医学
危险系数
内科学
糖尿病
比例危险模型
四分位数
2型糖尿病
昼夜节律
疾病
置信区间
内分泌学
心脏病学
作者
Lulu Yang,Hongliang Feng,Jie Chen,Yun Kwok Wing,Christian Benedict,Xiao Tan,Jihui Zhang
标识
DOI:10.1016/j.diabres.2023.110262
摘要
Aims: To examine the associations of disrupted circadian rest-activity rhythm (CRAR) with cardiovascular diseases and mortality among people with type 2 diabetes.Methods: A total of 3147 participants with baseline type 2 diabetes (mean age 65.21 years, 39.78% female; mean HbA1c 50.02 mmol/mol) from UK Biobank were included.The following CRAR parameters were derived from acceleration data: interdaily stability (IS), intradaily variability (IV), relative amplitude (RA), most active 10 h period onset (M10 onset), and least active 5 h period onset (L5 onset).We used Cox proportional hazards models to estimate the associations of CRAR with cardiovascular diseases and mortality, adjusting for sociodemographic, lifestyle, and health characteristics.Results: Participants in the lowest quartile of IS and RA exhibited the greatest risk of developing cardiovascular disease (IS, hazard ratio [HR] Q1 vs. Q4 1.40 [95% confidence interval (CI) 1.04, 1.88]; RA, HR Q1 vs. Q4 2. 45 [95% CI 1.73, 3.49]).However, the association between delayed L5 onset and cardiovascular disease risk did not reach statistical significance.Additionally, we found that high IV and low RA were associated with all-cause and cardiovascular mortality.Conclusion: Objectively determined CRAR disturbances may increase the risk of cardiovascular diseases and mortality among people with type 2 diabetes.
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