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Social isolation, loneliness and subsequent risk of major adverse cardiovascular events among individuals with type 2 diabetes mellitus

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General Psychiatry 2023年第6期36卷 481-490页

作者： Yannis Yan Liang Yilin Chen Hongliang Feng Huachen Xue Yu Nie Qi-Yong H ai Jiacheng Ma Lulu Yang Jihui Zhang sizhi ai Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical UniversityGuangzhouGuangdongChina institute of Psycho-neuroscience The Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina Guangdong Cardiovascular Institute Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouGuangdongChina State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science Department of Neurology and National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina Department of Health Technology and Informatics The Hong Kong Polytechnic UniversityKowloonHong Kong Department of Cardiology Heart CenterThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiHenanChina

Background Individuals with type 2 diabetes mellitus(T2DM)are more vulnerable to social disconnection compared with the general population;however,there are few relevant studies investigating this issue.aims To investigate whether social isolation or loneliness may be associated with subsequent risk of developing major adverse cardiovascular events,whether these associations vary according to fatal and non-fatal outcomes and how behavioural,psychological and physiological factors mediate these associations.Methods This longitudinal analysis included data from 19360 individuals with T2DM at baseline(2006-2010)from the UK Biobank.Social isolation and loneliness were measured using self-report questionnaires.The study outcomes included the first events of myocardial infarction(MI)or stroke(n=2273)and all-cause(n=2820)or cardiovascular disease-related mortality through linked hospital data ordeath registries.Results Over a median follow-up of 12.4 years(interquartile range(IQR):11.6-13.3 years),participants who were more socially isolated(most social isolation vs least social isolation)experienced increased risks for all-cause(hazard ratio(HR):1.33,95%confidence interval(Cl):1.19 to 1.47)and cardiovascular disease(HR:1.36,95%Cl:1.17 to 1.59)mortality but not first Ml or stroke.Loneliness(yes vs no)was associated with a greater risk for a composite of incident MI or stroke(HR:1.37,95%Cl:1.19 to 1.57)but not mortality.Social isolation was associated with fatal Ml and stroke,whereas loneliness was associated with non-fatal Ml and stroke.The significant associations of social isolation and loneliness with outcomes were mainly mediated by behavioural factors(mediating proportion:17.8%-28.2%and 17.6%-17.8%,respectively).Conclusions Among individuals with T2DM,social isolation and loneliness are associated with a greater risk of developing major adverse cardiovascular events,with differences in both risks stratified according to fatal and non-fatal events and underlying mediating factors.

关键词： cardiovascular mortality mellitus

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Causal relationships between chronotype and risk of multiple cancers by using longitudinal data and Mendelian randomization analysis

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Science China(Life Sciences) 2023年第10期66卷 2433-2436页

作者： Shanshan Tian Longtao Huangfu sizhi ai Junwei Zheng Le Shi Wei Yan Ximei Zhu Qianwen Wang Jiahui Deng Yanping Bao Suhua Chang Lin Lu Peking University Sixth Hospital Peking University Institute of Mental HealthNHC Key Laboratory of Mental Health(Peking University)National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital)Beijing 100191China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education) Division of Gastrointestinal Cancer Translational Research LaboratoryPeking University Cancer Hospital&InstituteBeijing 100142China Department of Cardiology Heart CenterThe First Affiliated Hospital of Xinxiang Medical UniversityXinxiang 453100China National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Peking UniversityBeijing 100191China Chinese Academy of Medical Sciences Research Unit(No.2018RU006) Peking UniversityBeijing 100191China Peking-Tsinghua Center for Life Sciences PKU-IDG/McGovern Institute for Brain ResearchBeijing 100871China

Dear Editor,Cancer is the second leading cause of death worldwide,and the cancer situation is becoming more complicated(Zhou et al.,2022).The International Agency for Research on Cancer(IARC)Monographs Working Group c... 详细信息

关键词： Cancer death

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Association between sleep duration and metabolic syndrome: linear and nonlinear Mendelian randomization analyses

Association between sleep duration and metabolic syndrome: l...

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中国睡眠研究会第十五届全国学术年会

作者： sizhi ai The Affiliated Brain Hospital of Guangzhou Medical University

Background: Observational studies have found that both short and long sleep duration are associated with increased risk of metabolic syndrome(MetS).This study aimed to examine the associations of genetically determined sleep durations with MetS and its five components(i.e., central obesity, high blood pressure, dyslipidemia, hypertriglyceridemia,and hyperglycemia) among a group of elderly population.Methods: In 335,727 participants of White British from the UK Biobank, linear Mendelian randomization(MR) methods were first employed to examine the causal association of genetically predicted continuous sleep duration with MetS and its each component.Nonlinear MR analyses were performed to determine the nonlinearity of these associations.The causal associations of short and long sleep duration with MetS and its components were further assessed by using genetic variants that associated with short(≤ 6 h) and long sleep(≥ 9 h) durations.Results: Linear MR analyses demonstrated that genetically predicted 1-h longer sleep duration was associated with a 13% lower risk of MetS, a 30% lower risk of central obesity, and a 26% lower risk of hyperglycemia.Non-linear MR analyses provided evidence for non-linear associations of genetically predicted sleep duration with MetS and its five components(all P values < 0.008).Genetically predicted short sleep duration was moderately associated with MetS and its four components, including central obesity, dyslipidemia, hypertriglyceridemia, and hyperglycemia(all P values < 0.002), whereas genetically long sleep duration was not associated with MetS and any of its components.Conclusions: Genetically predicted short sleep duration, but not genetically predicted long sleep duration, is a potentially causal risk factor for MetS.

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Association between Alcohol Consumption and Sleep Traits: Observational and Mendelian Randomization Studies in the UK Biobank

Association between Alcohol Consumption and Sleep Traits: Ob...

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中国睡眠研究会第十五届全国学术年会

作者： Junwei Zheng Jie Shi Yan Sun sizhi ai National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Peking University The Affiliated Brain Hospital of Guangzhou Medical University

Objective: Previous studies have shown that excessive alcohol consumption is associated with poor sleep.However, the health risks of light-to-moderate alcohol consumption in relation to sleep traits(e.g., insomnia, snoring, sleep duration and chronotype) remain undefined, and their causality is still unclear in the general population.To identify the association between alcohol consumption and multiple sleep traits using an observational and Mendelian randomization(MR) design.Methods: Observational analyses and one-sample MR(linear and nonlinear) were performed using clinical and individual-level genetic data from the UK Biobank(UKB).Two-sample MR was assessed using summary data from genome-wide association studies from the UKB and other external consortia.Phenotype analyses were externally validated using data from the National Health and Nutrition Examination Survey(2017–2018).Data analysis was conducted from January 2022 to October 2022.The association between alcohol consumption and six self-reported sleep traits(short sleep duration, long sleep duration, chronotype, snoring, waking up in the morning, and insomnia).Results: This study included 383,357 UKB participants(mean [SD] age, 57.0 [8.0] years;46% male) who consumed a mean(SD) of 9.0(10.0) standard drinks(one standard drink equivalent to 14 g of alcohol) per week.In the observational analyses, alcohol consumption was significantly associated with all sleep traits.Light-moderate-heavy alcohol consumption was linearly linked to snoring and the evening chronotype but nonlinearly associated with insomnia, sleep duration, and napping.In linear MR analyses, a 1-SD(14 g) increase in genetically predicted alcohol consumption was associated with a 1.14-fold(95% CI, 1.07-1.22) higher risk of snoring(P <.001), a 1.28-fold(95% CI, 1.20-1.37) higher risk of evening chronotype(P <.001) and a 1.24-fold(95% CI, 1.13-1.36) higher risk of difficulty waking up in the morning(P <.001).Nonlinear MR analyses did not reveal significant results after Bonferroni adjustment but s

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Associations of Accelerometer-measured Sleep Duration and Efficiency with Mortality in 90 398 Middle-aged Adults

Associations of Accelerometer-measured Sleep Duration and Ef...

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中国睡眠研究会第十四届全国学术年会

作者： Huachen Xue Yan Liang sizhi ai Jihui Zhang The Affiliated Brain Hospital of Guangzhou Medical University Guangdong Cardiovascular Institute Guangdong Provincial People's HospitalGuangdong Academy of Medical Sciences Department of Cardiology Heart Center The First Affiliated Hospital of Xinxiang Medical University

Objectives: To investigate the associations of accelerometermeasured sleep duration and efficiency and their interaction effect on mortality risks.Patients and Methods: The UK Biobank is a population-based study that includes over 500 000 individuals across the United Kingdom between 2006 and 2010. This study included participants who wore wrist accelerometers for 7 consecutive days between February 2013 and December 2015. Follow-up duration was 6.4(interquartile range [IQR], 5.8 to 6.9) years. Data analysis was conducted from June 1, 2021 to December 31, 2021.Results: Of the 90 398 participants(mean [standard deviation, SD] age, 62.4 [7.8] years, 39 342(43.5%) were male). The associations between continuous sleep duration and mortality were nonlinear(P nonlinear<.001). In the fully adjusted Cox models, compared with normal sleep duration, short sleep duration increased all-cause(hazard ratios [HR], 1.27;95% CI, 1.11 to 1.45), cardiovascular diseases(CVD)-caused, and other-caused mortality risks, while long sleep duration elevated all-cause(HR, 1.16;95% CI, 1.06 to 1.28), cancer-caused, and other-caused mortality risks. After excluding participants with baseline CVD and cancer, the associations of long sleep duration with mortality became statistically insignificant. Lower sleep efficiency was associated with an increased risk of all-cause and CVD-caused mortality. Sleep duration and efficiency interacted to increase all-cause mortality risk(P interaction=.015).Conclusions: Accelerometer-measured short sleep duration and lower sleep efficiency were associated with increased mortality risks, while long sleep duration was likely a surrogate marker of underlying morbidities.

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Sleep Duration and Metabolic Syndrome: A Mendelian Randomization Study Short title: Sleep duration and metabolic syndrome

Sleep Duration and Metabolic Syndrome: A Mendelian Randomiza...

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中国睡眠研究会第十四届全国学术年会

作者： Jiayin Li Yan Liang sizhi ai Jihui Zhang The Affiliated Brain Hospital of Guangzhou Medical University Guangdong Cardiovascular Institute Guangdong Provincial People's HospitalGuangdong Academy of Medical Sciences Department of Cardiology Heart Center The First Affiliated Hospital of Xinxiang Medical University

Background. Observational studies have found that both short and long sleep duration are associated with increased risk of metabolic syndrome(MetS). This study aimed to examine the associations of genetically determined sleep durations and MetS and its components. Methods. In 335,727 participants of White British from the UK Biobank, linear Mendelian randomization(MR) methods were first employed to examine the causal association of genetically predicted continuous sleep duration with MetS and its each component. Nonlinear MR analyses were performed to determine the shape of these associations. The causal associations of short and long sleep duration with MetS and its components were further assessed by using genetic variants that associated with short(≤ 6 h) and long sleep(≥ 9 h) durations.Results. Linear MR analyses demonstrated that genetically predicted 1-hour longer sleep duration was associated with a 13% lower risk of MetS, a 30% lower risk of central obesity, and a 26% lower risk of hyperglycemia. Non-linear MR analyses provided evidence for non-linear associations of genetically predicted sleep duration with MetS and its five components(all P values < 0.008). Genetically predicted short sleep duration was moderately associated with MetS and its components except for high blood pressure, whereas genetically long sleep duration was not associated with MetS and any of its components.Conclusion. Genetically predicted short sleep duration, but not genetically predicted long sleep duration, is a potentially causal risk factor for MetS.

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Objectively measured amplitude of circadian rest-activity rhythm and health risk

Objectively measured amplitude of circadian rest-activity rh...

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中国睡眠研究会第十四届全国学术年会

作者： Hongliang Feng Lulu Yang sizhi ai Yue Liu Binbin Lei Jihui Zhang Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences) Guangdong Cardiovascular Institute Guangdong Provincial People's HospitalGuangdong Academy of Medical Sciences Li Chiu Kong Family Sleep Assessment Unit Department of Psychiatry Faculty of Medicine The Chinese University of Hong Kong Department of Cardiology Heart Center The First Affiliated Hospital of Xinxiang Medical University Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University

Background: The expected health effects of circadian rhythm are of major public health interest. However, due to the obvious difficulties in measuring circadian rhythm in terms of serial sampling across different time points and days among free-living subjects, its associations with universal health outcomes among the general population are largely unknown. Thus, this study aimed to examine the associations between accelerometer-measured amplitude of circadian rest-activity rhythm and health risk among the general population.Methods: In this prospective population based UK Biobank cohort study, of 103 682 participants who were 43 to 79 years old and had accelerometer data, 92 614(mean age 62.36 years, 56.38% female) were eligible for inclusion. These participants were recruited between 2013 and 2015. Follow-up occurred through May 2021. The amplitude of circadian rest-activity rhythm was measured by relative amplitude using accelerometer data. Lower relative amplitude was defined as the first quintile of relative amplitude. Participants in the remaining quintiles served as the reference group. The outcomes included incident cardiovascular, cancer, infectious, respiratory,and digestive diseases, as well as all-cause and cause-specific mortality. They were collected through hospital inpatient admissions, death registry, and cancer registry.Results: Decreased relative amplitude was significantly associated with higher hazards for the incidences of cardiovascular(adjusted HR: 1.12, 95% CI: 1.06-1.17), cancer(1.08, 1.01-1.15), infectious(1.33, 1.24-1.44), respiratory(1.28, 1.20-1.36), and digestive diseases(1.09, 1.04-1.14), and mortality from all-cause(1.41, 1.28-1.56), cardiovascular diseases(1.70, 1.31-2.20), cancer(1.24, 1.06-1.46), and respiratory diseases(1.46, 1.12-1.91). These associations were rather consistent after multiple testing correction and comprehensive sensitivity analyses. Decreased amplitude of circadian rest-activity rhythm exhibited the strongest associations with eight out of nine tested outcom

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Association between rest-activity rhythm and risk of atrial fibrillation: findings from the UK Biobank Study

Association between rest-activity rhythm and risk of atrial ...

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中国睡眠研究会第十四届全国学术年会

作者： Lulu Yang Hongliang Feng sizhi ai Yue Liu Binbin Lei Jie Chen Jihui Zhang Guangdong Provincial People's Hospital The Chinese University of Hong Kong The Affiliated Brain Hospital of Guangzhou Medical University

Introduction: Evidence shows a prominent circadian variation is present in atrial fibrillation attacks. However, it remains unknown whether disrupted circadian rhythm could predict the risk of atrial fibrillation. This study aimed to examine rest-activity rhythm characteristics in relation to atrial fibrillation in a large population-based cohort.Methods: This prospective study included 92614 participants with 7-days accelerometer from the UK Biobank. Rest-activity characteristics were derived from 7-day accelerometer data using nonparametric rhythm analysis, including interdaily stability(IS), intradaily variability(IV), relative amplitude(RA), and most active 10 h period(M10) and least active 5 h period(L5) counts and onset. Cox proportional hazard regression, with time since accelerometer wearing time as the start of follow-up, was used to model the associations of rest-activity rhythm characteristics and risk of atrial fibrillation.Results: Multiple rest-activity characteristics predicted an increase in AF risk, including rest-activity states(IV, hazard ratio [HR]Q4 vs. Q1 1.14 [95% CI 1.02, 1.27]), weakened rhythm amplitudes(RA, HRQ1 vs. Q4 1.44 [95% CI 1.28, 1.62]), great nocturnal activity levels(L5, HRQ4 vs. Q1 1.84 [95% CI 1.39, 2.44]), and low daytime activity levels(M10, HRQ1 vs. Q4 1.33 [95% CI 1.18, 1.50]) were found to associate with an increased risk of AF. The association between nighttime activity offset and risk of AF was of marginal significance(L5 onset, HRdelayed vs. intermediate 1.10 [95% CI 1.00, 1.22]). No associations of fragmentation of unstable interdaily patterns(IS) and daytime activity patterns phase(M10 onset) with the incidence of AF were observed in our study.Conclusions: Our findings showed disrupted rest-activity rhythm was associated with an increased risk of atrial fibrillation among the general population. Future studies are needed to determine whether strategies to improve circadian function affect the risk of atrial fibrillation.

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Associations of timing of physical activity with all-cause and cause-specific mortality in a prospective cohort study

Associations of timing of physical activity with all-cause a...

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中国睡眠研究会第十五届全国学术年会

作者：封红亮 Lulu Yang Yannis Yan Liang sizhi ai Yaping Liu Yun Kwok Wing Jihui Zhang Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangdong Cardiovascular Institute Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Li Chiu Kong Family Sleep Assessment Unit Department of Psychiatry Faculty of Medicine The Chinese University of Hong Kong

Little is known about optimal timing of physical activity to maximize health benefits.We performed a cohort study with valid accelerometer data and all-cause and cause-specific mortality outcomes.Moderate-to-vigorous intensity physical activity(MVPA) at any time of day is associated with lower risks for all-cause, cardiovascular disease, and cancer mortality.In addition, compared with morning group, midday-afternoon and mixed MVPA timing groups have lower risks of all-cause and cardiovascular disease mortality.Here, we show that MVPA timing may have potential to improve health.

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Association between accelerometer-measured amplitude of rest–activity rhythm and future health risk

Association between accelerometer-measured amplitude of rest...

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中国睡眠研究会第十五届全国学术年会

作者：封红亮 Lulu Yang sizhi ai Yue Liu Weijie Zhang Yaping Liu Yun Kwok Wing Jihui Zhang Center for Sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical University Guangdong Cardiovascular Institute Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Li Chiu Kong Family Sleep Assessment Unit Department of Psychiatry Faculty of Medicine The Chinese University of Hong Kong

The health effects of rest–activity rhythm are of major interest to public health, but its associations with health outcomes among general population remain largely elusive.We aimed to examine the associations between accelerometer-measured rest–activity rhythm amplitude and health risks.Our results suggest that low rest–activity rhythm amplitude might contribute to major health outcomes(even stronger than physical activity and poor sleep) and provide further evidence to promote risk-modifying strategies associated with rest–activity rhythm to improve health and longevity.

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