour increase in nighttime fasting (roughly 1 SD) was associated with a 4% lower 2-hour glucose measurement [β, 0.96; 95% confidence interval (CI), 0.93-1.00; P < 0.05], and a nonstatistically significant decrease in HbA1c. Logistic regression models indicate that each 3-hour increase in nighttime fasting duration was associated with roughly a 20% reduced odds of elevated HbA1c (OR, 0.81; 95% CI, 0.68-0.97; P < 0.05) and nonsignificantly reduced odds of elevated 2-hour glucose.
A longer nighttime duration was significantly associated with improved glycemic regulation.
Randomized trials are needed to confirm whether prolonged nighttime fasting could improve biomarkers of glucose control, thereby reducing breast cancer risk.
一项新的研究方向表明，与睡眠-觉醒周期同步的每日进食-禁食时间表具有与乳腺癌高度相关的代谢影响。我们在美国2009 - 2010年国家健康与营养检查调查中研究了夜间禁食时长与乳腺癌风险生物标志物之间的关联。
有2212名女性的饮食、人体测量和糖化血红蛋白（HbA1c）数据，1066名女性有餐后2小时血糖浓度数据。夜间禁食时长通过24小时饮食记录计算得出。采用单独的线性回归模型研究夜间禁食与HbA1c及餐后2小时血糖浓度之间的关联。逻辑回归模型模拟夜间禁食与HbA1c升高（HbA1c≥39 mmol/mol或5.7%）和餐后2小时血糖升高（血糖≥140 mg/dL）之间的关联。所有模型均对年龄、教育程度、种族/民族、体重指数、总热量摄入、晚餐热量摄入以及每日进食次数进行了调整。
夜间禁食每增加3小时（约1个标准差），餐后2小时血糖测量值降低4%[β，0.96；95%置信区间（CI），0.93 - 1.00；P < 0.05]，HbA1c有非统计学意义的降低。逻辑回归模型表明，夜间禁食时长每增加3小时，HbA1c升高的几率降低约20%（OR，0.81；95% CI，0.68 - 0.97；P < 0.05），餐后2小时血糖升高的几率有非显著降低。
更长的夜间禁食时长与改善血糖调节显著相关。
需要进行随机试验来确认延长夜间禁食是否能改善血糖控制生物标志物，从而降低乳腺癌风险。
