ABSTRACT

Advances in research have linked alterations of circadian rhythms with obesity. However, few studies have focused on the recovery of the circadian expression after a weight loss treatment. Our aim was to study the alterations of the circadian rhythmicity due to morbid obesity and the recovery of the circadian pattern after weight loss in a cohort of patients who underwent sleeve gastrectomy. For this purpose, 41 patients with severe obesity (75% women; age [mean (SD)] 49.7 ± 10 years; BMI 44.3 ± 6.2 kg/m2) were monitored before bariatric surgery and 9 months afterward. On both occasions, activity and wrist temperature were determined by actigraphy and were related with weight loss. Anthropometric, biochemical, and sleep-related variables, along with dietary intake and physical activity, were analyzed in relation with circadian rhythmicity. Results show significant differences in the circadian expression before and after 9 months of bariatric surgery, with more stable and less fragmented rhythms after weight loss. Moreover, only after surgery were the circadian variables associated to sleep timing and chronotype. The findings of this study indicate that weight loss treatment in patients with morbid obesity improves the circadian rhythm expression, and in such a way that it could be associated with better sleep quality. Moreover, it allows the recovery of the relationship between sleep patterns and circadian rhythm that was lost due to the obesity.

摘要

研究进展已将昼夜节律的改变与肥胖联系在一起。然而，很少有研究集中于减肥治疗后昼夜节律的恢复。我们的目的是研究一组患有袖套胃切除术的患者因病态肥胖引起的昼夜节律变化和体重减轻后昼夜节律的恢复。为此，在减肥手术之前和之后的9个月对41例严重肥胖的患者（75％的女性；平均年龄[SD] 49.7±10岁； BMI 44.3±6.2 kg / m2）进行了监测。在两种情况下，活动性和腕部温度均通过书法确定，并与体重减轻有关。人体生理，生化和睡眠相关的变量，以及饮食摄入和体育锻炼，与昼夜节律有关。结果显示，减肥手术9个月之前和之后，昼夜节律的表达存在显着差异，减肥后节律更加稳定，节律更加零散。而且，只有在手术后，昼夜节律变量才与睡眠时间和表型有关。这项研究的结果表明，对病态肥胖症患者进行减肥治疗可以改善昼夜节律的表达，并可以改善睡眠质量。而且，它可以恢复由于肥胖而丧失的睡眠方式和昼夜节律之间的关系。仅在手术后，昼夜节律变量才与睡眠时间和表型有关。这项研究的结果表明，对病态肥胖症患者进行减肥治疗可以改善昼夜节律的表达，并可以改善睡眠质量。而且，它可以恢复由于肥胖而丧失的睡眠方式和昼夜节律之间的关系。仅在手术后，昼夜节律变量才与睡眠时间和表型有关。这项研究的结果表明，对病态肥胖症患者进行减肥治疗可以改善昼夜节律的表达，并可以改善睡眠质量。而且，它可以恢复由于肥胖而丧失的睡眠方式和昼夜节律之间的关系。