Don't leave a light on for me: commentary on Kim et al. "Light at night in older age is associated with obesity, diabetes, and hypertension".
Don't leave a light on for me: commentary on Kim et al. "Light at night in older age is associated with obesity, diabetes, and hypertension".
复制标题
别给我留灯：金等人的评论。
作者：
Duffy,JeanneF;Yuan,RobinK
在世纪，广泛的电气化和相对便宜的电灯改变了地球仪上数百万人的日常生活模式。人类突然能够操纵他们的光明-黑暗循环，不再每晚都被托付在黑暗中。长期以来，人们一直清楚获得24小时廉价照明的好处，但夜间照明（LAN）对人类健康的负面影响直到最近才得到研究。虽然我们仍然受到太阳活动周期的影响[1]，但有大量证据表明，睡眠的时间已经推迟，导致日落和就寝时间之间的夜间时间暴露更多[2，3]。此外，许多人由于夜间工作、睡眠中断以及在睡前和夜间醒来期间使用发光电子设备而经历额外的LAN暴露。除了在我们清醒时受到LAN的影响外，越来越多的证据表明，即使在睡眠时暴露在光线下也会对健康产生负面影响。这种暴露也很普遍，无论是来自家庭内部的光源还是来自外部的光源，特别是在城市地区。横断面和前瞻性研究都发现，更多的LAN与肥胖和体重增加的患病率更高，甚至与冠心病的风险有关，但大多数先前的研究都集中在LAN对儿童，青少年和年轻人的影响。老年人在睡眠时是否暴露于类似数量的LAN，以及这种暴露是否会对健康产生负面影响尚不清楚。在这一期的《睡眠》[4]中，Kim等人在552名社区老年人中探索了LAN暴露与心血管疾病（CVD）风险之间的关联。利用芝加哥健康老龄化研究（CHAS）参与者从腕戴设备收集的1周活动和光照数据，他们根据参与者每天最不活跃的5小时事件期间是否有光照，将其分为LAN和No-LAN组。LAN组的就寝时间较晚，睡眠时间较短，入睡后觉醒较多，睡眠效率较低。然后，他们使用标准化问卷测试了LAN暴露与从相同参与者收集的健康数据之间的关联，揭示了LAN与肥胖，糖尿病和高血压患病率增加之间的显着关联，即使在调整人口统计学特征，睡眠和其他活动变量之后。在进一步将LAN组分为低LAN和高LAN亚组后，探索性分析发现LAN没有显著的剂量依赖性效应; LAN亚组之间在CVD风险因素方面没有显著差异，尽管两者都比无LAN组更有可能患有肥胖，糖尿病和高血压。CVD风险与24小时光照模式的其他指标（如平均/中位光照强度、峰值强度和LAN时间）之间没有发现关联。Kim等人的研究结果加入了越来越多的证据，将暴露于LAN与广泛的负面健康结果联系起来，包括癌症[5]，抑郁症[6]和心脏代谢疾病，如糖尿病和超重/肥胖[7]。之前在尼日利亚[8]和韩国[9]进行的横断面研究报告称，通过卫星图像测量，生活在室外LAN较高地区的成年人超重和肥胖的患病率增加。类似地，在英国[10]和美国的成年女性中进行的大型研究
In the 20th century, widespread electrification and relatively inexpensive electric lighting transformed the daily pattern of life for millions of people across the globe. Humans were suddenly able to manipulate their light-dark cycle, no longer consigned to remain in the dark throughout each night. The benefits of access to round-the-clock inexpensive lighting have long been clear, but the negative impacts of light at night (LAN) on human health have only recently been studied. Although we still are influenced by the solar cycles [1], there is extensive evidence that the timing of sleep has shifted later, resulting in more light exposure in the evening hours between sunset and bedtime [2, 3]. In addition, many individuals experience additional exposure to LAN due to working at night, sleep disruptions, and using light-emitting electronic devices before sleep and during nighttime awakenings. In addition to the impact of LAN while we are awake, there is accumulating evidence that exposure to light even while sleeping can have negative impacts on health. Such exposure is also widespread, both from light sources inside the home and those from outside, particularly in urban areas. Both cross-sectional and prospective studies have found that more LAN is associated with a greater prevalence of obesity and weight gain, and even with the risk of coronary heart disease, but most of those prior studies have focused on the impact of LAN on children, adolescents, and young to middle-aged adults. Whether older adults are exposed to similar amounts of LAN while sleeping, and whether there are negative health outcomes from that exposure is not known. In this issue of SLEEP [4], Kim et al. explored the association between exposure to LAN and cardiovascular disease (CVD) risk in a population of 552 community-dwelling older adults. Using1 week of activity and light data collected from a wrist-worn device by participants in the Chicago Healthy Aging Study (CHAS), they categorized participants into LAN and No-LAN groups based on whether they had light exposure during their least active 5-hr episode each day. The LAN group had later bedtimes, shorter sleep, more wake after sleep onset, and lower sleep efficiency than the No-LAN group. They then tested for associations between LAN exposure and health data collected from the same participants using standardized questionnaires, revealing a significant association between LAN and increased prevalence of obesity, diabetes, and hypertension, even after adjusting for demographic characteristics, sleep, and other activity variables. Upon further dividing the LAN group into Low-and High-LAN subgroups, the exploratory analysis found no significant dosedependent effect of LAN; there were no significant differences between the LAN subgroups in CVD risk factors, although both remained more likely than the No-LAN group to have obesity, diabetes, and hypertension. No association was found between CVD risk and other measures of 24-hr light exposure patterns such as mean/median light intensity, peak intensity, and LAN timing.The findings by Kim et al. join a growing body of evidence linking exposure to LAN with a wide range of negative health outcomes, including cancer [5], depression [6], and cardiometabolic diseases such as diabetes and overweight/obesity [7]. Previous cross-sectional studies conducted in Nigeria [8] and South Korea [9] have reported an increased prevalence of overweight and obesity in adults living in regions with high outdoor LAN as measured by satellite imagery. Similarly, large studies in adult women in the United Kingdom [10] and the United States