Social Jetlag, Chronotype, and Cardiometabolic Risk

J Clin Endocrinol Metab. 2015 Dec;100(12):4612-20. doi: 10.1210/jc.2015-2923. Epub 2015 Nov 18.

Abstract

Context: Shift work, which imposes a habitual disruption in the circadian system, has been linked to increased incidence of cardiometabolic diseases, and acute circadian misalignment alters various metabolic processes. However, it remains unclear whether day-to-day circadian dysregulation contributes to these risks beyond poor sleep and other behavioral characteristics.

Objective: Individuals differ in circadian phase preference, known as chronotype, but may be constrained by modern work obligations to specific sleep schedules. Individuals experience social jetlag (SJL) due to a habitual discrepancy between their endogenous circadian rhythm and actual sleep times imposed by social obligations. Here, we examined whether chronotype and/or SJL associate with components of cardiovascular disease risk beyond the known effects of sleep disturbances, poor health behaviors, and depressive symptomatology.

Design: Participants were healthy, midlife adults who worked part- or full-time day shifts (n = 447; mean age, 42.7 [range, 30-54] y; 53% female; 83% white). Chronotype was assessed with the Composite Scale of Morningness. SJL was quantified as the difference (in minutes) between the midpoints of actigraphy-derived sleep intervals before work vs non-workdays.

Results: Multiple regression analyses showed that SJL related to a lower high-density lipoprotein-cholesterol level, higher triglycerides, higher fasting plasma insulin, insulin resistance, and adiposity (P < .05), even after adjustment for subjective sleep quality, actigraphy-derived sleep characteristics, depressive symptomatology, and health behaviors. Evening chronotype associated with lower high-density lipoprotein-cholesterol after adjustment for covariates.

Conclusion: Our findings suggest that a misalignment of sleep timing is associated with metabolic risk factors that predispose to diabetes and atherosclerotic cardiovascular disease.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adiposity / physiology
  • Adult
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology*
  • Cholesterol, HDL / blood
  • Circadian Rhythm
  • Depression / psychology
  • Female
  • Health Behavior
  • Humans
  • Insulin / blood
  • Insulin Resistance
  • Jet Lag Syndrome / complications
  • Jet Lag Syndrome / physiopathology*
  • Jet Lag Syndrome / psychology
  • Life Style
  • Male
  • Metabolic Diseases / etiology
  • Metabolic Diseases / physiopathology*
  • Middle Aged
  • Sleep Disorders, Circadian Rhythm / physiopathology
  • Sleep Disorders, Circadian Rhythm / psychology
  • Social Environment
  • Triglycerides / blood
  • Work Schedule Tolerance*

Substances

  • Cholesterol, HDL
  • Insulin
  • Triglycerides