Morning Circadian Misalignment Is Associated With Insulin Resistance in Girls With Obesity and Polycystic Ovarian Syndrome
Morning Circadian Misalignment Is Associated With Insulin Resistance in Girls With Obesity and Polycystic Ovarian Syndrome
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DOI：
10.1210/jc.2018-02385
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发表时间：
2019-08-01
影响因子：
5.8
通讯作者：
Cree-Green, Melanie
中科院分区：
文献类型：
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作者：
Simon, Stacey L.;McWhirter, Laura;Cree-Green, Melanie
内容：据我们所知，尽管青春期典型的昼夜节律延迟（这是昼夜健康与胰岛素敏感性（SI）之间的新兴联系）以及PCOS患者SI降低，但尚未对多囊卵巢综合征（PCOS）女孩的昼夜节律进行检查。目的：为了研究肥胖青春期多囊卵巢综合征（PCOS）女孩和对照组之间褪黑激素昼夜节律的差异，设计：横断面研究，对象：肥胖青春期女性PCOS患者（n = 59）和非PCOS患者（n = 33）。结果：估计睡眠持续时间和时间从家庭活动监测，在实验室每小时采样昏暗的光，唾液褪黑激素和空腹激素分析。所有参与者都睡眠不足。与对照组相比，多囊卵巢综合征女孩的褪黑激素偏移的时钟时间较晚，褪黑激素偏移相对于睡眠时间较晚，褪黑激素分泌持续时间较长。唤醒时间之后的较晚褪黑激素偏移（即，在生物学夜晚期间发生的早晨觉醒）与较高的血清游离睾酮水平和较差的SI相关。分析仍然显着控制后，白天嗜睡和睡眠呼吸障碍。结论：在PCOS的女孩昼夜失调的特点是晚褪黑激素偏移相对于时钟时间和睡眠时间。多囊卵巢综合征和肥胖女孩的晨起昼夜节律失调与代谢失调有关。患有PCOS和肥胖的女孩的临床护理将受益于睡眠和昼夜健康的评估。需要更多的研究来了解这一人群中早晨昼夜节律失调和SI之间关系的机制。
Context: To our knowledge, circadian rhythms have not been examined in girls with polycystic ovarian syndrome (PCOS), despite the typical delayed circadian timing of adolescence, which is an emerging link between circadian health and insulin sensitivity (SI), and decreased SI in PCOS.Objective: To examine differences in the circadian melatonin rhythm between obese adolescent girls with PCOS and control subjects, and evaluate relationships between circadian variables and SI.Design: Cross-sectional study.Participants: Obese adolescent girls with PCOS (n = 59) or without PCOS (n = 33).Outcome Measures: Estimated sleep duration and timing from home actigraphy monitoring, in-laboratory hourly sampled dim-light, salivary-melatonin and fasting hormone analysis.Results: All participants obtained insufficient sleep. Girls with PCOS had later clock-hour of melatonin offset, later melatonin offset relative to sleep timing, and longer duration of melatonin secretion than control subjects. A later melatonin offset after wake time (i.e., morning wakefulness occurring during the biological night) was associated with higher serum free testosterone levels and worse SI regardless of group. Analyses remained significant after controlling for daytime sleepiness and sleep-disordered breathing.Conclusion: Circadian misalignment in girls with PCOS is characterized by later melatonin offset relative to clock time and sleep timing. Morning circadian misalignment was associated with metabolic dysregulation in girls with PCOS and obesity. Clinical care of girls with PCOS and obesity would benefit from assessment of sleep and circadian health. Additional research is needed to understand mechanisms underlying the relationship between morning circadian misalignment and SI in this population.