Association of circadian rest-activity rhythms with cardiovascular disease and mortality in type 2 diabetes

Diabetes Res Clin Pract. 2023 Mar:197:110262. doi: 10.1016/j.diabres.2023.110262. Epub 2023 Jan 20.

Abstract

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, HRQ1 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.

Keywords: Cardiovascular disease; Circadian rhythm; Mortality; Type 2 Diabetes.

MeSH terms

  • Aged
  • Cardiovascular Diseases*
  • Circadian Rhythm
  • Diabetes Mellitus, Type 2*
  • Female
  • Humans
  • Male
  • Rest
  • Sleep