Abbott Sabra M, Malkani Roneil G, Zee Phyllis C
Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Eur J Neurosci. 2020 Jan;51(1):567-583. doi: 10.1111/ejn.14298. Epub 2019 Jan 3.
Circadian rhythm disorders have been classically associated with disorders of abnormal timing of the sleep-wake cycle, however circadian dysfunction can play a role in a wide range of pathology, ranging from the increased risk for cardiometabolic disease and malignancy in shift workers, prompting the need for a new field focused on the larger concept of circadian medicine. The relationship between circadian disruption and human health is bidirectional, with changes in circadian amplitude often preceding the classical symptoms of neurodegenerative disorders. As our understanding of the importance of circadian dysfunction in disease grows, we need to develop better clinical techniques for identifying circadian rhythms and also develop circadian based strategies for disease management. Overall this review highlights the need to bring the concept of time to all aspects of medicine, emphasizing circadian medicine as a prime example of both personalized and precision medicine.
昼夜节律紊乱一直以来都与睡眠-觉醒周期的异常时间安排紊乱相关，然而昼夜节律功能障碍可在广泛的病理过程中起作用，从轮班工作者患心脏代谢疾病和恶性肿瘤的风险增加，这促使需要一个专注于昼夜医学这一更大概念的新领域。昼夜节律紊乱与人类健康之间的关系是双向的，昼夜节律振幅的变化通常先于神经退行性疾病的典型症状出现。随着我们对昼夜节律功能障碍在疾病中的重要性的理解不断加深，我们需要开发更好的临床技术来识别昼夜节律，还需要制定基于昼夜节律的疾病管理策略。总体而言，本综述强调了将时间概念引入医学各个方面的必要性，强调昼夜医学是个性化和精准医学的一个主要范例。
