Circadian regulation of glucose, lipid, and energy metabolism in humans

Molecular responses of paddy field carp (Cyprinus carpio) in the agricultural heritage to major environmental factors in paddy fields

As a core element of the Globally Important Agricultural Heritage System (GIAHS), the Qingtian paddy field carp (Cyprinus carpio, PF-carp) has been domesticated for over 1200 years in paddy field environments. This species has successfully adapted to shallow-water conditions in paddy fields. To reveal the adaptation mechanism, we conducted transcriptome sequencing on the hepatopancreas of PF-carp under two temperature conditions (28 °C and 38 °C) and concurrently analysed RNA-seq data from hypoxic conditions in the same tissue. By analysing high-temperature transcriptome data, 3154 differentially expressed genes (DEGs) were identified. KEGG analysis indicated that DEGs involved various pathways, including protein processing in endoplasmic reticulum, circadian rhythm, and HIF-1 signaling pathway. Notably, protein processing in endoplasmic reticulum was significantly enriched with key genes such as HSP70, HSP90, HSP40, CNX, CRT, and Bip. Through concurrent analysis of RNA-seq data from hypoxic conditions, we found that PF-carp regulate their metabolism through multiple pathways and produce almost opposite metabolic regulation to adapt to high temperature and hypoxic environments. The opposite activation state observed in the HIF-1 signaling pathway is particularly intriguing. In conclusion, PF-carp appear to rely on protein processing in endoplasmic reticulum to maintain cell homeostasis at high temperatures. The HIF-1 signaling pathway may emerged as a key player in adapting PF-carps to paddy fields. This study provides valuable insights into the adaptive mechanisms of domesticated fish in paddy fields.

Associations of reproductive factors and circadian syndrome in middle-aged and elderly women: A nationwide cross-sectional study from China, the United Kingdom and the United States

Circadian Syndrome (CircS) was recently recognized as a novel predictor of cardiovascular disease (CVD) risk, with reproductive factors playing an important role in CVD risk. Yet, studies linking reproductive factors to CircS remain sparse. Data on middle-aged and elderly women were extracted from three nationally representative surveys: the China Health and Retirement Longitudinal Study (CHARLS) and the English Longitudinal Study on Ageing (ELSA) provided the training set, and the National Health and Nutrition Examination Survey (NHANES) constituted the validation set. We employed logistic regression to evaluate the association between self-reported reproductive factors and CircS risk, with inverse probability of treatment weighting (IPTW) and subgroup analyses conducted to verify the stability. A total of 11,721 participants were analyzed. CircS prevalence differed significantly across countries, with 51.40 % in China and 20.19 % in the United Kingdom. Early menarche (age <12 years) correlated with increased CircS risk in CHARLS (OR 1.38 [95 % CI 0.99-1.92]; p = 0.061), ELSA (OR 1.64 [95 % CI 1.36-1.98]; p < 0.001), and NHANES (OR1.52 [95 % CI: 1.21-1.89]; p < 0.001). Premature menopause (age <40 years) was associated with a roughly 30 % higher CircS risk. A shorter reproductive lifespan was significantly linked to CircS, with this relationship emerging at a reproductive lifespan of ≥40 years in CHARLS (OR1.39 [95 % CI: 1.04-1.84]; p = 0.024). The aforementioned correlations retained significance following IPTW and subgroup analyses. Early menarche, premature menopause, and abbreviated reproductive lifespans may negatively affect CircS. Public health strategies should incorporate menstrual cycle-related reproductive health into primary CircS prevention.

Glyphosate exposure impairs glucose and lipid metabolism by disturbing the circadian clock system in mice liver

Glyphosate, the most extensively applied organophosphonate herbicide, poses risks to aquatic ecosystems and potentially compromises human health via dietary exposure. Although toxicological assessments have confirmed glyphosate-induced hepatotoxicity in mammalian systems, the cellular pathogenesis involving metabolic disruption warrants further mechanistic investigation. This study aimed to elucidate the effect of glyphosate exposure on hepatic glucose/lipid metabolism and its association with circadian clock disruption using murine hepatocytes (AML12) and mice models. Time-course analysis revealed that glyphosate exposure significantly suppressed core circadian and metabolic transcripts in AML12 hepatocytes, with corresponding reduction in NR1D1 protein level. Longitudinal locomotor activity monitoring revealed that glyphosate exposure caused photophase-specific hyperlocomotion and circadian period elongation in mice. Glyphosate exposure elicited marked depletion of hepatic glycogen reserves and serum total cholesterol concentrations. Notably, glyphosate also disrupted the expression of hepatic metabolic genes, paralleled by alterations of circadian clock genes expression at both mRNA and protein levels in mice. Additionally, Hmgcr and Glut2 mRNA levels were significantly decreased in Bmal1-/- AML12 cells compared to their control groups, no further significant reduction was detected in Bmal1-/- AML12 cells with glyphosate exposure. Collectively, the current study demonstrated that glyphosate exposure impairs glucose and lipid metabolism by disturbing the circadian clock system.

A lipid metabolism related gene signature predicts postoperative recurrence in pancreatic cancer through multicenter cohort validation

Postoperative recurrence of pancreatic adenocarcinoma (PAAD) remains a major challenge. This study aims to establish and validate a lipid metabolism-related prognostic model to predict recurrence in PAAD patients. The TCGA-PAAD database was used to establish a training cohort, which was validated using the ICGC database and multiple center cohorts. A prognostic model based on LASSO Cox regression and a nomogram was developed and further validated. Among 196 lipid metabolism-related genes, four were selected for the prognostic model. Patients were stratified into high- and low-risk groups based on the risk score. Univariate and multivariate Cox regression analyses showed that tumor site, T stage, N stage, M stage, and risk score were significantly associated with progression-free interval (PFI). High-risk patients had worse PFI, overall survival (OS), and disease-specific survival (DSS) (all P < 0.05). Time-dependent ROC and decision curve analyses confirmed the superior diagnostic capacity of the nomogram. GSEA revealed enrichment in G2M checkpoint, glycolysis, estrogen response, and hypoxia pathways for the high-risk group. Additionally, high-risk scores correlated with poor immune infiltration, gene mutations, and tumor mutational burden (TMB). Single-cell analysis suggested that risk genes interact with various cell types to promote PAAD progression. A novel lipid metabolism-related prognostic model was developed and validated to predict recurrence and survival in PAAD patients, with strong accuracy and stability.

Wakefulness after sleep offset and the elevated risk of mortality in older adults with evening preferences: A community-based 5-year longitudinal study

BACKGROUND AND OBJECTIVES

This study investigated the relationship between wakefulness after sleep offset timing (WASF), evening chronotype preferences, and mortality risk in community-dwelling older adults.

RESEARCH DESIGN AND METHODS

We conducted a community-based longitudinal study with a sample of 4167 older adults aged ≥60. The sleep characteristics, WASF, subjective chronotype preferences, and other relevant variables of the participants at baseline were evaluated. We examined the association between WASF and mortality over a 5-year period using Cox proportional hazards models, with stratification by subjective chronotype preferences to explore potential effect modification.

RESULTS

Data from 3734 participants were analyzed (71.1 ± 6.9 years; 2114 [56.6 %] women). The 5-year mortality incidence was 6.3 %. Overall, participants had a median (IQR) of 5.0 (2-20) min WASF, and 767 (20.6 %) were evening types. WASF of ≤5 min = 10.6 (95 % CI, 8.9-12.8), WASF of >5 min = 14.6 (95 % CI, 12.1-17.6). The mortality incidence rates per 1000 person-years were: WASF of ≤5 min = 10.6 (95 % CI, 8.9-12.8) and WASF of >5 min = 14.6 (95 % CI, 12.1-17.6). Even after adjusting for covariates, the longer WASF participants had a higher hazard ratio of 1.40 (95 % CI, 1.04-1.88) compared to the shorter WASF participants. Regular, prolonged WASF was found to be significantly associated with an increased risk of mortality among evening-type individuals (2.69; 95 % CI: 1.19-6.08) in the stratified model based on subjective chronotype preferences. However, we found no statistically significant association among the other types.

DISCUSSION AND IMPLICATIONS

Reducing morning time in bed, and addressing prolonged WASF are crucial factors in decreasing mortality risk among older adults, especially among those with evening preferences.

Chronotype in relation to shift work: A cohort study among 37,731 female nurses

Chronotype may affect tolerance for circadian disruption induced by shift work. This study examines the association between chronotype, self-reported sleep timing, shift type preference, and sleep problems among nurses, and studies chronotype stability over time. The study included 37,731 Dutch female nurses who completed a baseline (2011) and follow-up questionnaire (2017), with information on shift work (e.g., job history, shift type preference [collected in 2017 only]), and sleep characteristics (e.g., chronotype, preferred sleep-wake time in a work-free period [collected in 2017 only], and sleep problems between working days according to Medical Outcomes Study-Sleep Problem Index II [MOS-SPI-II]). The association between chronotype and sleep timing was examined using (age-adjusted) linear regression. Associations between chronotype and shift type preference and sleep problems (MOS-SPI-II >30) were examined using ordered logistic and Poisson regression, respectively. With later chronotype, midsleep time increased (definite evening vs. intermediate types [reference]: β = 55 min, 95% confidence interval [95% CI]: 54-55), the odds ratio (OR) for 1-point increase in preference for night (2.68; 95% CI: 2.48-2.90) and evening shifts increased (OR 2.20; 95% CI: 2.03-2.38), while the odds for day (OR 0.17; 95% CI: 0.16-0.18) and morning shifts (OR 0.22; 95% CI: 0.21-0.24) decreased. Intermediate chronotype was associated with fewer sleep problems (median MOS-SPI-II = 27.2, p < 0.01), compared with definite morning (28.9) and evening types (31.7). This study shows that chronotype is associated with sleep-wake times in a work-free period, shift type preference, and sleep problems in nurses. Future studies on the association of shift work-induced circadian disruption and health outcomes should therefore consider chronotype as effect-modifier.

Adverse effects of late sleep on physical health in a large cohort of community-dwelling adults

AIMS

Sleep timing, influenced by chronotype, behavior, and circadian rhythms, is critical for human health. While previous research has linked chronotype to various health outcomes, the impact of aligning sleep timing with chronotype on physical health remains underexplored. The objective of this study is to investigate the association between chronotype, actual sleep timing, and their alignment with a spectrum of physical health outcomes.

METHODS

Objective sleep timing (actigraphy, categorized as early, intermediate, or late) and chronotype (self-reported, categorized as morning, intermediate, or evening types) were derived from the UK Biobank (n=73,888 middle-aged and older adults) and used in cross-sectional and longitudinal analyses. Physical health outcomes included metabolic disorders, diabetes, obesity, hypertension, circulatory disorders, digestive disorders, respiratory disorders, and all-cause cancer based on ICD10 codes. Analyses were adjusted for demographic factors, sleep duration and sleep timing stability.

RESULTS

As compared to morning types with early behavior (aligned), morning types with late behavior (misaligned) had an increased risk of all included physical health disorders (p's<0.001). As compared to evening-types with late behavior (aligned), however, evening-types with early behavior (misaligned) had a decreased risk of diabetes, obesity, hypertension, circulatory disorders, and respiratory disorders (p < 0.01). Longitudinal analyses, in which the likelihood of developing de novo physical health disorders was associated with chronotype, behavioral timing, and alignment between the two, confirmed cross-sectional findings.

CONCLUSION

Late sleep timing across chronotypes was consistently associated with adverse physical health outcomes. These findings underscore the importance of going to sleep early, regardless of preference.

Chronobiologically-informed features from CGM data provide unique information for XGBoost prediction of longer-term glycemic dysregulation in 8,000 individuals with type-2 diabetes

Type 2 Diabetes causes dysregulation of blood glucose, which leads to long-term, multi-tissue damage. Continuous glucose monitoring devices are commercially available and used to track glucose at high temporal resolution so that individuals can make informed decisions about their metabolic health. Algorithms processing these continuous data have also been developed that can predict glycemic excursion in the near future. These data might also support prediction of glycemic stability over longer time horizons. In this work, we leverage longitudinal Dexcom continuous glucose monitoring data to test the hypothesis that additional information about glycemic stability comes from chronobiologically-informed features. We develop a computationally efficient multi-timescale complexity index, and find that inclusion of time-of-day complexity features increases the performance of an out-of-the-box XGBoost model in predicting the change in glucose across days. These findings support the use of chronobiologically-inspired and explainable features to improve glucose prediction algorithms with relatively long time-horizons.

Multidimensional sleep impairment predicts steatotic liver disease spectrum risk

To evaluate the correlation between various sleep and the risk of NAFLD\MAFLD\MASLD. This study included 4772 subjects from the National Health and Nutrition Examination Survey data from 2017 to 2020. Poor sleep factors were defined as: ①abnormal sleep duration (< 7 h or > 8 h); ②snoring; ③sleep apnea; ④self-reported sleep disorder; ⑤ daytime sleepiness. The frequency of each sleep factor was scored, and the scores of all components were summed to obtain a sleep score ranging from 0 to 12. The higher the score, the less healthy the sleep pattern. Then we divided the overall sleep pattern into mild (sleep score 0-3 points), moderate (sleep score 4-7 points) or severe (sleep score 8-12 points) sleep pattern according to the distribution of sleep scores. Multiple logistic regression and restricted cubic spline graph analysis were used to determine the association between sleep and NAFLD\MAFLD\MASLD. In Model 1 and Model 2, sleep score as a continuous or categorical variable had an effect on NAFLD\MAFLD\MASLD(p <0.05). The risk of NAFLD\MAFLD\MASLD was higher in subjects with severe sleep patterns (p < 0.05). Snoring and sleepy during day was associated with NAFLD\MAFLD\MASLD (p < 0.05). We then drew a restricted cubic spline plot and found that sleep duration was nonlinearly associated with MAFLD\MASLD (p < 0.01), and the risk of MAFLD\MASLD was lower when the sleep duration was 7.5 ~ 9.5 h/d. In this nationally representative survey, severe sleep patterns were associated with an increased risk of NAFLD/MAFLD/MASLD. It is worth noting that sleep duration was nonlinearly associated with MAFLD and MASLD.

Relationship between dietary energy and macronutrient intake at dinner versus breakfast and biological aging and premature mortality: Assessment of 2003-2014 National Health and Nutrition Examination Survey participants

BACKGROUND

The impact of dietary patterns on health and lifespan is well-established, yet the effects of meal timing on the aging process and risk of premature death remain unclear. This study aimed to investigate the association between the difference in energy and macronutrient intake at dinner versus breakfast and the risk of premature mortality and biological aging.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2014, a cohort of 27,261 adults was examined. Dietary data were collected through 24-h dietary recalls, and Cox proportional hazards models and binary logistic regression models were used to assess the risk of premature death and indicators of biological aging.

RESULTS

Individuals with higher energy and protein intake at dinner compared to breakfast exhibited an increased risk of premature death and higher biological aging indicators. Isocaloric substitution of energy and macronutrients from breakfast to dinner significantly increased the risk of aging.

CONCLUSION

The difference in energy and macronutrient intake at dinner versus breakfast is closely associated with the risk of premature death and biological aging. The findings underscore the potential impact of meal timing on metabolic health and lifespan extension.

Time-restricted eating in people at high diabetes risk does not affect mitochondrial bioenergetics in peripheral blood mononuclear cells and platelets

Overweight and obesity are linked to mitochondrial alterations, impaired glucose tolerance and a high risk of type 2 diabetes. Time-restricted eating (TRE) may aid in facilitating weight loss to prevent diabetes. Here, we investigated if TRE in individuals with overweight and prediabetes or obesity affects mitochondrial bioenergetics of peripheral blood mononuclear cells (PBMCs) and platelets using the Seahorse extracellular flux technology. In a 3-month randomized controlled trial, PBMCs/platelets were analyzed from 52 participants before and after a TRE intervention with a 10-h eating window or habitual living. PBMC and platelet respiratory function was evaluated through sequential addition of substrates, uncouplers, and inhibitors in living cells. After 3 months, there were no statistically significant differences in mitochondrial respiration within or between the TRE and control groups. Association analyses between PBMC/platelet respiration and clinical parameters including body mass index and fat mass showed no significant effects. In conclusion, 3 months of 10-h TRE does not alter the mitochondrial bioenergetics of PBMCs and platelets in individuals with high risk of type 2 diabetes.

Nanoparticles targeting the central circadian clock: Potential applications for neurological disorders

Circadian rhythms and their involvement with various human diseases, including neurological disorders, have become an intense area of research for the development of new pharmacological treatments. The location of the circadian clock machinery in the central nervous system makes it challenging to reach molecular targets at therapeutic concentrations. In addition, a timely administration of the therapeutic agents is necessary to efficiently modulate the circadian clock. Thus, the use of nanoparticles in circadian clock dysfunctions may accelerate their clinical translation by addressing these two key challenges: enhancing brain penetration and/or enabling their formulation in chronodelivery systems. This review describes the implications of the circadian clock in neurological pathologies, reviews potential molecular targets and their modulators and suggests how the use of nanoparticle-based formulations could improve their clinical success. Finally, the potential integration of nanoparticles into chronopharmaceutical drug delivery systems will be described.

The effect of altered sleep timing on glycaemic outcomes: Systematic review of human intervention studies

AIMS

Alterations in sleep timing can lead to disturbances in glycaemic control, although the evidence is inconsistent. Therefore, this systematic review summarizes results from human intervention studies of altered sleep timing on glycaemic outcomes.

MATERIALS AND METHODS

As part of a broader search on the effect of altering timing of sleep, physical activity and dietary intake, Medline and Embase were searched from inception to February 2023, and subsequent reference searches were done. With the help of a machine learning-aided program 'ASReview', we selected any type of intervention study in the general adult population, which acutely delayed sleep by ≥2 h for at least one night, while the total time in bed was the same between early and late sleep. Quality assessment was done using the quality assessment tool for quantitative studies.

RESULTS

In total, 14 studies (159 adults with normal or increased weight) were identified. Methodological quality was high (n = 4), moderate (n = 7) or low (n = 3). Acute delays of sleep onset showed unfavourable effects in 10 out of 27 measured glycaemic outcomes (one-six studies reported on each outcome) with outcomes mostly measured in the postprandial period, compared to (early) nighttime sleep.

CONCLUSIONS

Acutely delaying sleep timing might have unfavourable effects on glycaemic outcomes, compared to (early) nighttime sleep. Future research does however need better controlled trials, also measuring and controlling sleep quantity, sleep quality, physical activity and dietary intake, with longer follow-up periods, consistent outcomes and designs and more diverse populations to provide targeted advice regarding the optimal timing for sleep.

PROTOCOL REGISTRATION

This review is part of a larger search 'The effect of altering timing of physical activity, sleep and energy intake on glycaemia and Type 2 Diabetes risk in humans', of which the protocol was registered in the PROSPERO database on 27 November 2021 under number: CRD42021287828.

Improved Afternoon Hepatic Glucose Disposal and Storage Requires Morning Engagement of Hepatic Insulin Receptors

Glucose tolerance improves significantly upon consuming a second, identical meal later in the day (second-meal phenomenon). We previously established that morning hyperinsulinemia primes the liver for increased afternoon hepatic glucose uptake (HGU). Although the route of insulin delivery is an important determinant of the mechanisms by which insulin regulates liver glucose metabolism (direct hepatic vs. indirect insulin action), it is not known whether insulin's delivery route affects the second-meal response. To determine whether morning peripheral insulin delivery (as occurs clinically, i.e., subcutaneously) can enhance afternoon HGU, conscious dogs were treated in the morning with insulin delivered either via the portal vein or peripherally (leg vein), while glucose was infused to maintain euglycemia. Consequently, arterial insulin levels increased similarly in both groups, but relative hepatic insulin deficiency occurred with peripheral insulin delivery. In the afternoon, all animals were challenged with the same hyperinsulinemic-hyperglycemic clamp to simulate identical postprandial-like conditions. The substantial enhancement of HGU in the afternoon caused by morning portal vein insulin delivery was lost when insulin was delivered peripherally. This indicates that morning insulin does not cause the second-meal phenomenon via its indirect actions on the liver but, rather, through direct activation of hepatic insulin signaling.

ARTICLE HIGHLIGHTS

Morning insulin delivery primes the liver for increased hepatic glucose uptake (HGU) later in the day, but until now, the mechanism (direct hepatic and/or indirect insulin action) remained unclear. This study compared insulin infusion via endogenous (hepatic portal vein) and clinical (peripheral) routes to assess their impact on afternoon hepatic glucose disposal. Arterial hyperinsulinemia in the morning, without a concomitant increase in insulin at the liver, failed to induce a significant enhancing effect on afternoon HGU and glycogen storage, unlike morning hepatic portal vein insulin delivery, which did. These findings highlight the importance of achieving appropriate hepatic insulin exposure in the morning to effectively prime the liver for enhanced glucose disposal later in the day.

Diurnal Variation in Melatonin-Mediated Cardiac Protection via Per2 Expression in Heart

Myocardial ischemia/reperfusion (MIR) injury, a primary cause of mortality in acute myocardial infarction, exhibits diurnal variation associated with disruptions in diurnal rhythm. Melatonin (MLT), a potent antioxidant known for its cardioprotective properties, also demonstrates diurnal rhythmicity. This study aimed to investigate the time-dependent cardioprotective effects of MLT in MIR and to clarify the role of the circadian gene Per2 in mediating these effects. Using in vivo (mice) and in vitro (H9c2 cardiomyocytes) models of MIR, we administered MLT at two distinct diurnal time points: ZT1 and ZT13. We evaluated infarct size, cardiac function, apoptosis, and the expression levels of Per2 and other circadian genes. Pretreatment with MLT at ZT13 significantly reduced infarct size and enhanced cardiac function compared to ZT1 administration. This time-dependent cardioprotective effect correlated with the diurnal expression pattern of Per2, which was notably augmented by dark phase administration of MLT without phase alteration. Crucially, Per2 knockdown in both models abrogated the cardioprotective effects of MLT. Our findings underscore that MLT confers superior cardioprotection against MIR injury when administered at dark phase, aligning with the circadian variation of Per2 expression. These effects reveal the therapeutic potential of targeting the MLT-Per2 axis in chronotherapy to mitigate MIR injury.

Assessment of canonical diurnal variations in plasma glucose using quantile regression modelling and Chronomaps

OBJECTIVES

Diurnal variation of plasma glucose levels may contribute to diagnostic uncertainty. The permissible time interval, pT(t), was proposed as a time-dependent characteristic to specify the time within which glucose levels from two consecutive samples are not biased by the time of blood collection. A major obstacle is the lack of population-specific data that reflect the diurnal course of a measurand. To overcome this issue, an approach was developed to detect and assess diurnal courses from big data.

METHODS

A quantile regression model, QRM, was developed comprising two-component cosinor analyses and time, age, and sex as predictors. Population-specific canonical diurnal courses were generated employing more than two million plasma glucose values from four different hospital laboratory sites. Permissible measurement uncertainties, pU, were also estimated by a population-specific approach to render Chronomaps that depict pT(t) for any timestamp of interest.

RESULTS

The QRM revealed significant diurnal rhythmometrics with good agreement between the four sites. A minimum pT(t) of 3 h exists for median glucose levels that is independent from sampling times. However, amplitudes increase in a concentration-dependent manner and shorten pT(t) down to 72 min. Assessment of pT(t) in 793,048 paired follow-up samples from 99,453 patients revealed a portion of 24.2 % sample pairs that violated the indicated pT(t).

CONCLUSIONS

QRM is suitable to render Chronomaps from population specific time courses and suggest that more stringent sampling schedules are required, especially in patients with elevated glucose levels.

A Transcriptomic Dataset of Liver Tissues from Global and Liver-Specific Bmal1 Knockout Mice

The circadian clock regulates various physiological processes in mammals. The core circadian clock gene Bmal1 is crucial for maintaining the oscillations of the circadian clock system by controlling the rhythmic expression of numerous circadian clock-controlled genes. To explore the transcriptional changes associated with Bmal1 deletion in liver tissues, we collected liver tissues from global and liver-specific Bmal1 knockout mice, along with their respective control groups, at two circadian time points (CT2 and CT14) and used them for transcriptome sequencing analysis. Genotyping, locomotor activity analysis, and comprehensive quality control analyses, including base quality scores, GC content, and mapping rates, confirmed the high quality of sequencing data. Differential expression analysis and RT-qPCR validation confirmed the reliability and validity of the dataset. These data offer a valuable resource for researchers investigating the role of BMAL1 in liver physiology, pathology, and the broader field of circadian biology.

Sleep deprivation alters hepatic UGT1A9 and propofol metabolism in mice

Sleep deprivation (SD) causes circadian misalignment, and circadian clock disruption is associated with metabolic diseases such as obesity, insulin resistance, and diabetes. However, the underlying mechanism for SD-induced circadian clock disruption as well as metabolic enzyme changes is still lacking. Here, we developed SD sensitizes mice with disrupted circadian rhythms to demonstrate the regulation role and mechanism of SD in UDP-glucuronosyltransferases (UGTs) expression and the metabolism of corresponding substrates. We found that UGT Family 1 Member A9 (UGT1A9) expression was significantly decreased in the liver of SD mice, which led to an elevation exposure and prolonged anesthesia effect of propofol, which was attributed to the decreased metabolism. Meanwhile, SD down-regulated basic helix-loop-helix ARNT like 1 (BMAL1) and its target clock genes period circadian clock (Per), cryptochrome circadian regulator (Cry), and nuclear receptor subfamily 1 group D member 1 (Rev-erb) expression in mice. Furthermore, the positive regulation of UGTIA9 mRNA and protein levels by Bmal1 was confirmed in hepatocyte-specific Bmal1-knockout mice (Bmal1-hkO) and Bmal1-overexpressed AML-12 cells. At last, through a combination of promoter analysis, luciferase reporter assay, and chromatin immunoprecipitation (ChIP) assay, it was conducted that Bmal1 regulates Ugtla9 expression by directly binding the -864 bp E-box in Ugtla9 promotor or indirectly acting on the Rev-erbα- differentiated embryo chondrocyte 2 (Dec2) axis. In conclusion, our findings suggested that SD can lead to altered drug disposition and effects in vivo, and Bmal1 plays a crucial role in the crosstalk between SD-induced circadian clock disruption and drug metabolism. It initiates a new direction for the understanding of drug efficacy and toxicity changes in SD conditions and provides a scientific basis for improving the rationality of drug use.

Feasibility of an At-Home Experimental Circadian Misalignment Induction for Adolescents

Despite extensive research on the effects of sleep restriction on adolescent health, the field lacks experimental methods to study the health effects of mistimed sleep, which is also common among adolescents. This paper describes a novel 3-week experimental protocol that was designed to compare sleep restriction, like what many adolescents experience on school nights, against sleep that meets the recommended duration but is timed to be relatively aligned or misaligned with their circadian phase. Healthy 14-18-year-olds, classified as early ("Lark") and late ("Owl") chronotypes, entered a six-night chronotype-aligned stabilization condition, followed by five nights of sleep restriction, a return to the stabilization schedule, and five nights of healthy sleep duration (HS). During HS, participants were randomly assigned to early-to-bed versus late-to-rise arms, intended to align with or misalign with their circadian phase. Actigraphy monitored sleep, and weekly dim-light melatonin onset (DLMO) assessed circadian phase. Analyses confirmed that the protocol met five key validation metrics related to differential attrition, sleep timing, circadian phase, and experimental induction of HS that is timed to be relatively aligned vs. misaligned with circadian phase. This protocol appears useful for future research into how misaligned sleep patterns, which occur regularly for many adolescents, may impact health.

Study protocol of the PRINCESS trial-PReoperative INtermittent fasting versus CarbohydratE loading to reduce inSulin resiStance versus standard of care in orthopaedic patients: a randomised controlled trial

INTRODUCTION

Surgical trauma induces a metabolic stress response, resulting in reduced insulin sensitivity and hyperglycaemia. Postoperative insulin resistance (IR) is associated with postoperative complications, and extended preoperative fasting may further aggravate the postoperative metabolic stress response. Nutritional strategies, such as carbohydrate loading (CHL), have been successfully used to attenuate postoperative IR. Recent evidence suggests that time-restricted feeding (TRF), a form of intermittent fasting, improves IR in the general population, even after a short period of TRF. We hypothesise that TRF, as well as CHL, improve postoperative IR.

METHODS AND ANALYSIS

This open-label, single-centre, randomised controlled trial will compare the effect of short-term preoperative TRF, CHL and standard preoperative fasting on perioperative IR. A total of 75 orthopaedic patients presenting for elective intermediate to major surgery at a Dutch academic hospital will be randomly assigned to a control group (standard preoperative fasting), a TRF group or a CHL group. The primary outcome is postoperative IR, based on the updated homeostasis model assessment of IR, on the first day after surgery. Statistical analyses are performed using Student's t-tests or Mann-Whitney U tests.

ETHICS AND DISSEMINATION

The local medical ethics committee of the Amsterdam UMC, the Netherlands, approved the trial protocol in January 2023 (NL81556.018.22). No publication restrictions apply, and the results of the study will be disseminated through a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

NCT05760339.

Chronic Dexamethasone Disturbs the Circadian Rhythm of Melatonin and Clock Genes in Goats

Dex is a drug commonly used as an immunosuppressive and anti-inflammatory agent in humans and animals. GCs have a profound impact on melatonin expression and biological rhythm. However, the effect of chronic exposure to Dex on melatonin secretion and biological clock gene expression in ruminants is still unclear. Ten goats were randomly divided into two groups: the control group was injected with saline, and the Dex-treated group was intramuscularly injected daily for 21 d with 0.2 mg/kg Dex. The rhythm of melatonin secretion in the plasma was disturbed in the Dex group, and the plasma and colon levels of melatonin were lower in the Dex group compared to the control group (p < 0.05). Dex leads to a significant decrease in the expression of Arylalkylamine N-acetyltransferase (AANAT), a key melatonin synthase, in the pineal gland and colon. Detecting intestinal leakage-related indices showed that diamine oxidase (DAO) and lipopolysaccharide (LPS) content increased significantly in the Dex group (p < 0.05). We also detected genes associated with biological rhythms in the plasma. In the control group, the five tested genes showed circadian rhythms, but the circadian rhythms of Clock, Cry1, Cry2, and Per2 were abolished or blunted by the Dex (p < 0.05). Protein levels of CLOCK and BMAL1 in the colon changed significantly (p < 0.05). In conclusion, the above experimental results show that chronic exposure to Dex leads to the disorder of the circadian rhythms of melatonin secretion and clock genes.

Leptin Receptor Deficiency-Associated Diabetes Disrupts Lacrimal Gland Circadian Rhythms and Contributes to Dry Eye Syndrome

Purpose

This study investigated the impact of hyperglycemia in type 2 diabetes mellitus (T2DM) on the circadian rhythms and function of lacrimal glands (LGs) in contributing to dry eye syndrome. We assessed the effects of hyperglycemia on circadian gene expression, immune cell recruitment, neural activity, and metabolic pathways, and evaluated the effectiveness of insulin in restoring normal LG function.

Methods

Using a T2DM mouse model (db/db mice), circadian transcriptomic changes in LGs were analyzed through RNA sequencing over a 24-hour period. Rhythmic expression of core clock genes, immune and neural activity, and metabolic pathways were evaluated. The effects of insulin treatment on these parameters were also assessed.

Results

Hyperglycemia disrupted the circadian expression of core clock genes in LGs, leading to a 50% reduction in rhythmic gene expression. This was associated with altered immune cell recruitment, impaired neural activity, and metabolic changes. Insulin treatment lowered blood glucose levels but did not restore normal circadian function or tear secretion, exacerbating dry eye syndrome in diabetic mice.

Conclusions

T2DM significantly disrupts circadian rhythms and function in lacrimal glands, contributing to dry eye syndrome. The limited efficacy of insulin in restoring circadian regulation suggests that hyperglycemia-induced dysfunction in LGs is not solely dependent on blood glucose levels, highlighting the need for therapies targeting circadian rhythms in diabetic ocular complications.

Association of Insomnia, Lipid Profile, and Lipid-Lowering Medications: A Narrative Review

Sleep is a fundamental phenomenon that helps maintain normal physiological processes. Conversely, sleep disorders, usually presented as insomnia, are a common public health problem that can lead to multiple pathophysiological changes in humans, including lipid metabolic abnormality. Interestingly, several previous studies have examined the potential relation of insomnia to metabolic syndrome and hyperlipidemia and found that insomnia was associated with elevated plasma cholesterol and triglyceride concentrations. This review summarizes evidence regarding the linkage between insomnia and lipid abnormalities. Moreover, the underlying physiologic mechanisms linking insomnia to lipid abnormalities are systemically discussed. Finally, issues with lipid-lowering drugs and the risk of insomnia are also presented. This knowledge can improve our understanding of the pathophysiological features of insomnia, which may help to prevent and treat insomnia-induced dyslipidemia clinically.

Light Environment of Arctic Solstices is Coupled With Melatonin Phase-Amplitude Changes and Decline of Metabolic Health

Light environment in the Arctic differs widely with the seasons. Studies of relationships between objectively measured circadian phase and amplitude of light exposure and melatonin in community-dwelling Arctic residents are lacking. This investigation combines cross-sectional (n = 24-62) and longitudinal (n = 13-27) data from week-long actigraphy (with light sensor), 24-h salivary melatonin profiles, and proxies of metabolic health. Data were collected within the same week bracketing spring equinox (SE), and winter/summer solstices (WS/SS). Drastic seasonal differences in blue light exposure (BLE) corresponded to seasonal changes in the 24-h pattern of melatonin, which was phase delayed and reduced in normalized amplitude (NA) during WS/SS compared to SE. The extent of individual melatonin's acrophase and Dim Light Melatonin Onset (DLMO) change from SE to WS correlated with that from SE to SS. Although similar in extent and direction, melatonin phase changes versus SE were linked to morning BLE deficit in WS, contrasting to evening BLE excess in SS. Seasonal changes in sleep characteristics were closely associated with changes in the phases of BLE and melatonin. Proxies of metabolic health included triglycerides (TG), high-density lipoprotein cholesterol (HDL), TG/HDL ratio, and cortisol. Adverse seasonal changes in these proxies were associated with delayed acrophases of BLE and melatonin during WS and SS. TG and TG/HDL were higher in WS and SS than in SE, and cross-sectionally correlated with later melatonin and BLE acrophases, while lower HDL was associated with later BLE onset and later melatonin acrophase. Overall, this study shows that optimal 24-h patterns of light exposure during SE is associated with an earlier acrophase and a larger 24-h amplitude of melatonin, and that both features are linked to better metabolic health. Improving light hygiene, in particular correcting winter morning light deficit and summer evening light excess may help maintain metabolic health at high latitudes. Novel solutions for introducing proper circadian light hygiene such as human-centric light technologies should be investigated to address these issues in future studies.

Metabolic Profiling Analysis of Congenital Adrenal Hyperplasia via an Untargeted Metabolomics Strategy

Congenital adrenal hyperplasia (CAH) manifests as an autosomal recessive disorder characterized by defects in the enzymes responsible for steroid synthesis. This work aims to perform metabolic profiling of patients with CAH, screen key differential metabolites compared to the control group, and discover the associated metabolic pathways implicated in CAH. Serum samples obtained from 32 pediatric male patients with CAH and 31 healthy control group candidates were subjected to analysis using non-targeted metabolomics strategy using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). A total of 278 differential metabolites were identified and annotated in KEGG. Operating characteristic curves (ROC) measurement exhibited 9 metabolites exhibiting high efficacy in differential diagnosis, as evidenced by an area under ROC curve (AUC) exceeding 0.85. Pathway analysis uncovered notable disruptions in steroid hormone biosynthesis (p <0.0001), purine metabolism and irregularities in lipid metabolism and amino acid metabolism, including tyrosine and alanine, in CAH patients. These findings demonstrate that metabolic pathways of purine, amino acid and lipid metabolism, apart from steroid hormone biosynthesis, may be disrupted and associated with CAH. This study helps provide insight into the metabolic profile of CAH patients and offers a new perspective for monitoring and administering follow-up care to CAH patients.

Chronobiological Factors Influencing Glycemic Control and Birth Outcomes in Gestational Diabetes Mellitus

BACKGROUND/OBJECTIVES

Studies have shown that chronobiological factors may adversely affect glycemic control in patients with type 2 diabetes mellitus. We assessed the association of chronobiological factors with glycemic control and neonatal birth weight in women with GDM.

METHODS

A prospective cohort study included 208 women aged 18-45 years with a singleton pregnancy who were randomly selected from among women undergoing follow-up for GDM at the Maternal-Fetal Medicine Unit of a tertiary medical center. Nutrition, sleep, and lifestyle patterns were assessed from onset of GDM until birth along with glycemic control and birth outcomes.

RESULTS

Multivariate analyses on a cohort of 208 women revealed that suboptimal glycemic control was associated with a late breakfast (RR = 2.26; 95% CI 1.09-4.67), increased carbohydrate intake in the evening (RR = 1.19; 95% CI 1.003-1.42), and poor sleep quality (RR = 2.14; 95% CI 1.04-4.41). The adjusted relative risk for neonatal birth weight above the 85th percentile was associated with increased carbohydrate intake in the morning (RR = 1.70; 95% CI 1.30-2.23) and increased carbohydrate intake in the evening (RR = 1.39; 95% CI 1.16-1.67).

CONCLUSIONS

Chronobiological factors are associated with suboptimal glycemic control and birth weight above the 85th percentile in women with GDM. The study was registered under ClinicalTrials.gov.org, identifier: NCT02916667.

Insufficient Sleep Syndrome in Childhood

Sleep disorders in children have a negative impact on mental and physical development, and a lack of sleep is one of the most important problems in infancy. At the age when naps are commonly accepted, the judgment of whether the amount of sleep is adequate has been based on the total amount of sleep per day. In other words, the idea is that even if the amount of sleep at night is insufficient, it is not considered insufficient if it is compensated for by taking a long nap or sleeping late on weekend mornings. However, these lifestyle habits disrupt the circadian rhythm and cause social jet lag, which is not appropriate for healthy mental and physical development. Therefore, in this review, I present the average required nighCime basic sleep duration (NBSD) of 10 h for Japanese and 11 h for Caucasian children as a judgment standard. (1) If the child sleeps less than 8 h at night, and (2) if the child sleeps less than 9 h at night or 30 to 60 min less than the required NBSD, immediate treatment is recommended. I also discuss briefly how to address sleep insufficiency in childhood.

One minute of light-intensity stair-stepping decreases postprandial glycaemia in the evening in non-diabetic adults: A randomized controlled trial

Prior studies have investigated the efficacy of a single 1 min bout of stair-stepping on reducing postprandial blood glucose (BG) in the morning, but none have investigated this effect in the evening when glycaemic responses are larger due to circadian regulation and β-cell responsiveness. This work investigated the efficacy of a 1 min bout of self-selected, low-intensity stair-stepping performed in the evening on reducing the change from baseline to the 60 min time point postprandial BG. Thirty people (43% male, 29 (10) years) participated in a randomized crossover-controlled trial. Participants completed two separate evening trials following an oral glucose tolerance test (OGTT) (75 g of dextrose dissolved in water): (a) 0 min of stair-stepping seated control condition, and (b) 1 min of stair-stepping condition. One minute of stair-stepping attenuated the change from baseline to 60 min postprandial BG versus control condition (2.5 (2.8) vs. 4.3 (2.3) mmol/L (P < 0.001). Area under the curve (AUC) and incremental area under the curve (iAUC) were lower for the 1 min condition versus control (mean difference = -0.4,95% CI: 0.1-0.8 (P = 0.023) and (mean difference = -0.6, 95% CI 0.1-1.1 mmol/L-1 min-1 (P = 0.043), respectively. The modified BORG rate of perceived exertion scale showed participants perceived the exercise as light intensity (1.9 (1.1)). A single, 1 min bout of low-intensity stair stepping at a self-selected pace reduced evening postprandial BG levels following an OGTT in young non-diabetic adults.

Adherence and Retention in Early or Late Time-Restricted Eating: A Narrative Review of Randomized Controlled Trials

Time-restricted eating (TRE) is a form of intermittent fasting that involves reducing the time-period in which food is typically consumed daily. While TRE is known to induce health benefits, particularly for adults with obesity, there is currently debate about whether the time of day in which food is consumed also contributes to the health benefits of TRE. Early TRE (eTRE) and late TRE (lTRE) are subtypes of TRE that involve consuming food and caloric beverages either in the early or later part of the day. A growing body of literature indicates that eTRE may offer additional health benefits compared with lTRE. An important and unanswered question, however, is whether most adults can adhere to this type of eating pattern and whether adherence and retention differ between eTRE and lTRE. This narrative review compared adherence and retention in studies that implemented either eTRE or lTRE in adults for 8 weeks or longer. Five databases were searched, and 10 studies met our eligibility criteria. The key finding was that participants had high and comparable levels of adherence and retention in both eTRE and lTRE interventions. Specifically, the mean adherence rate was 81.4% for eTRE and 82.3% for lTRE, while the mean retention rate was 81% for eTRE and 85.8% for lTRE in eligible studies. Thus, the findings support the feasibility of both approaches. The lowest adherence and retention rates occurred in studies in which either eTRE or lTRE regimens were combined with other dietary interventions. Notably, the duration of the eating window did not seem to negatively affect adherence and retention rates for either eTRE or lTRE. More research is warranted to determine the influence of other factors, such as age and study location, on adherence to and retention of both eTRE and lTRE interventions.

Weight-neutral early time-restricted eating improves glycemic variation and time in range without changes in inflammatory markers

Early time-restricted eating (eTRE) is a dietary strategy that restricts caloric intake to the first 6-8 h of the day and can effect metabolic benefits independent of weight loss. However, the extent of these benefits is unknown. We conducted a randomized crossover feeding study to investigate the weight-independent effects of eTRE on glycemic variation, multiple time-in-range metrics, and levels of inflammatory markers. Ten adults with prediabetes were randomized to eTRE (8-h feeding window, 80% of calories consumed before 14:00 h) or usual feeding (50% of calories consumed after 16:00 h) for 1 week followed by crossover to the other schedule. Using continuous glucose monitoring, we showed that eTRE decreased glycemic variation (mean amplitude of glycemic excursion) and time in hyperglycemia greater than 140 mg/dL without affecting inflammatory markers (erythrocyte sedimentation rate and C-reactive protein). These data implicate eTRE as a candidate dietary intervention for the weight-independent management of dysglycemia in high-risk individuals.

Perfluorooctanoic acid induces transgenerational modifications in reproduction, metabolism, locomotor activity, and sleep behavior in Drosophila melanogaster and deleterious effects in human cancer cells

Perfluorooctanoic acid (PFOA) has been widely documented to affect various aspects of health, including development, metabolism and neuronal function in a variety of organisms. Despite numerous reports detailing these effects, a comprehensive mechanistic model remains elusive, especially with regard to the long-term effects of PFOA, as it bioaccumulates in food chains with a long half-life. In this study, we evaluated the impact of PFOA on several critical physiological states of Drosophila melanogaster. Our findings indicate that PFOA exposure significantly decreases reproductive capacity and induces alterations in starvation resistance and feeding behavior in flies. Interestingly, PFOA exposure also caused changes in locomotor activity and sleep patterns compared with flies receiving a standard diet. Notably, compared with controls, the F2 generation showed increased locomotion and shorter sleep duration during the dark phase, even without direct exposure to PFOA, indicating possible transgenerational effects. Transcriptomic analysis revealed that PFOA also disrupts fatty acid metabolism and alters the expression of immune-responsive genes in Drosophila. In the U-2 OS human osteosarcoma cell line, we examined the impact of PFOA on circadian rhythm regulatory proteins and discovered that, compared with controls, BMAL1 levels increased at concentrations from 10 nM to 10 μM. In summary, this research highlights the influence of PFOA on diverse biological processes, including reproduction, feeding behavior, starvation resistance, locomotion, and sleep activity in Drosophila. It also highlights the ability of PFOA to alter BMAL1 expression patterns in human osteosarcoma cells with deleterious effects.

Light modulates glucose and lipid homeostasis via the sympathetic nervous system

Light is an important environmental factor for vision and for diverse physiological and psychological functions. Light can also modulate glucose metabolism. Here, we show that in mice, light is critical for glucose and lipid homeostasis by regulating the sympathetic nervous system, independent of circadian disruption. Light deprivation from birth elicits insulin hypersecretion, glucagon hyposecretion, lower gluconeogenesis, and reduced lipolysis by 6 to 8 weeks in male, but not female, mice. These metabolic defects are consistent with blunted sympathetic activity, and indeed, sympathetic responses to a cold stimulus are substantially attenuated in dark-reared mice. Further, long-term dark rearing leads to body weight gain, insulin resistance, and glucose intolerance. Notably, metabolic dysfunction can be partially alleviated by 5 weeks exposure to a regular light-dark cycle. These studies provide insight into circadian-independent mechanisms by which light directly influences whole-body physiology and better understanding of metabolic disorders linked to aberrant environmental light conditions.

Sex-dependent effects of chronic jet lag on circadian rhythm and metabolism in mice

BACKGROUND

The circadian clock integrates external environmental changes into the internal physiology of organisms. Perturbed circadian clocks due to misaligned light cycles increase the risk of diseases, including metabolic disorders. However, the effects of sex differences in this context remain unclear.

METHODS

Circadian misalignment was induced by a chronic jet lag (CJL) shift schedule (light-on time advanced by 6 h every 2 days) in C57BL/6N male and female mice. Core body temperature and activity rhythms were recorded using a nano tag, and the gene expression rhythms of clock and clock-controlled genes in the liver and adrenal glands were analyzed using qPCR. Glucose metabolism and insulin response were evaluated using glucose tolerance, insulin sensitivity, and glucose response assays. Castration and testosterone replacement were performed to assess the fundamental role of testosterone in male phenotypes under CJL.

RESULTS

Under CJL treatment, male mice exhibited increased weight gain, whereas females exhibited decreased weight gain compared to that of the respective controls. CJL treatment induced a lower robustness of circadian rhythms in core body temperature and a weaker rhythm of clock gene expression in the liver and adrenal glands in females, but not in males. Only male mice exhibited glucose intolerance under CJL conditions, without the development of insulin resistance. Castrated mice without testosterone exhibited decreased weight gain and reduced robustness of body temperature rhythm, as observed in intact females. Testosterone replacement in castrated mice recovered the CJL-induced weight gain, robustness of temperature rhythm, and glucose intolerance observed in intact males.

CONCLUSIONS

Significant sex-based differences were observed in circadian clock organization and metabolism under CJL. Testosterone plays a crucial role in maintaining the circadian clock and regulating CJL metabolism in males.

Chronotype, temporal patterns of eating and diet composition on work and work-free days

Temporal patterns of eating and diet composition are influenced by factors including circadian preference (chronotype) and work schedule, yet their combined influence is unknown. We investigated relationships between chronotype, temporal eating patterns (duration of eating window (DEW), time of first (FEO) and last (LEO) eating occasions), and diet composition on workdays (WD) and work-free days (FD). Non-shift workers (n = 39) completed the Chrononutrition Questionnaire (CNQ) (age: 38.8 ± 17.2 years, BMI: 24.8 ± 4.78 kg/m2, 82% female) that captures chronotype and temporal eating patterns, and returned work diaries (work schedule) and 7-day food diaries (diet composition) after 2 weeks. Twenty-nine participants provided dietary data for at least two work and work-free days. Later chronotype was associated with later FEO on FD (rs = 0.45, p = 0.004), later LEO on FD (rs = 0.60, p < 0.001) and WD (rs = 0.61, p < 0.001), and longer DEW on WD (rs = 0.37, p = 0.024). Relationships between chronotype and diet composition were small. Later FEO was associated with higher % energy from fat (rs = 0.39, p = 0.043) and lower fibre intake (rs = -0.69, p < 0.001) on WD. Later chronotypes had shorter and later eating windows on FD than WD. Our findings suggest that relationships between chronotype, temporal eating patterns, and diet composition differ by day type. Further investigation may inform dietary strategies that are day-specific.

Glycaemic Response to Acute Aerobic and Anaerobic Exercise Performed in the Morning or Afternoon in Healthy Subjects: A Crossover Trial

BACKGROUND

The regular practice of physical activity is considered a health promoter and appears to be one of the main contributors to the prevention of chronic diseases. However, the potential effects of exercise on health depending on the time of day at which it is performed have not yet been fully elucidated.

OBJECTIVES

To evaluate the effect of physical exercise (aerobic or anaerobic) and chronobiology (morning or afternoon) on the glycemic metabolism of healthy subjects.

METHODS

Healthy subjects participated in aerobic or anaerobic physical exercise sessions, either in the morning or in the afternoon. Blood was drawn from the subjects before, at the end of the exercise and 2 hours after the end of the exercise. Glycemic parameters were analyzed at these time points. A general linear model test was performed after verifying the normal distribution of the raw data (as assessed by the Shapiro-Wilk test) or after a logarithmic/square root transformation, considering aerobic or anaerobic exercise and morning or afternoon exercise as independent variables.

RESULTS

Twenty-three subjects (14 women and 9 men) were included in the study. The rate of change in glucose levels was significantly higher at the end of anaerobic exercise compared to aerobic exercise (1.19 ± 0.04 vs. 0.98 ± 0.02, respectively), with a more pronounced decrease in insulin and C-peptide levels following aerobic exercise. In addition, the increase of glucose was higher after the exercise in the morning compared with the afternoon (1.14 ± 0.03 vs. 1.03 ± 0.03, respectively).

CONCLUSIONS

The type of exercise and chronobiology influence short-term glucose metabolism.

Melatonin Ameliorates Abnormal Sleep-Wake Behavior via Facilitating Lipid Metabolism in a Zebrafish Model of Parkinson's Disease

Sleep-wake disorder is one of the most common nonmotor symptoms of Parkinson's disease (PD). Melatonin has the potential to improve sleep-wake disorder, but its mechanism of action is still unclear. Our data showed that melatonin only improved the motor and sleep-wake behavior of a zebrafish PD model when melatonin receptor 1 was present. Thus, we explored the underlying mechanisms by applying a rotenone model. After the PD zebrafish model was induced by 10 nmol/L rotenone, the motor and sleep-wake behavior were assessed. In situ hybridization and real-time quantitative PCR were used to detect the expression of melatonin receptors and lipid-metabolism-related genes. In the PD model, we found abnormal lipid metabolism, which was reversed by melatonin. This may be one of the main pathways for improving PD sleep-wake disorder.

Imaging Techniques and Biochemical Biomarkers: New Insights into Diagnosis of Pancreatic Cancer

Pancreatic cancer (PaC) incidence is increasing, but our current screening and diagnostic strategies are not very effective. However, screening could be helpful in the case of PaC, as recent evidence shows that the disease progresses gradually. Unfortunately, there is no ideal screening method or program for detecting PaC in its early stages. Conventional imaging techniques, such as abdominal ultrasound, CT, MRI, and EUS, have not been successful in detecting early-stage PaC. On the other hand, biomarkers may be a more effective screening tool for PaC and have greater potential for further evaluation compared to imaging. Recent studies on biomarkers and artificial intelligence (AI)-enhanced imaging have shown promising results in the early diagnosis of PaC. In addition to proteins, non-coding RNAs are also being studied as potential biomarkers for PaC. This review consolidates the current literature on PaC screening modalities to provide an organized framework for future studies. While conventional imaging techniques have not been effective in detecting early-stage PaC, biomarkers and AI-enhanced imaging are promising avenues of research. Further studies on the use of biomarkers, particularly non-coding RNAs, in combination with imaging modalities may improve the accuracy of PaC screening and lead to earlier detection of this deadly disease.

[Screening for sleep disorders in internal medicine as potential comorbidities of systemic autoimmune diseases and improving patients' quality of life]

Sleep medicine and internal medicine share a global and transdisciplinary vision of human physiology and illnesses, with an approach guided by the complaint and semiology. In France, approximately 13 to 18 million individuals suffer from a sleep disorder: these disorders therefore represent a public health problem. Their comorbidities with systemic autoimmune diseases are frequent. As such, this article suggests an approach to screening for sleep disorders in daily clinical practice of internal medicine leading, when appropriate, to request specialized diagnostic and/or therapeutic care in sleep medicine to substantially improve patients' quality of life.

The association of 24-hour behavior rhythms with stroke among American adults with prediabetes/diabetes: evidence from NHANES 2011-2014

BACKGROUND

Emerging evidence suggests that circadian rhythms play a role in the regulation of cardiovascular diseases (CVDs). We aim to examine the relationship between the 24-hour behavior rhythms (activity-rest and feeding-fasting rhythms) and stroke.

METHODS

The study included 3201 adult participants with prediabetes/diabetes from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. The 24-hour behavior rhythm indices were calculated using data from accelerometer wearable device and dietary recall for two nonconsecutive days. Six indices were calculated including interdaily stability (IS), intradaily variability (IV), relative amplitude (RA), average activity during the least active continuous 5-hour period (L5), Average activity during the most active continuous 10-hour period (M10) which reflects the activity-rest rhythm, and feeding rhythm score which reflects the feeding-fasting rhythm. These continuous variables were divided into quintiles for logistic regression models.

RESULTS

Comparing participants in quintile 1, those in quintile 5 of IS and RA exhibited a lower odds of stroke. Conversely, participants in quintile 5 of IV, L5, and L5 start time demonstrated a higher odds of stroke. Furthermore, participants in quintile 5 of feeding rhythm score had a significantly lower odds of stroke. The associations of IV and feeding rhythm score with stroke were more pronounced in participants with diabetes compared to those with prediabetes/diabetes. No significant associations were observed between other 24-hour behavior rhythms and stroke.

CONCLUSIONS

Overall, this study highlights a significant association between 24-hour behavior rhythm and stroke in American adults with prediabetes/diabetes.

Does intermittent nutrition enterally normalise hormonal and metabolic responses to feeding in critically ill adults? A protocol for the DINE-Normal proof-of-concept randomised parallel-group study

INTRODUCTION

Over half of patients who spend >48 hours in the intensive care unit (ICU) are fed via a nasogastric (NG) tube. Current guidance recommends continuous delivery of feed throughout the day and night. Emerging evidence from healthy human studies shows that NG feeding in an intermittent pattern (rather than continuous) promotes phasic hormonal, digestive and metabolic responses that are important for effective nutrition. It is not yet known whether this will translate to the critically ill population. Here, we present the protocol for a proof-of-concept study comparing diurnal intermittent vs continuous feeding on hormonal and metabolic outcomes for patients in the ICU.

METHODS AND ANALYSIS

The study is a single-centre, prospective, randomised, open-label trial comparing intermittent enteral nutrition with the current standard practice of continuous enteral feeding. It aims to recruit participants (n=30) needing enteral nutrition via an NG tube for >24 hours who will be randomised to a diurnal intermittent or a continuous feeding regimen with equivalent nutritional value. The primary outcome is peak plasma insulin/c-peptide within 3 hours of delivering the morning intermittent feed on the second study day, compared with that seen in the continuous feed delivery group at the same time point. Secondary outcomes include feasibility, tolerability, efficacy and metabolic/hormonal profiles.

ETHICS AND DISSEMINATION

We obtained ethical approval from the Wales Research Ethics Committee 3 prior to data collection (reference 23/WA/0297). We will publish the results of this study in an open-access peer-reviewed journal.

TRIAL REGISTRATION NUMBER

NCT06115044.

Interaction Between Early Meals (Big-Breakfast Diet), Clock Gene mRNA Expression, and Gut Microbiome to Regulate Weight Loss and Glucose Metabolism in Obesity and Type 2 Diabetes

The circadian clock gene system plays a pivotal role in coordinating the daily rhythms of most metabolic processes. It is synchronized with the light-dark cycle and the eating-fasting schedule. Notably, the interaction between meal timing and circadian clock genes (CGs) allows for optimizing metabolic processes at specific times of the day. Breakfast has a powerful resetting effect on the CG network. A misaligned meal pattern, such as skipping breakfast, can lead to a discordance between meal timing and the endogenous CGs, and is associated with obesity and T2D. Conversely, concentrating most calories and carbohydrates (CH) in the early hours of the day upregulates metabolic CG expression, thus promoting improved weight loss and glycemic control. Recently, it was revealed that microorganisms in the gastrointestinal tract, known as the gut microbiome (GM), and its derived metabolites display daily oscillation, and play a critical role in energy and glucose metabolism. The timing of meal intake coordinates the oscillation of GM and GM-derived metabolites, which in turn influences CG expression, playing a crucial role in the metabolic response to food intake. An imbalance in the gut microbiota (dysbiosis) can also reciprocally disrupt CG rhythms. Evidence suggests that misaligned meal timing may cause such disruptions and can lead to obesity and hyperglycemia. This manuscript focuses on the reciprocal interaction between meal timing, GM oscillation, and circadian CG rhythms. It will also review studies demonstrating how aligning meal timing with the circadian clock can reset and synchronize CG rhythms and GM oscillations. This synchronization can facilitate weight loss and improve glycemic control in obesity and those with T2D.

Circadian chronotherapies of coronary heart disease and its biological risk factors: A United States Prescribers' Digital Reference-based review

Chronotherapy is the timing of medications to circadian rhythms to optimize beneficial and minimize adverse outcomes. We reviewed the US Online Prescribers' Digital Reference for the specified administration schedule of medications prescribed to manage coronary heart disease (CHD) and its major risk factors. For arterial hypertension, dosing of terazosin and guanfacine is recommended in the evening and thiazide, thiazide-like, and sulfonamide diuretics morning; Verapamil (Verelan®) morning, its "PM" formulation evening, and long-acting diltiazem (Cardizem® LA), per clinical goal, morning or evening. Most hyperlipidemia medications are recommended in the evening. Many hyperglycemia medications are intended for morning ingestion, but, when indicated, some may be prescribed in unequal doses or intervals. For obesity, administration of appetite suppressant psychostimulants and sympathomimetics is stipulated for morning ingestion. Sleep insufficiency medications are to be taken before bedtime. For tobacco dependence, transdermal nicotine patch application is recommended in the morning, and bupropion early, but not late, during the wake span. For alcohol dependence, disulfiram is intended for morning ingestion. For thromboembolism prophylaxis, factor Xa inhibitor rivaroxaban is recommended at dinner and low-dose acetylsalicylic acid before bedtime. Medications for angina pectoris and edema of congestive heart failure are stipulated for morning administration. Overall, >200 medications prescribed to manage CHD and its risk factors qualify as chronotherapies.

Association between sleep quality and cognitive impairment in older adults hypertensive patients in China: a case-control study

Background

Previous studies have found that poor sleep quality promotes the occurrence of cognitive impairment (CI), but this relationship has been rarely reported in older adults hypertensive patients. The purpose of this study was to investigate the relationship between sleep quality and CI in older adults hypertensive patients and the mediating effect of sleep quality between physical activity (PA) and CI.

Methods

A total of 2072 older adults hypertensive patients were included in this case-control study. Five hundred and eighteen older adults hypertensive patients with CI were matched 1:3 by age and sex to 1,554 older adults hypertensive patients with normal cognitive function. The International Physical Activity Questionnaire-Long Form, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination were used to evaluate PA intensity, sleep quality, and cognitive function in older adults hypertensive patients. Multivariate logistic regression and the mediation package in R Language were used to analyze the relationship between sleep quality and CI and the mediating effect of sleep quality between PA intensity and CI in older adults hypertensive patients.

Results

After adjusting for all confounding factors, sleep quality was positively correlated with CI in older adults hypertensive patients (OR = 2.565, 95%CI: 1.958-3.360, p < 0.001), and this relationship also existed in the older adults hypertensive patients with education levels of primary school and below and junior high school and above (OR = 2.468, 95%CI: 1.754-3.473, p < 0.001; OR = 2.385, 95%CI: 1.367-4.161, p = 0.002). In addition, sleep quality mediated part of the mediating effect between PA intensity and CI in older adults hypertensive patients (Za*Zb: - 17.19339; 95%CI: -0.37312, -0.04194).

Conclusion

Poor sleep quality was associated with the occurrence of CI in older adults hypertensive patients, and this relationship also existed in older adults hypertensive patients with education levels of primary school and below and junior high school and above.

Causal Relationship between Television Viewing Time, Cardiovascular Diseases, and Potential Mechanisms

BACKGROUND

As the predominant leisure-time sedentary behavior, television viewing was documented to increase cardiovascular diseases in observational studies, yet the causal relationship and potential mechanisms remain to be determined.

OBJECTIVES

To systematically investigate the causal relationship between television viewing time, cardiovascular diseases, and potential mechanisms.

METHODS

We conducted a two-sample Mendelian randomization (MR) analysis to estimate causal associations with cardiovascular diseases and biomarkers of cardiometabolic risk. The random inverse-variance weighted method was used as the primary estimate. To account for multiple comparisons, a Bonferroni correction p value for cardiovascular diseases and biomarkers of cardiometabolic risk was 0.0045 and 0.0024, respectively.

RESULTS

Genetically instrumented television viewing time was associated with higher risks of type 2 diabetes (odd ratio [OR]=2.51; 95% confidence interval [CI]: 1.89-3.33; p<0.00001), hypertension (OR=2.11; 95% CI: 1.67-2.66; p<0.00001), coronary heart disease (OR=1.53; 95% CI: 1.23-1.91; p=0.00015), and heart failure (OR=1.42; 95% CI: 1.18-1.70; p=0.00017). Suggestive evidence of harmful associations was also observed for peripheral artery disease (OR=1.58; 95% CI: 1.07-2.34; p=0.02253) and ischemic stroke (OR=1.34; 95% CI: 1.10-1.63; p=0.00328). Biomarkers of cardiometabolic risk, including interleukin 10, leptin, visceral adipose, abdominal subcutaneous adipose, liver fat, body mass index, waist circumference, triglycerides, and C-reactive protein, were increased. Systolic blood pressure, heart rate, low-density lipoprotein, and total cholesterol were potentially increased while high-density lipoprotein was decreased. However, television viewing time had no effect on venous thromboembolism or pulmonary embolism.

CONCLUSION

Television viewing time was causally associated with increased risks of cardiovascular diseases, which may be explained by metabolic and inflammatory mechanisms.

BACKGROUND

An overview of the effect of television viewing time on cardiovascular diseases and biomarkers of cardiometabolic risk.

Meal Timing and Depression Among Chinese Children and Adolescents: Cross-Sectional Study

Background

Depression in children and adolescents is a rising concern in China. Dietary behavior is a critical determinant of mental health. Meal timing, or the schedule of meal consumption, has been related to several metabolic disorders. However, the effect of meal timing on mental health is scarce, particularly in children and adolescents who are in a critical period of physical and psychological development.

Objective

This research examined the relationship between meal timing and depression in children and adolescents in China.

Methods

Children and adolescents from grades 1 to 9 were recruited from 16 districts in Shanghai, China, from January 3 to January 21, 2020. Ten schools attended the study. A survey was distributed to the students and their parents to collect demographic and health-related information. Depression was measured by the Children's Depression Inventory-Short Form. Breakfast consumption was analyzed as a binary outcome. Participants were defined as breakfast consumers if they never skipped breakfast during the week. They were otherwise defined as breakfast skippers if they skipped breakfast at least once per week. A similar categorization was applied to analyze food intake proximal to bed. Daily eating windows were calculated using the last food intake time frame-the first food intake time frame. Participants were classified into eating window groups of less than 10 hours, 10-12 hours, and more than 12 hours. A logistic regression model was used to compute the odds ratio (OR) and 95% CI.

Results

A total of 6874 participants were included in the analysis. Participants who skipped breakfast were associated with a 2.70 times higher occurrence of depression (OR 2.70, 95% CI 2.24-3.26; P<.001). The prevalence of depression was 1.28 times higher in participants who ate before bed than in those who never ate before bed (OR 1.28, 95% CI 1.08-1.50; P<.001). The occurrence of depression was 1.37 times higher if the eating time window was shorter than 10 hours (OR 1.37, 95% CI 1.08-1.73; P=.009) and 1.23 times higher if the eating time window was longer than 12 hours (OR 1.23, 95% CI 1.01-1.50; P=.004). The lowest occurrence of depression was observed at 11.5 hours. Subgroup analysis showed that such relationships remained significant in adolescents aged 10 years or older. In children, only skipping breakfast was associated with a higher odds of depression (OR 2.77, 95% CI 1.94-3.96; P<.001).

Conclusions

Breakfast skipping and eating before bed significantly increase the occurrence of depression. The optimal daily eating window to lower the occurrence of depression is 11.5 hours in children and adolescents. Daily eating windows longer than 12 hours or shorter than 10 hours are associated with an elevated occurrence of depression. Current findings advocate evidence-based dietary strategies to prevent and treat depression in children and adolescents.

Associations between antimony exposure and glycated hemoglobin levels in adolescents aged 12-19 years: results from the NHANES 2013-2016

Objective

This study aimed to investigate the association between antimony (Sb) exposure and glycated hemoglobin (HbA1c) levels in adolescents.

Methods

A cross-sectional study of 751 adolescents aged 12-19 years was conducted via the National Health and Nutrition Examination Survey (NHANES, 2013-2016). Survey-weighted linear regression and restricted cubic spline (RCS) analyses were applied to evaluate the relationship of urinary Sb exposure with HbA1c.

Results

A significant relationship was observed between urinary Sb concentrations and HbA1c levels (percent change: 0.93; 95% CI: 0.42, 1.45) after full adjustment. After converting urinary Sb levels to a categorical variable by tertiles (T1-T3), the highest quantile was associated with a significant increase in HbA1c (percent change: 1.45; 95% CI: 0.38, 2.53) compared to T1. The RCS models showed a monotonically increasing relationship of urinary Sb with HbA1c. Subgroup analyses revealed a sex-specific relationship between urinary Sb exposure and HbA1c with a significant positive association in males and a non-significant positive association in females. Sensitivity analyses further confirmed the relationship between urinary Sb and HbA1c, even after excluding participants who were overweight or obese (percent change: 1.58%, 95% CI: 0.88, 2.28) and those with serum cotinine levels ≥ 1 ng/mL (percent change: 1.14%, 95% CI: 0.49, 1.80).

Conclusion

Our findings indicated that increased Sb exposure may correlate with higher HbA1c levels, especially in male adolescents. More studies are needed to further explore and validate the potential mechanisms.

Light modulates glucose and lipid homeostasis via the sympathetic nervous system

Light is an important environmental factor for vision, and for diverse physiological and psychological functions. Light can also modulate glucose metabolism. Here, we show that in mice, light is critical for glucose and lipid homeostasis by regulating the sympathetic nervous system, independent of circadian disruption. Light deprivation from birth elicits insulin hypersecretion, glucagon hyposecretion, lower gluconeogenesis, and reduced lipolysis by 6-8 weeks, in male, but not, female mice. These metabolic defects are consistent with blunted sympathetic activity, and indeed, sympathetic responses to a cold stimulus are significantly attenuated in dark-reared mice. Further, long-term dark rearing leads to body weight gain, insulin resistance, and glucose intolerance. Notably, metabolic dysfunction can be partially alleviated by 5 weeks exposure to a regular light-dark cycle. These studies provide insight into circadian-independent mechanisms by which light directly influences whole-body physiology and inform new approaches for understanding metabolic disorders linked to aberrant environmental light conditions.

Blood-based biomemristor for hyperglycemia and hyperlipidemia monitoring

Thanks to its structural characteristics and signal patterns similar to those of human brain synapses, memristors are widely believed to be applicable for neuromorphic computing. However, to our knowledge, memristors have not been effectively applied in the biomedical field, especially in disease diagnosis and health monitoring. In this work, a blood-based biomemristor was prepared for in vitro detection of hyperglycemia and hyperlipidemia. It was found that the device exhibits excellent resistance switching (RS) behavior at lower voltage biases. Through mechanism analysis, it has been confirmed that the RS behavior is driven by Ohmic conduction and ion rearrangement. Furthermore, the hyperglycemia and hyperlipidemia detection devices were constructed for the first time based on memristor logic circuits, and circuit simulations were conducted. These results confirm the feasibility of blood-based biomemristors in detecting hyperglycemia and hyperlipidemia, providing new prospects for the important application of memristors in the biomedical field.

Timing matters: diurnal variation of maximal fat oxidation and substrate oxidation rates in metabolic syndrome-a randomized crossover study

PURPOSE

The aim of this study was to investigate if diurnal oscillation in maximal fat oxidation (MFO) and substrate oxidation rates during exercise exists in subjects with metabolic syndrome (MetS).

METHODS

In a randomized crossover design, 14 MetS patients were assigned to two graded exercise tests conditions performed in the morning (between 7:00 and 9:00 a.m) and in the afternoon (between 4:00 and 5:00 p.m). MFO was defined as the highest absolute value of fat oxidation obtained from the average of last 2-min stages during an indirect calorimetry test.

RESULTS

MFO increased by 20.6% from morning to afternoon (p = 0.0002, Cohen's d = 0.52). There was a significant time of day, (p < 0.0001, η2p = 0.76) and intensity effect (p = 0.002, η2p = 0.32) in fat oxidation (Fatox) rates indicating that Fatox was higher in the afternoon than in the morning.

CONCLUSION

Our study extends previous findings on the existence of diurnal variation in maximal fat oxidation to MetS patients, highlighting the afternoon as a more favorable time for fat utilization during exercise. These findings have practical implications for optimizing training timing in MetS patients.

TRIAL REGISTRATION NUMBER

PACTR202306776991260.

Microglia, circadian rhythm and lifestyle factors

Microglia, a vital homeostasis-keeper of the central nervous system, perform critical functions such as synaptic pruning, clearance of cellular debris, and participation in neuroinflammatory processes. Recent research has shown that microglia exhibit strong circadian rhythms that not only actively regulate their own immune activity, but also affect neuronal function. Disruptions of the circadian clock have been linked to a higher risk of developing a variety of diseases. In this article we will provide an overview of how lifestyle factors impact microglial function, with a focus on disruptions caused by irregular sleep-wake patterns, reduced physical activity, and eating at the wrong time-of-day. We will also discuss the potential connection between these lifestyle factors, disrupted circadian rhythms, and the role of microglia in keeping brain health. This article is part of the Special Issue on "Microglia".