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Associations between chronotype, morbidity and mortality in the UK Biobank cohort.

作者信息

Knutson Kristen L, von Schantz Malcolm

机构信息

a Center for Circadian and Sleep Medicine, Department of Neurology , Northwestern University , Chicago , IL , USA.

b Faculty of Health and Medical Sciences , University of Surrey , Surrey , UK.

出版信息

Chronobiol Int. 2018 Aug;35(8):1045-1053. doi: 10.1080/07420528.2018.1454458. Epub 2018 Apr 11.


DOI:10.1080/07420528.2018.1454458
PMID:29642757
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6119081/
Abstract

Later chronotype (i.e. evening preference) and later timing of sleep have been associated with greater morbidity, including higher rates of metabolic dysfunction and cardiovascular disease (CVD). However, no one has examined whether chronotype is associated with mortality risk to date. Our objective was to test the hypothesis that being an evening type is associated with increased mortality in a large cohort study, the UK Biobank. Our analysis included 433 268 adults aged 38-73 at the time of enrolment and an average 6.5-year follow-up. The primary exposure was chronotype, as assessed through a single self-reported question-defining participants as definite morning types, moderate morning types, moderate evening types or definite evening types. The primary outcomes were all-cause mortality and mortality due to CVD. Prevalent disease was also compared among the chronotype groups. Analyses were adjusted for age, sex, ethnicity, smoking, body mass index, sleep duration, socioeconomic status and comorbidities. Greater eveningness, particularly being a definite evening type, was significantly associated with a higher prevalence of all comorbidities. Comparing definite evening type to definite morning type, the associations were strongest for psychological disorders (OR 1.94, 95% CI 1.86-2.02, p = < 0.001), followed by diabetes (OR 1.30, 95% CI 1.24-1.36, p = < 0.001), neurological disorders (OR 1.25, 95% CI 1.20-1.30, p = < 0.001), gastrointestinal/abdominal disorders (OR 1.23, 95% CI 1.19-1.27, p = < 0.001) and respiratory disorders (OR 1.22, 95% CI 1.18-1.26, p = < 0.001). The total number of deaths was 10 534, out of which 2127 were due to CVD. Greater eveningness, based on chronotype as an ordinal variable, was associated with a small increased risk of all-cause mortality (HR 1.02, 95% CI 1.004-1.05, p = 0.017) and CVD mortality (HR 1.04, 95% CI 1.00-1.09, p = 0.06). Compared to definite morning types, definite evening types had significantly increased risk of all-cause mortality (HR 1.10, 95% CI 1.02-1.18, p = 0.012). This first report of increased mortality in evening types is consistent with previous reports of increased levels of cardiometabolic risk factors in this group. Mortality risk in evening types may be due to behavioural, psychological and physiological risk factors, many of which may be attributable to chronic misalignment between internal physiological timing and externally imposed timing of work and social activities. These findings suggest the need for researching possible interventions aimed at either modifying circadian rhythms in individuals or at allowing evening types greater working hour flexibility.

摘要

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本文引用的文献

[1]
Lower nocturnal urinary 6-sulfatoxymelatonin is associated with more severe insulin resistance in patients with prediabetes.

Neurobiol Sleep Circadian Rhythms. 2017-6-28

[2]
Relationship of Sleep Duration With All-Cause Mortality and Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.

J Am Heart Assoc. 2017-9-9

[3]
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Nord J Psychiatry. 2017-11

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Ann Hum Biol. 2017-11

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Comparison of Sociodemographic and Health-Related Characteristics of UK Biobank Participants With Those of the General Population.

Am J Epidemiol. 2017-11-1

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J Biol Rhythms. 2017-8

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Eur J Public Health. 2018-2-1

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Sleep disruption, chronotype, shift work, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins.

Cancer Causes Control. 2016-11

[9]
Chronotype and circadian rhythm in bipolar disorder: A systematic review.

Sleep Med Rev. 2016-7-1

[10]
Genome-Wide Association Analyses in 128,266 Individuals Identifies New Morningness and Sleep Duration Loci.

PLoS Genet. 2016-8-5

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