Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea.
Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Diabetes Metab J. 2024 Sep;48(5):847-863. doi: 10.4093/dmj.2024.0237. Epub 2024 Sep 1.
The widespread and pervasive use of artificial light at night (ALAN) in our modern 24-hour society has emerged as a substantial disruptor of natural circadian rhythms, potentially leading to a rise in unhealthy lifestyle-related behaviors (e.g., poor sleep; shift work). This phenomenon has been associated with an increased risk of type 2 diabetes mellitus (T2DM), which is a pressing global public health concern. However, to date, reviews summarizing associations between ALAN and T2DM have primarily focused on the limited characteristics of exposure (e.g., intensity) to ALAN. This literature review extends beyond prior reviews by consolidating recent studies from 2000 to 2024 regarding associations between both indoor and outdoor ALAN exposure and the incidence or prevalence of T2DM. We also described potential biological mechanisms through which ALAN modulates glucose metabolism. Furthermore, we outlined knowledge gaps and investigated how various ALAN characteristics beyond only light intensity (including light type, timing, duration, wavelength, and individual sensitivity) influence T2DM risk. Recognizing the detrimental impact of ALAN on sleep health and the behavioral correlates of physical activity and dietary patterns, we additionally summarized studies investigating the potential mediating role of each component in the relationship between ALAN and glucose metabolism. Lastly, we proposed implications of chronotherapies and chrononutrition for diabetes management in the context of ALAN exposure.
在我们的现代 24 小时社会中,夜间人工照明(ALAN)的广泛和普遍使用已经成为自然昼夜节律的主要干扰因素,可能导致与不健康生活方式相关的行为(例如睡眠不佳;轮班工作)增加。这种现象与 2 型糖尿病(T2DM)的风险增加有关,这是一个紧迫的全球公共卫生问题。然而,迄今为止,总结 ALAN 与 T2DM 之间关联的综述主要集中在对 ALAN 暴露(例如强度)的有限特征上。这篇文献综述通过整合 2000 年至 2024 年期间关于室内和室外 ALAN 暴露与 T2DM 发病率或患病率之间关联的最新研究,扩展了之前的综述。我们还描述了 ALAN 调节葡萄糖代谢的潜在生物学机制。此外,我们概述了知识空白,并研究了除光强度(包括光类型、时间、持续时间、波长和个体敏感性)以外的各种 ALAN 特征如何影响 T2DM 风险。认识到 ALAN 对睡眠健康以及身体活动和饮食模式的行为相关性的有害影响,我们还总结了研究每个成分在 ALAN 与葡萄糖代谢之间关系中的潜在中介作用的研究。最后,我们提出了在 ALAN 暴露背景下,时间疗法和时间营养对糖尿病管理的意义。