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英国生物库横断面研究中围产期光周期与糖尿病和昼夜类型患病率的关联。

Perinatal photoperiod associations with diabetes and chronotype prevalence in a cross-sectional study of the UK Biobank.

机构信息

Institute and Policlinic for Occupational Medicine, Environmental Medicine, and Prevention Research, University of Cologne, Medical Faculty and University Hospital of Cologne, Cologne, Germany.

Institute of Medical Statistics and Computational Biology, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany.

出版信息

Chronobiol Int. 2021 Mar;38(3):343-359. doi: 10.1080/07420528.2020.1849254. Epub 2021 Jan 12.

DOI:10.1080/07420528.2020.1849254
PMID:33435754
Abstract

Experimental studies indicate that perinatal light may imprint the circadian timing system, subsequently affect later life physiology, and possibly disease risk. We combined individual time-of-year of birth and corresponding latitude to determine perinatal photoperiod characteristics for UK Biobank participants (n = 460,761) and tested for associations with diabetes mellitus (DM, the pathophysiology of which is often linked with circadian disruption) and chronotype (a trait co-governed by the circadian timing system) prevalence in a cross-sectional investigation. The UK Biobank is a population-based cohort with a 5.5% participation rate (~9.2 million individuals were invited into the study between 2006 and 2010). We defined three groups based on photoperiods experienced in the 3 trimester of pregnancy and first 3 months post-birth time windows: (1) those who exclusively experienced non-extreme photoperiods (NEP, 8-16 hours), (2) those who experienced at least one extreme short photoperiod (ESP, <8 hours), and those who experienced at least one extreme long photoperiod (ELP, >16 hours). For individuals in each group and time window, mean daily photoperiod and relative photoperiod range (relative = relative to the mean) were calculated. Inclusion of relative photoperiod range adds dispersion information (relative change of photoperiods) to statistical models. Multivariable and multinomial logistic regression analyses were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Increased 3 trimester relative range was associated with decreased odds of DM (OR 0.63 95%CI 0.49-0.81) in the NEP group, but increased odds of DM were detected for the ESP (OR 1.34, 95%CI 0.96-1.86) and ELP groups (OR 1.32, 95%CI 0.78-2.22). Increased 3 trimester relative range was associated with increased odds of being a "Morning" (OR 1.20, 95%CI 1.02-1.41) or "Evening" (OR 1.43, 95%CI 1.21-1.69) chronotype in the NEP group, but this was not observed in other groups. Additionally, different effect sizes and directions of association with DM were observed in different strata of ethnicity and chronotype and statistically significant odds ratio modifications were detected. In conclusion, perinatal photoperiod associations with DM and chronotype prevalence are detected in the UK Biobank. NEP, ESP, and ELP differences are speculated to be caused by a non-linear dose-response to photoperiods from 0-24 hours or by confounding due to artificial light playing a dominant role in ESP individuals and seeking darkness in ELP individuals. Ethnicity and chronotype may be important effect modifiers of perinatal photoperiod associations with DM. Potential for selection biases due to low UK Biobank participation rate disallows stating conclusions too strongly. Overall, further studies are needed to confirm different perinatal photoperiod associations with DM and chronotype. Further investigations into the hypothesized imprinting mechanism are also warranted.

摘要

实验研究表明,围产期光照可能会影响昼夜节律计时系统,进而影响后期的生理机能,并可能增加患病风险。我们结合个体的出生年份和相应的纬度,确定了英国生物库参与者(n=460761)围产期的光周期特征,并在横断面研究中测试了它们与糖尿病(DM,其病理生理学通常与昼夜节律紊乱有关)和昼夜类型(受昼夜计时系统共同控制的特征)患病率之间的关联。英国生物库是一个基于人群的队列,参与率为 5.5%(2006 年至 2010 年间,约有 920 万人受邀参加该研究)。我们根据妊娠 3 个月和出生后 3 个月的时间窗内经历的光周期,将参与者分为三组:(1)仅经历非极端光周期(NEP,8-16 小时)的人;(2)至少经历过一次极端短光周期(ESP,<8 小时)的人;(3)至少经历过一次极端长光周期(ELP,>16 小时)的人。对于每组和每个时间窗中的个体,计算了平均每日光周期和相对光周期范围(相对=相对于平均值)。纳入相对光周期范围可将离散信息(光周期的相对变化)添加到统计模型中。我们使用多变量和多项逻辑回归分析来估计优势比(OR)和相应的 95%置信区间(CI)。在 NEP 组中,3 个月孕期的相对范围增加与糖尿病(DM)患病几率降低相关(OR 0.63,95%CI 0.49-0.81),但在 ESP 组(OR 1.34,95%CI 0.96-1.86)和 ELP 组(OR 1.32,95%CI 0.78-2.22)中,DM 患病几率增加。在 NEP 组中,3 个月孕期的相对范围增加与成为“早晨”(OR 1.20,95%CI 1.02-1.41)或“晚上”(OR 1.43,95%CI 1.21-1.69)型昼夜类型的几率增加相关,但在其他组中未观察到这种情况。此外,还观察到不同的种族和昼夜类型亚组中,DM 的关联效应大小和方向存在差异,并且检测到了统计学意义上的优势比修正。总之,在英国生物库中检测到围产期光周期与 DM 和昼夜类型患病率之间存在关联。ESP 个体中人工光起主导作用,ELP 个体寻求黑暗,这可能导致 NEP、ESP 和 ELP 之间的差异是由 0-24 小时的光周期非线性剂量反应引起的,或由混杂因素引起的。种族和昼夜类型可能是围产期光周期与 DM 关联的重要效应修饰因子。由于英国生物库的参与率较低,不能得出强烈的结论,存在选择偏差的可能性。总的来说,需要进一步的研究来证实不同的围产期光周期与 DM 和昼夜类型的关联。还需要进一步研究假设的印迹机制。

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