Abstract
Social jetlag – a measure of disruption of the circadian system – has been linked to obesity, but its association with metabolic complications in non-communicable chronic diseases (NCCDs) is unknown in the literature. We examined the associations between social jetlag and obesity status and metabolic parameters among individuals with NCCDs. Patients (n = 792) with NCCDs (obesity, systemic arterial hypertension, type 2 diabetes mellitus or dyslipidaemia) attended clinics of the public health service of the city of Uberlândia, Minas Gerais State, Brazil. They were classified in three obesity statuses: non-obese: BMI < 30 kg/m2; metabolically healthy obese (MHO): BMI ≥ 30 kg/m2 and less than three high-risk biomarkers for metabolic syndrome; and metabolically unhealthy obese (MUO): BMI ≥ 30 kg/m2 and with high-risk values on three or more biomarkers for metabolic syndrome. After adjustments for confounding variables, social jetlag was positively associated with fasting glucose levels among all subjects (β = 0.08, p = 0.03) and MUO subjects (β = 0.32, p < 0.001). Patients with social jetlag (>1 h) presented a significant odds ratio (OR) of being overweight (OR = 2.0, confidence interval (CI) = 1.2–3.6, p = 0.006) and MUO (OR = 1.8, CI = 1.1–2.8, p = 0.01). These results suggest that social jetlag is associated with a higher risk of overweight and related metabolic complications in individuals with NCCDs.
Highlights
The prevalence of obesity has increased rapidly over the past three decades, reaching epidemic levels worldwide[1, 2]
This study evaluated the relationship between social jetlag, obesity, metabolic parameters and blood pressure among individuals with non-communicable chronic diseases (NCCDs)
A higher odds of being overweight and an metabolically unhealthy obese (MUO) was found in individuals with social jetlag, even after adjustment for factors that may influence the development of excess weight and its metabolic complications
Summary
The prevalence of obesity has increased rapidly over the past three decades, reaching epidemic levels worldwide[1, 2]. Despite increased adiposity, ‘metabolically healthy obese’ (MHO) subjects are characterized by a favourable metabolic profile: high levels of insulin sensitivity, a low prevalence of systemic arterial hypertension, favourable lipid and inflammation profiles[5] In this context, a better understanding of the risk factors that can trigger or protect the comorbidities commonly associated with obesity could be important to avoid the poor prognosis of this disease[5,6,7]. Obesity has traditionally been thought to be caused by changes in diet and decreased levels of physical activity[8], recent research has suggested that a number of alternative factors may be involved with the obesity genesis, such as circadian misalignment and sleep debt[9, 10] In this sense, social jetlag – which describes the chronic jetlag-like phenomenon occasioned by work or study schedules and reflects a misalignment between an individual’s endogenous circadian clock and actual sleep times11 – seems to be associated with overweight[10] and metabolic parameters[12]. The objective of this study was to analyse the associations between social jetlag and metabolic parameters among individuals with NCCDs, addressing different obese statuses
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