个人光照暴露模式与2型糖尿病发病率：对1300万小时光传感器数据及67万人年前瞻性观察的分析
Personal light exposure patterns and incidence of type 2 diabetes: analysis of 13 million hours of light sensor data and 670,000 person-years of prospective observation.
作者信息
Windred Daniel P, Burns Angus C, Rutter Martin K, Ching Yeung Chris Ho, Lane Jacqueline M, Xiao Qian, Saxena Richa, Cain Sean W, Phillips Andrew J K
机构信息
Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
出版信息
Lancet Reg Health Eur. 2024 Jun 5;42:100943. doi: 10.1016/j.lanepe.2024.100943. eCollection 2024 Jul.
BACKGROUND
Light at night disrupts circadian rhythms, and circadian disruption is a risk factor for type 2 diabetes. Whether personal light exposure predicts diabetes risk has not been demonstrated in a large prospective cohort. We therefore assessed whether personal light exposure patterns predicted risk of incident type 2 diabetes in UK Biobank participants, using ∼13 million hours of light sensor data.
METHODS
Participants (N = 84,790, age (M ± SD) = 62.3 ± 7.9 years, 58% female) wore light sensors for one week, recording day and night light exposure. Circadian amplitude and phase were modeled from weekly light data. Incident type 2 diabetes was recorded (1997 cases; 7.9 ± 1.2 years follow-up; excluding diabetes cases prior to light-tracking). Risk of incident type 2 diabetes was assessed as a function of day and night light, circadian phase, and circadian amplitude, adjusting for age, sex, ethnicity, socioeconomic and lifestyle factors, and polygenic risk.
FINDINGS
Compared to people with dark nights (0-50th percentiles), diabetes risk was incrementally higher across brighter night light exposure percentiles (50-70th: multivariable-adjusted HR = 1.29 [1.14-1.46]; 70-90th: 1.39 [1.24-1.57]; and 90-100th: 1.53 [1.32-1.77]). Diabetes risk was higher in people with lower modeled circadian amplitude (aHR = 1.07 [1.03-1.10] per SD), and with early or late circadian phase (aHR range: 1.06-1.26). Night light and polygenic risk independently predicted higher diabetes risk. The difference in diabetes risk between people with bright and dark nights was similar to the difference between people with low and moderate genetic risk.
INTERPRETATION
Type 2 diabetes risk was higher in people exposed to brighter night light, and in people exposed to light patterns that may disrupt circadian rhythms. Avoidance of light at night could be a simple and cost-effective recommendation that mitigates risk of diabetes, even in those with high genetic risk.
FUNDING
Australian Government Research Training Program.
背景
夜间光照会扰乱昼夜节律，而昼夜节律紊乱是2型糖尿病的一个风险因素。个人光照暴露是否能预测糖尿病风险尚未在大型前瞻性队列中得到证实。因此，我们利用约1300万小时的光传感器数据，评估了英国生物银行参与者的个人光照暴露模式是否能预测2型糖尿病的发病风险。
方法
参与者（N = 84790，年龄（均值±标准差）= 62.3 ± 7.9岁，58%为女性）佩戴光传感器一周，记录白天和夜间的光照暴露情况。根据每周的光照数据对昼夜节律振幅和相位进行建模。记录2型糖尿病的发病情况（1997例；随访7.9 ± 1.2年；排除光照追踪前的糖尿病病例）。根据白天和夜间光照、昼夜节律相位和昼夜节律振幅评估2型糖尿病的发病风险，并对年龄、性别、种族、社会经济和生活方式因素以及多基因风险进行调整。
研究结果
与夜间黑暗（第0 - 50百分位数）的人相比，夜间光照越亮，糖尿病风险越高（第50 - 70百分位数：多变量调整后的风险比= 1.29 [1.14 - 1.46]；第70 - 90百分位数：1.39 [1.24 - 1.57]；第90 - 100百分位数：1.53 [1.32 - 1.77]）。昼夜节律振幅较低（每标准差的调整后风险比= 1.07 [1.03 - 1.10]）以及昼夜节律相位较早或较晚的人糖尿病风险更高（调整后风险比范围：1.06 - 1.26）。夜间光照和多基因风险独立预测更高的糖尿病风险。夜间明亮和黑暗的人之间糖尿病风险的差异与低和中度遗传风险的人之间的差异相似。
解读
夜间光照较亮以及暴露于可能扰乱昼夜节律的光照模式下的人2型糖尿病风险更高。避免夜间光照可能是一项简单且经济有效的建议，可降低糖尿病风险，即使对那些遗传风险高的人也是如此。
资助
澳大利亚政府研究培训项目。
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