Reproducibility and associations with obesity and insulin resistance of circadian-rhythm parameters in free-living vs. controlled conditions during the PREVIEW lifestyle study

• Published in: International Journal of Obesity Vol. 45; no. 9; pp. 2038 - 2047
• Main Authors: Drummen, Mathijs, Tischmann, Lea, Gatta-Cherifi, Blandine, Raben, Anne, Adam, Tanja, Westerterp-Plantenga, Margriet S.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2021; Nature Publishing Group
• Subjects: 692/163/2743/393; 692/700/2817; Age; Aged; Alignment; Amplitudes; Body Mass Index; Body size; Body weight loss; Care and treatment; Circadian rhythm; Circadian Rhythm - physiology; Circadian rhythms; Controlled conditions; Development and progression; Diabetes; Diabetes mellitus; Epidemiology; Factor analysis; Female; Health aspects; Health Promotion and Disease Prevention; Humans; Insulin; Insulin resistance; Insulin Resistance - physiology; Internal Medicine; Life Style; Living conditions; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Obesity; Obesity - complications; Obesity - physiopathology; Parameters; Patient outcomes; Physiological aspects; Population studies; Prediabetic state; Public Health; Reproducibility; Reproducibility of Results; Stability; Temperature measurement; Wrist; Europe
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/s41366-021-00873-8

Background Circadian rhythm is altered in individuals with obesity and insulin resistance, showing a smaller amplitude, less stability, and increased intradaily variation. Objective We compared reproducibility of circadian-rhythm parameters over time and under free-living vs. controlled conditions in participants with obesity and pre-diabetes after 2- and 3-year weight-loss maintenance during the 3-year PREVIEW (PREVention of diabetes through lifestyle intervention and population studies In Europe and around the World) study. Associations of obesity and insulin resistance with circadian-rhythm parameters were assessed. Subjects and methods Circadian-rhythm parameters were determined using continuous wrist-temperature measurements in free-living environments at year 2 ( n  = 24; age 56.8 ± 10.3 y; body mass index (BMI) = 30 ± 3.9 kg/m 2 ; homeostatic model assessment of insulin resistance (HOMA-IR) 2.4 ± 1.1), at year 3 ( n  = 97; age 61.7 ± 7.8; BMI = 29.7 ± 3.9; HOMA-IR 2.9 ± 2.1), and at year 3 in a controlled condition ( n  = 38; age 63.4 ± 6.7; BMI = 28.7 ± 3.9; HOMA-IR 3.8 ± 1.4). Reproducibility was assessed by analyzing repeatability coefficients (CR), differences, and associations, over time as well as between conditions. Associations of BMI and HOMA-IR with circadian-rhythm parameters were assessed at y-3 in both conditions using factor analysis, followed by Pearson’s correlations. Results Reproducibility of circadian-rhythm parameters over time in the free-living environments was high (CR 0.002–5.26; no significant differences; associated amplitudes r  = 0.57; p  < 0.01). In contrast, reproducibility between different conditions was low (CR 0.02–11.36; significant differences between most parameters ( p  < 0.05); yet associated amplitudes r  = 0.59; p  < 0.01). In the controlled vs. free-living condition circadian-rhythm was more stable; BMI and HOMA-IR were associated with the physiological amplitude-related parameters ( r  = −0.45; p  < 0.01; r  = −0.33; p  < 0.05). In the free-living environment, BMI and behavioral circadian-rhythm parameters indicating circadian alignment, contributed most to the explained variation (47.1%), and were inversely associated ( r  = −0.22; p  < 0.05), while HOMA-IR was inversely associated with stability-related circadian-rhythm parameters ( r  = −0.21; p  < 0.05). Conclusions Circadian rhythm was highly reproducible over time in the free-living environments, yet different under different conditions, being more stable in the controlled condition. BMI may play a significant role in circadian alignment and vice versa in the free-living environment.