Health, Medical, and Neuropsychology Unit, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333, Leiden, AK, the Netherlands.
Leiden Institute for Brain and Cognition, Leiden, the Netherlands.
Clin Rheumatol. 2021 Jun;40(6):2185-2192. doi: 10.1007/s10067-020-05546-x. Epub 2021 Jan 16.
Rheumatoid arthritis (RA) patients show an earlier circadian rhythm (i.e. serum melatonin peaks earlier during the night, indicating an earlier timing of the internal circadian pacemaker). In the current study, we examined whether the chronotype, which is influenced by the circadian rhythm, is also earlier. In addition, we explored whether chronotype is related to disease activity and patient-reported outcomes.
The chronotype (Munich Chronotype Questionnaire) of patients with RA (n = 121; mean age 60 years, 73% female) was compared with that of subjects from the general population (norm group; n = 1695) with a one-sample t test. In addition, we investigated chronotype in relation to disease activity (Disease Activity Score; DAS), reported morning stiffness, fatigue (Checklist Individual Strength), and health-related quality of life (RAND-36).
The chronotype of patients with RA was, on average, 23 min (95% CI, 15 to 31 min) earlier than that of the norm group (t(115) = - 5.901, p < 0.001, d = 0.55). Chronotype was not related to disease activity or patient-reported outcomes (p > 0.05).
As expected, chronotype was earlier in RA patients. However, in this correlational study, chronotype was not related to disease activity or patient-reported outcomes. An experimental study is needed to examine whether delaying the circadian rhythm has a positive influence on these outcomes. This insight could improve our understanding of the pathophysiology of RA and contribute to exploring new treatment possibilities. Key Points • This is the first study examining chronotype in patients with rheumatoid arthritis, and how chronotype relates to disease activity and patient-reported outcomes. • We found an earlier chronotype in patients with rheumatoid arthritis than in subjects from the general population. • In this correlational study, chronotype was not related to disease activity or patient-reported outcomes. An experimental study is needed to examine whether delaying the circadian rhythm positively influences these outcomes.
类风湿关节炎（RA）患者的昼夜节律（即夜间血清褪黑素峰值提前，表明内部生物钟起搏时间提前）更早。在本研究中，我们检查了受昼夜节律影响的时型是否也更早。此外，我们还探讨了时型是否与疾病活动度和患者报告的结局相关。
采用慕尼黑时型问卷（Munich Chronotype Questionnaire）比较 121 例 RA 患者（平均年龄 60 岁，73%为女性）与时型正常人群（正态组；n=1695）的时型，采用单样本 t 检验。此外，我们还调查了时型与疾病活动度（疾病活动评分；DAS）、报告的晨僵、疲劳（个体力量检查表）和健康相关生活质量（RAND-36）的关系。
RA 患者的时型平均比正态组早 23 分钟（95%可信区间，15 至 31 分钟）（t(115)=-5.901，p<0.001，d=0.55）。时型与疾病活动度或患者报告的结局无关（p>0.05）。
正如预期的那样，RA 患者的时型更早。然而，在这项相关性研究中，时型与疾病活动度或患者报告的结局无关。需要进行实验研究以检验延迟昼夜节律是否对这些结局有积极影响。这一见解可以加深我们对 RA 病理生理学的理解，并有助于探索新的治疗可能性。
这是第一项研究 RA 患者时型的研究，以及时型与疾病活动度和患者报告的结局的关系。
我们发现 RA 患者的时型比正常人群更早。
在这项相关性研究中，时型与疾病活动度或患者报告的结局无关。需要进行实验研究以检验延迟昼夜节律是否对这些结局有积极影响。
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