Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
Cattedra Unesco "Educazione Alla Salute e allo Sviluppo Sostenibile", Federico II University, 80131 Naples, Italy.
Nutrients. 2021 Sep 28;13(10):3444. doi: 10.3390/nu13103444.
To investigate the potential association among Craniopharyngioma (CP), chronotypes and metabolic risk profile.
The study population included 28 patients (46.4% males; 42.6 ± 15.8 years) and 28 controls, age, gender and BMI matched (46.4% males; 46.5 ± 12.9 years). In this study sample, we evaluated: anthropometric measurements (waist circumference, WC; BMI), plasma glucose, lipid profile, and systolic (SBP) and diastolic (DBP) blood pressure. Morningness-Eveningness was measured with the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ), which included 19 questions about preferred sleep time and daily performance.
in both patients and controls grade I obesity was detected in 15 subjects (53.6%), grade II obesity in 13 subjects (46.4%). In the patient group, the mean score of chronotype was 47.8 ± 12.6. In particular, 9 patients (32.1%) exhibited the morning chronotype, 6 (21.4%) the intermediate chronotype and 13 (46.4.%) the evening chronotype. No significant difference was found in gender and age among the chronotype categories. Patients with the evening chronotype had higher blood pressure values and worse metabolic parameters than those with the morning chronotype. In the control group, the mean score of the chronotype was 57.6 ± 9.5. In particular, 16 (57.1%) subjects exhibited the morning chronotype, 10 (35.7%) the intermediate chronotype and only 2 (7.1.%) the evening chronotype. The prevalence of intermediate and evening chronotypes was higher in females than males ( = 0.021), while males have a higher prevalence of the morning chronotype. Subjects with intermediate and evening chronotypes had worse metabolic parameters than those with the morning chronotype. In patients, the chronotype score was inversely correlated to WC, BMI, SBP, DBP, plasma glucose, total cholesterol, triglycerides, LDL cholesterol and positively correlated with HDL cholesterol. No correlation was found between age and chronotype. In controls, the chronotype score was inversely correlated to WC, BMI, plasma glucose, total cholesterol, LDL cholesterol. No correlation was found among chronotype and age, blood pressure, triglycerides, HDL cholesterol. Considering the whole population of the study (patients and controls), at logistic regression the chronotype score was significantly associated with the presence of CP.
for the first time thus far, our study puts the light on the association of the CP with chronotypes and metabolic alterations in this disease, which are the main determinants of the reduced quality of life, higher morbidity and mortality in this setting of patients. This finding suggests that alterations of chronotype might represent an adjunctive risk for CP patients and a possible target for their integrate management.
探讨颅咽管瘤（CP）、睡眠时相和代谢风险特征之间的潜在关联。
研究人群包括 28 例患者（46.4%为男性；42.6±15.8 岁）和 28 例年龄、性别和 BMI 匹配的对照组（46.4%为男性；46.5±12.9 岁）。在本研究样本中，我们评估了：人体测量学测量（腰围、BMI）、血浆葡萄糖、血脂谱以及收缩压（SBP）和舒张压（DBP）。采用 Horne-Ostberg 睡眠时相问卷（MEQ）评估晨型/晚型，该问卷包含 19 个关于偏好睡眠时间和日常表现的问题。
在患者和对照组中，均有 15 例（53.6%）存在 I 级肥胖，13 例（46.4%）存在 II 级肥胖。在患者组中，时相平均得分为 47.8±12.6。具体而言，9 例（32.1%）患者为晨型，6 例（21.4%）为中间型，13 例（46.4%）为晚型。时相类别在性别和年龄方面无显著差异。晚型患者的血压值和代谢参数较晨型患者差。在对照组中，时相平均得分为 57.6±9.5。具体而言，16 例（57.1%）为晨型，10 例（35.7%）为中间型，仅 2 例（7.1.%）为晚型。女性中间型和晚型的患病率高于男性（=0.021），而男性晨型的患病率较高。中间型和晚型患者的代谢参数较晨型患者差。在患者中，时相评分与 WC、BMI、SBP、DBP、血浆葡萄糖、总胆固醇、甘油三酯、LDL 胆固醇呈负相关，与 HDL 胆固醇呈正相关。年龄与时相无相关性。在对照组中，时相评分与 WC、BMI、血浆葡萄糖、总胆固醇、LDL 胆固醇呈负相关。时相与年龄、血压、甘油三酯、HDL 胆固醇无相关性。考虑到研究人群（患者和对照组）的整体情况，logistic 回归分析表明，时相评分与 CP 的存在显著相关。
本研究首次阐明了 CP 与睡眠时相和代谢改变之间的关联，这些改变是 CP 患者生活质量下降、发病率和死亡率升高的主要决定因素。这一发现提示，时相改变可能是 CP 患者的附加风险因素，也是其综合管理的可能靶点。
