Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
Crit Rev Food Sci Nutr. 2023;63(25):7546-7563. doi: 10.1080/10408398.2022.2047882. Epub 2022 Mar 14.
Chronotype is the attitude of subjects to carry out their daily activities mainly in the morning ("lark") or in the evening ("owl"). The intermediate chronotype is located between these two categories. It has been demonstrated that chronotype can influence the incidence, course and response to treatments of tumors. In particular patients diagnosed with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) and evening chronotype are characterized by unhealthy lifestyle, obesity, metabolic syndrome, a worsen cardiometabolic profile, a poor prognosis with a progressive disease and the development of metastasis. In addition, evening chronotype has been associated with sleep disturbances, which in turn have been related to tumor development and progression of tumors. There is a strict connection between sleep disturbances and NENs because of the hyperactivation of proangiogenic factors that caused aberrant neoangiogenesis. A nutritional tailored approach could represent a tool to align subjects with evening chronotype to physiological biological rhythms based on the properties of some macro and micronutrients of being substrate for melatonin synthesis. Thus, we aimed to provide an overview on the association of chronotype categories and sleep disturbances with NENs and to provide nutritional advices to manage subjects with NENs and these disturbances of circadian rhythm.
时型是指主体主要在早上（“百灵鸟”）或晚上（“猫头鹰”）进行日常活动的态度。中间时型位于这两个类别之间。已经证明，时型可以影响肿瘤的发生、病程和对治疗的反应。特别是诊断为胃肠胰神经内分泌肿瘤（GEP-NENs）和夜间时型的患者，其特点是生活方式不健康、肥胖、代谢综合征、心血管代谢状况恶化、疾病进展和转移的预后不良。此外，夜间时型与睡眠障碍有关，而睡眠障碍又与肿瘤的发生和肿瘤的发展有关。由于促血管生成因子的过度激活导致异常的新生血管形成，因此睡眠障碍与 NENs 之间存在严格的联系。根据一些宏量和微量营养素作为褪黑素合成底物的特性，量身定制的营养方法可能是一种将具有夜间时型的个体与生理生物节律相匹配的工具。因此，我们旨在概述时型类别和睡眠障碍与 NENs 的关联，并提供管理 NENs 患者和这些昼夜节律紊乱的营养建议。
