Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA.
Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA.
Sleep. 2024 Jan 11;47(1). doi: 10.1093/sleep/zsad262.
Although insufficient sleep is a risk factor for metabolic syndrome (MetS), the circadian timing of sleep (CTS) is also involved in cardiac and metabolic regulation. We examined whether delays and deviations in the sleep midpoint (SM), a measure of CTS, modify the association between visceral adipose tissue (VAT) and MetS in adolescents.
We evaluated 277 adolescents (median 16 years) who had at least 5 nights of at-home actigraphy (ACT), in-lab polysomnography (PSG), dual-energy X-ray absorptiometry (DXA) scan, and MetS score data. Sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL) were examined as effect modifiers of the association between VAT and MetS, including waist circumference, blood pressure, insulin resistance, triglycerides, and cholesterol. Linear regression models adjusted for demographics, ACT-sleep duration, ACT-sleep variability, and PSG-apnea-hypopnea index.
The association between VAT and MetS was significantly stronger (p-values for interactions < 0.001) among adolescents with a schooldays SM later than 4:00 (2.66 [0.30] points increase in MetS score), a SI higher than 1 hour (2.49 [0.30]) or a SJL greater than 1.5 hours (2.15 [0.36]), than in those with an earlier SM (<3:00; 1.76 [0.28]), lower SI (<30 minutes; 0.98 [0.70]), or optimal SJL (<30 minutes; 1.08 [0.45]).
A delayed sleep phase, an irregular sleep-wake cycle, and greater social jetlag on schooldays identified adolescents in whom VAT had a stronger association with MetS. Circadian misalignment is a risk factor that enhances the impact of visceral obesity on cardiometabolic morbidity and should be a target of preventative strategies in adolescents.
尽管睡眠不足是代谢综合征（MetS）的一个危险因素，但睡眠中点的昼夜节律（CTS）也与心脏和代谢调节有关。我们研究了睡眠中点（SM）的延迟和偏差是否会改变青少年内脏脂肪组织（VAT）与 MetS 之间的关联。
我们评估了 277 名至少有 5 个夜间家庭活动记录仪（ACT）、实验室多导睡眠图（PSG）、双能 X 射线吸收仪（DXA）扫描和 MetS 评分数据的青少年。SM、睡眠不规律（SI）和社会时差（SJL）被作为 VAT 与 MetS 之间关联的效应修饰剂进行研究，包括腰围、血压、胰岛素抵抗、甘油三酯和胆固醇。线性回归模型调整了人口统计学、ACT 睡眠时间、ACT 睡眠变异性和 PSG 呼吸暂停低通气指数。
在上学日 SM 晚于 4:00 的青少年（MetS 评分增加 2.66[0.30]分）、SI 高于 1 小时（2.49[0.30]）或 SJL 大于 1.5 小时（2.15[0.36]）的青少年中，VAT 与 MetS 的关联明显更强（交互作用的 p 值<0.001），而在 SM 较早（<3:00；1.76[0.28]）、SI 较低（<30 分钟；0.98[0.70]）或 SJL 较理想（<30 分钟；1.08[0.45]）的青少年中则较弱。
上学日时睡眠相位延迟、睡眠-觉醒周期不规律和更大的社会时差确定了 VAT 与 MetS 关联更强的青少年。昼夜节律失调是一种危险因素，会增加内脏肥胖对心血管代谢发病率的影响，应成为青少年预防策略的目标。
