美国内科医学年鉴2023年月10月12日 一项涉及60,000多名护士的研究表明，患有晚间睡眠型的人患糖尿病的风险较高，并且经常从事不健康的生活习惯。对中年护士的大型研究发现，那些有晚间睡眠型的人更有可能从事整体不健康的生活方式，特别是吸烟，睡眠不佳和缺乏身体活动，并且患糖尿病的风险高出72%。
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最近涉及60,000多名中年护士的研究发现，那些晚上睡眠型的人，其特征是在当天晚些时候感觉更有活力，患糖尿病的风险更高。此外，这些人往往表现出不健康的生活习惯，如吸烟、睡眠不足和缺乏身体活动。这是与具有早晨时间型的人相比。然而，作者指出，参与者的职业、教育水平和社会经济地位等因素可能会影响这些结果。这项研究的结果于12月<>日发表在《内科医学年鉴》上。
了解时间类型
时间型，也称为昼夜节律偏好，是一种部分由遗传决定的结构，指的是一个人对更早或更晚的睡眠时间的倾向。大约8%的人口拥有晚间睡眠型。值得注意的是，这与代谢调节不良、血糖控制紊乱、代谢紊乱以及 2 型糖尿病的发病率和患病率较高有关。然而，观察到的夜间睡眠型与糖尿病风险升高之间联系背后的确切原因仍然难以捉摸。
详细的研究结果
来自布莱根妇女医院和哈佛医学院的科学家在 63 年至 676 年期间对 45,62 名年龄在 2009 至 2017 岁之间没有癌症、心血管疾病或糖尿病病史的护士进行了一项前瞻性队列研究。
研究人员发现，具有“明确晚上”时间类型的参与者比报告“明确早晨”时间类型的参与者有不健康生活方式的可能性高54%。在随访期间，晚间睡眠型患者患糖尿病的风险也高出72%。
根据作者的说法，即使在调整了所有测量的生活方式和社会人口因素之后，这种关联也减弱了，但仍然存在。他们强调，这些结果仅限于最近没有上夜班的人。未来需要利用时间型遗传决定因素对其他人群进行研究，以确定他们的发现是否适用于男性、非白人种族或族裔群体或其他社会经济阶层。此外，饮食、运动和体重的代际差异可能会限制他们的发现对年轻或年长一代或当前时代的适用性。
编辑见解
哈佛大学陈曾熙公共卫生学院和哈佛医学院的作者的一篇相应社论强调，有几个因素，包括心理因素、工作类型以及可能的生活类型变化可能会混淆这项研究的结果。他们补充说，结果表明，由于时间类型和工作时间不匹配而不是时间类型而导致的昼夜节律错位可能是这些结果的潜在机制。
社论作者认为，这项研究增加了越来越多的证据表明，将夜班工人重新分配到夜班可以改善轮班工人的睡眠并改善他们的代谢健康。最后，他们指出，这些结果指出了开发标准化工具以在一个人的一生中定期评估时间类型的潜在好处。
有关本研究的更多信息，请参阅熬夜与糖尿病风险增加有关。
参考文献：“美国中年女性的时间型、不健康的生活方式和糖尿病风险：一项前瞻性队列研究”，作者：Sina Kianersi，DVM，博士;刘悦，医学博士;玛尔塔·瓜施-费雷博士;苏珊·雷德林，医学博士，公共卫生硕士;伊娃·谢恩哈默，医学博士，博士;孙琦，医学博士，ScD和黄天一，ScD，MSc，12年2023月10日，内科医学年鉴。
DOI： 7326.23/M0728-<>
原文：
Night Owl Phenomenon: The Hidden Dangers of an Evening Chronotype
TOPICS:American College Of PhysiciansCircadian RhythmDiabetesSleep Science
By AMERICAN COLLEGE OF PHYSICIANS SEPTEMBER 19, 2023
Night Owl Working Late Art
A study involving over 60,000 nurses revealed that individuals with an evening chronotype are at an elevated risk for diabetes and often engage in unhealthy lifestyle habits.
Large study of middle-aged nurses found those with an evening chronotype were more likely to engage in an overall unhealthy lifestyle particularly smoking, poor sleep, and physical inactivity, and had a 72 percent higher risk of developing diabetes.
Recent research involving over 60,000 middle-aged nurses has discovered that those with an evening chronotype, characterized by feeling more energetic later in the day, are at a heightened risk of diabetes. Additionally, these individuals tend to exhibit unhealthy lifestyle habits such as smoking, insufficient sleep, and physical inactivity. This is when compared to individuals with a morning chronotype. However, the authors indicate that factors like profession, education level, and socioeconomic status of participants could influence these results. The study’s findings were released on September 12 in the Annals of Internal Medicine.
Understanding Chronotype
Chronotype, also known as circadian preference, is a partly genetically determined construct and refers to one’s inclination for earlier or later sleeping times. Roughly 8% of the population possesses an evening chronotype. Notably, this has been associated with poor metabolic regulation, disturbances in glycemic control, metabolic disorders, and a higher incidence and prevalence of type 2 diabetes. However, the precise reasons behind the observed connection between an evening chronotype and elevated diabetes risk remain elusive.
Detailed Study Findings
Scientists from Brigham and Women’s Hospital and Harvard Medical School conducted a prospective cohort study of 63,676 nurses aged 45 to 62 years with no history of cancer, cardiovascular disease, or diabetes from 2009 to 2017.
The researchers discovered that participants with a “definite evening” chronotype were 54 percent more likely to have an unhealthy lifestyle than participants reporting a “definite morning” chronotype. Persons with evening chronotype also had a 72 percent higher risk of developing diabetes during the follow-up period.
According to the authors, this association weakened but persisted even after adjusting for all measured lifestyle and sociodemographic factors. They emphasize that these results are restricted to persons who did not work recent night shifts. Future investigation in other populations leveraging genetic determinants for chronotype is needed to determine whether their findings are applicable to men, non-White racial or ethnic groups, or other socioeconomic classes. Furthermore, generational differences in diet, exercise, and body weight may limit the applicability of their findings to younger or older generations or current times.
Editorial Insights
A corresponding editorial by authors from the Harvard T.H. Chan School of Public Health and Harvard Medical School highlights that several factors, including psychological factors, type of work, and possible lifetime changes to chronotype could confound the results of this study. They add that the results suggest that circadian misalignment due to a mismatch between chronotype and work timing, rather than the chronotype, may be a potential mechanism for these results.
The editorial authors suggest that this study adds to the growing evidence that reassigning evening chronotype workers to night shifts may improve sleep among shift workers and improve their metabolic health. Finally, they note that these results point to the potential benefit of developing standardized tools to assess chronotype regularly throughout a person’s life.
For more on this study, see Staying Up Late Tied to Increased Diabetes Risk.
Reference: “Chronotype, Unhealthy Lifestyle, and Diabetes Risk in Middle-Aged U.S. Women: A Prospective Cohort Study” by Sina Kianersi, DVM, PhD; Yue Liu, MD; Marta Guasch-Ferré, PhD; Susan Redline, MD, MPH; Eva Schernhammer, MD, DrPH; Qi Sun, MD, ScD and Tianyi Huang, ScD, MSc, 12 September 2023, Annals of Internal Medicine.
DOI: 10.7326/M23-0728