Circadian syndrome and incident non-neoplastic digestive disease in middle-aged and older Chinese adults: a prospective cohort study
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Summary Background Circadian syndrome (CircS) comprises metabolic abnormalities, short sleep, and depressive symptoms, and is associated with cardiovascular, liver, and lung diseases and mortality; evidence on digestive disease is scarce. We assessed its association with incident non-neoplastic digestive disease in Chinese adults. Methods In this prospective analysis of the China Health and Retirement Longitudinal Study (CHARLS), we included 2011 baseline participants aged ≥45 years free of digestive disease, with follow-up to 2018. CircS (≥4 of 7 components) was analysed as a continuous score and as a binary exposure. Cox models estimated hazard ratios (HRs) adjusting for demographic factors, BMI, smoking, and alcohol use. We did dose–response, component, subgroup, and sensitivity analyses; hs-CRP mediation was explored. Findings 907 (19·0%) of 4 771 participants developed digestive disease over a median 84 months. Each additional CircS component raised the risk by 9·1% (HR 1·091, 95% CI 1·041–1·144, P<0·001); CircS positivity (36·1%) was associated with a 25·7% higher risk (HR 1·257, 1·084–1·456, P=0·002). Risk rose approximately linearly to about 70% higher at 5–7 components. Short sleep (HR 1·178, 1·017–1·365) and depressive symptoms (HR 1·570, 1·367–1·803) were the only independently associated components; no metabolic component was associated. Results were robust across sensitivity analyses; hs-CRP did not mediate the association. Interpretation CircS is associated with incident non-neoplastic digestive disease, driven by its circadian–emotional rather than metabolic components. Sleep and mood may be targets for prevention. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Source: medRxiv
Authors: Lu Liu, Liqiong Zhao, Cailan Li, Yan Geng
Institution: Chinese People's Liberation Army
Language: English
Subfield: Endocrine and Autonomic Systems
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7214336389