A nonparametric methodological analysis of rest-activity rhythm in type 2 diabetes

Cavalcanti-Ferreira, Paula; Berk, Lee; Daher, Noha; Campus, Tania; Araújo, John Fontenele; Petrofsky, Jerrold S.; Lohman, Everett

doi:10.5935/1984-0063.20180044

Cited by 17 publications

(8 citation statements)

References 51 publications

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“… 9–13 Several studies using 24-hour accelerometer data have found that individuals with type 2 diabetes have impaired rest-activity rhythms, indexed by decreased overall rhythmicity and increased fragmentation. 14 15 A recent study 16 in older men (≥65 years) further observed that impaired rest-activity rhythm was not only associated with insulin resistance and type 2 diabetes at baseline but also associated with a higher risk of incident type 2 diabetes 3.5 years later, implicating that rest-activity rhythm may serve as a unique predictor of metabolic dysfunction.…”

Section: Introductionmentioning

confidence: 96%

Rest-activity circadian rhythm and impaired glucose tolerance in adults: an analysis of NHANES 2011–2014

McCall

et al. 2022

BMJ Open Diab Res Care

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IntroductionCircadian rhythm disturbance occurs in type 2 diabetes, yet it is unknown whether it also exists in the prediagnostic phase of the disease. Thus, we examined the association of rest-activity circadian rhythm with 2-hour glucose levels and the risk of impaired glucose tolerance (IGT) in a nationally representative sample of adults without diabetes using a cross-sectional design.Research design and methodsWe analyzed data from 2760 adults without diabetes (age ≥20) with at least 4 days of validated accelerometer recordings and a valid oral glucose tolerance test from the National Health and Nutrition Examination Survey 2011–2014. Non-parametric rest-activity circadian rhythm parameters were derived from the accelerometer recordings.ResultsIn the models adjusting for multiple covariates, a one-quantile increase in relative amplitude (ie, increased circadian rhythmicity) was associated with 2.66 mg/dL decrease in 2-hour glucose level (95% CI −3.94 to −1.38, p<0.001) and a decreased odds of IGT (OR 0.75, 95% CI 0.63 to 0.89, p=0.002). A one-quantile increase in intradaily variability (ie, increased rhythm fragmentation) was associated with 3.01 mg/dL increase in 2-hour glucose level (95% CI 1.52 to 4.49, p=0.001) and an increased odds of IGT (OR 1.37, 95% CI 1.19 to 1.58, p<0.001).ConclusionsCircadian disruption is significantly associated with impaired glucose homeostasis in a general population of adults without diabetes. The association of circadian rhythm abnormalities with indicators of the pre-diabetic state suggests that circadian dysfunction may contribute to early disease pathogenesis.

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Section: Introductionmentioning

confidence: 96%

Rest-activity circadian rhythm and impaired glucose tolerance in adults: an analysis of NHANES 2011–2014

McCall

et al. 2022

BMJ Open Diab Res Care

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“…The levels of these biomarkers were reduced in patients with higher amplitudes, implying that higher RA was negatively correlated with cognitive decline, which is consistent with the findings of this study. In addition, previous studies have observed that lower RA is closely related to diseases such as abnormal glucose tolerance and diabetes ( 13 , 26 , 27 ). Compared with normoglycemic older adults, the elderly with diabetes were more likely to have MCI.…”

Section: Discussionmentioning

confidence: 94%

Association between rest-activity rhythm and cognitive function in the elderly: The U.S. National Health and Nutrition Examination Survey, 2011-2014

Sun

Wang²,

Wang³

et al. 2023

Front. Endocrinol.

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BackgroundCircadian rhythm plays an essential role in various physiological and pathological processes related to cognitive function. The rest-activity rhythm (RAR) is one of the most prominent outputs of the circadian system. However, little is known about the relationships between RAR and different domains of cognitive function in older adults. The purpose of this study was to examine the relationships between RAR and various fields of cognitive function in older Americans.MethodsThis study included a total of 2090 older adults ≥ 60 years old from the National Health and Nutrition Examination Survey (NHANES) in 2011-2014. RAR parameters were derived from accelerometer recordings. Cognitive function was assessed using the word learning subtest developed by the Consortium to Establish a Registry for Alzheimer’s disease (CERAD W-L), the Animal Fluency Test (AFT) and the Digital Symbol Substitution Test (DSST). Linear regression was used to determine the relationships between RAR parameters (IS, IV, RA, L5, M10) and cognitive function scores (CERAD W-L, AFT, DSST).ResultsAfter adjusting for potential confounders, lower IS and M10 were associated with lower CERAD W-L scores (P=0.033 and P=0.002, respectively). Weaker RA and higher L5 were associated with lower AFT scores (P<0.001 and P=0.001, respectively). And lower IS, RA, and higher L5 were associated with lower DSST scores (P=0.019, P<0.001 and P<0.001, respectively). In addition, the results of sensitivity analysis were similar to those of our main analyses. The main correlation results between the RAR indicators and cognitive function were robust.ConclusionsThis study suggested that the weakened and/or disrupted RAR was associated with cognitive decline in different domains in Americans over the age of 60.

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“…Although circadian rhythm alteration secondary to the presence of T2D has been studied [ 30 ], studies of human circadian rhythms have shown that under the standard 24 h daily cycle, the circadian pattern is not purely sinusoidal, but is modelled by a 12 h component (second harmonic), which has been related to the interaction between the homeostatic and circadian sleep regulatory components [ 31 ]. The presence of this 12 h rhythm is noticeable by a post-noon peak in wrist temperature rhythm or by a post-noon dip in activity.…”

Section: Discussionmentioning

confidence: 99%

Circadian Patterns of Patients with Type 2 Diabetes and Obstructive Sleep Apnea

Cambras

Romero

Dı́ez-Noguera

et al. 2021

JCM

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Sleep apnea, a condition that modifies sleep and circadian rhythms, is highly prevalent in patients with diabetes. However, it is not known if there is an association between sleep apnea, circadian alterations and glycemic regulation in this type of patient. Here, a polysomnographic study was carried out on 21 women and 25 men (mean age = 64.3 ± 1.46 years) with diagnoses of type 2 diabetes to detect the presence of sleep apnea. Moreover, patients wore an actigraph and a temperature sensor on the wrist for one week, to study the manifestation of the circadian rhythms. The correlations of circadian and polysomnographic variables with the severity of apnea, measured by the apnea-hypopnea index, and with glycemic dysregulation, measured by the percentage of glycated hemoglobin, were analyzed. The mean apnea-hypoapnea index of all the participants was 39.6 ± 4.3. Apnea-hypoapnea index correlated with % N1, negatively with % N3, and also the stability of the active circadian rhythm. However, no significant correlation was found between the apnea-hypopnea index and wrist temperature rhythm and glycated hemoglobin. Glycated hemoglobin levels were negatively associated with the percentage of variance explained by the wrist temperature circadian rhythm (calculated via 24 and 12 h rhythms). This association was independent of body mass index and was strongest in patients with severe apnea. In conclusion, patients with diabetes showed altered circadian rhythms associated with a poor glycemic control and this association could partially be related to the coexistence of sleep apnea.

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A nonparametric methodological analysis of rest-activity rhythm in type 2 diabetes

Cited by 17 publications

References 51 publications

Rest-activity circadian rhythm and impaired glucose tolerance in adults: an analysis of NHANES 2011–2014

Rest-activity circadian rhythm and impaired glucose tolerance in adults: an analysis of NHANES 2011–2014

Association between rest-activity rhythm and cognitive function in the elderly: The U.S. National Health and Nutrition Examination Survey, 2011-2014

Circadian Patterns of Patients with Type 2 Diabetes and Obstructive Sleep Apnea

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