| Title: | A newly developed circadian imbalance index (CII) and risk of cardiovascular-kidney-metabolic disease in the UK biobank |
| Journal: | European Journal of Epidemiology |
| Published: | 21 Feb 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41721995/ |
| DOI: | https://doi.org/10.1007/s10654-026-01373-7 |
Publication 17683
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Abstract
To examine the association between combined circadian imbalance related traits and cardiovascular-kidney-metabolic (CKM) disease risk, and their potential interaction with night shift work. This study included 191,764 UK Biobank participants without major chronic diseases who were employed at baseline (2006-2010). The Circadian Imbalance Index (CII) was developed by combining several factors indicative of a propensity for circadian misalignment. One point was assigned for each of the following components if present: evening chronotype, sleep duration ≤ 6 or ≥ 9 h/day, high neuroticism (score ≥ 7), atypical caffeinated coffee consumption (0 or ≥ 5 cups/day), and vitamin D (< 50 nmol/L), resulting in a composite scale from 0 to 5. CKM outcome (type 2 diabetes, cardiovascular diseases, chronic kidney diseases) identified by ICD codes, self-reports, or death records. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the multivariable (MV)-adjusted association between the CII and CKM risk, including effect modification by night shift work. During a median follow-up of 13.5 years (through 2022), 16,907 incident CKM cases were identified. Among participants with European ancestry, for highest versus lowest (0-1) CII, the MV-adjusted risk of CKM was 1.95 (95%CI: 1.70-2.23; Ptrend<0.001). A significant positive relationship between CII and CKM risk was also observed in participants of Asian (HR = 2.03, 95%CI, 1.07-3.86; Ptrend=0.002), but not African ancestry (HR = 1.43, 95%CI, 0.67-3.06; Ptrend=0.35). Risks were higher in shift and night workers than day workers. Among Europeans, the HR for highest CII combined with current night shift work was 2.22 (95%CI, 1.95-2.53), with significant additive interaction (P < 0.05). In this large prospective study, Circadian Imbalance Index (CII) was associated with higher CKM risk in Europeans and Asians. Among Europeans, high CII plus night shift work posed the greatest risk.</p>
9 Authors
- Jing Zhang
- Dat Thien Tran
- Tala El Ghoul
- Susanne Strohmaier
- Magdalena Żebrowska
- Susan Redline
- Richa Saxena
- Martin K. Rutter
- Eva S. Schernhammer
1 Application
| Application ID | Title |
|---|---|
| 48576 | A multi-polygenic score of clock resilience and its utility in predicting vulnerability to night work with regards to chronic disease risk (cardiovascular disease, type 2 diabetes, depression, breast) |
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