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Fan Y, Zheng X, Xu T, Li P, Zhang Y, Ran Y, Wei T. Sleep factors and risk of thyroid cancer, nodules and dysfunction: Mendelian randomization study. Gland Surg 2025; 14:368-379. [PMID: 40256460 PMCID: PMC12004327 DOI: 10.21037/gs-24-435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 03/10/2025] [Indexed: 04/22/2025]
Abstract
Background The interplay between sleep physiology and endocrine regulation has been well-established, with the thyroid gland, as a key endocrine organ, demonstrating a physiologically plausible. Previous studies have indicated a potential correlation between sleep factors and thyroid diseases, yet causality remains uncertain. Given the complex interplay of confounders associated with sleep disorders and lifestyle factors, we employed a two-sample Mendelian randomization (MR) approach to minimize confounding bias and rigorously investigate the causal relationship. Methods The specific information on thyroid diseases-including thyroid cancer, thyroid nodules (TNs), and thyroid dysfunction-was obtained from the FinnGen Biobank using the International Classification of Diseases, 10th Revision (ICD-10). Information on sleep factors such as insomnia symptoms, chronotype, and sleep duration were sourced from genome-wide association studies (GWAS) conducted within the UK Biobank, which provides validated GWAS data through self-report assessment. We employed stringent single nucleotide polymorphisms (SNPs) selection criteria as instrumental variables (IVs) for analyzing sleep factors' causal impact on thyroid diseases. Statistical methods including inverse variance weighted (IVW), weighted median (WM), MR-Egger, and MR-PRESSO were utilized to determine causality, supplemented by F-statistics and sensitivity analyses to ensure robustness and detect biases. Results The analysis supported that a morning chronotype is protective against thyroid cancer, with results showing a significantly reduced risk [IVW: odds ratio (OR) =0.632, 95% confidence interval (CI): 0.426-0.937, P=0.02]. Conversely, insomnia symptoms were identified as a potential risk factor for developing TNs (IVW: OR =1.973, 95% CI: 1.152-3.377, P=0.01). Sensitivity analyses, including Cochran's Q test, MR-Egger intercept, and MR-PRESSO, showed no significant heterogeneity, horizontal pleiotropy, or outliers (all P values >0.05). However, no significant causal links were found between genetic predispositions to sleep factors and thyroid dysfunction. Conclusions These findings suggest that therapeutic management of sleep disorders could potentially reduce the risk of developing thyroid diseases, underscoring the importance of routine thyroid monitoring in individuals experiencing sleep disturbances.
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Affiliation(s)
- Yuanyuan Fan
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xun Zheng
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tianfeng Xu
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Pengyu Li
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yujie Zhang
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yanhao Ran
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Wei
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
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Shen Z, Zhao Y, Xu X, Yang H, He S, Ma J, Zhang S, Hou P, Sui F. Single-cell RNA sequencing integrated with bulk RNA sequencing analysis of clock circadian regulator with prognostic and immune microenvironment in thyroid cancer. Transl Oncol 2025; 53:102299. [PMID: 39892222 PMCID: PMC11833347 DOI: 10.1016/j.tranon.2025.102299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 01/05/2025] [Accepted: 01/28/2025] [Indexed: 02/03/2025] Open
Abstract
BACKGROUND Disruption of circadian rhythm was found to be associated with immune infiltration and thyroid cancer. However, the role of clock circadian regulator (CLOCK) in the progression of thyroid cancer and its immune microenvironment remains largely unexplored. Therefore, our aim was to explore the role and potential mechanism of CLOCK in thyroid cancer. METHODS Single cell sequencing analysis and bulk RNA sequencing analysis was used for LASSO regression and Kaplan-Meier survival estimates. Potential mechanism analysis were gained through KEGG/GO analysis, GSEA analysis and PPI network. In vivo and in vitro experiment was used for further validation. RESULTS The result showed CLOCK protein was overexpressed in thyroid cancer compared with normal tissue in both thyroid specific mouse model and human sample. A prognostic model incorporating CLOCK and other related genes (FAT4, OR6K2, STK40, TMEM63A, HRCT1, SUPT5H, and OR2C3) was developed using LASSO regression. Functional assay and bioinformatics analysis indicated that CLOCK knockdown hindered tumor growth and the activity of MAPK signaling. Besides, analyses of gene enrichment, signaling pathways, and immune checkpoints suggested that CLOCK might inhibit immune infiltration within the tumor microenvironment. Confirmatory in vitro experiments and immunohistochemical assays in human samples further linked high CLOCK expression to reduced T cell cytotoxicity and infiltration. CONCLUSION These findings underscore the pivotal role of CLOCK in thyroid cancer prognosis and immune suppression, highlighting its potential as a target for therapeutic intervention and prognostic assessment in thyroid cancer management.
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Affiliation(s)
- Zhen Shen
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China
| | - Yuelei Zhao
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China
| | - Xinxin Xu
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China
| | - Huini Yang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China
| | - Shuting He
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China
| | - Junchi Ma
- School of Information Engineering, Chang'an University, Shaanxi Province, PR China
| | - Shaoqiang Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China
| | - Peng Hou
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China; International Joint Research Center for Tumor Precision Medicine of Shaanxi Province, Xi'an 710061, Shaanxi Province, PR China
| | - Fang Sui
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, PR China.
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Jing Y, Liu M, Tang H, Kong N, Cai J, Yin Z. The effect of aerobic exercise on sleep disorder in menopausal women: a systematic review and meta-analyses. BMC Womens Health 2024; 24:635. [PMID: 39627770 PMCID: PMC11616110 DOI: 10.1186/s12905-024-03477-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 11/22/2024] [Indexed: 12/06/2024] Open
Abstract
OBJECTIVE This study systematically evaluated the effect of aerobic exercise on sleep disorders in menopausal women and proposed a practical program from the perspective of "what to practice," "how much to practice," and "how to practice." We proposed the program from the standpoint of training science. METHODS Up to March 20, 2023, a total of 16 articles and 19 RCT studies were retrieved from Web of Science, PubMed, Springer, Science Direct, China Knowledge Network, Wanfang, and VIP. The Cochrane Risk of Bias Assessment Tool was used to assess the quality of the literature, and We used RevMan5.3and STATA 16.0 software to provide a systematic review of included studies. RESULTS The overall effect of low- and moderate-intensity aerobic exercise interventions for sleep disorders in menopausal women had a moderate effect size (SMD = -0.52, P < 0.001), and the effect values between different intervention frequencies (I2 = 60%), intervention duration (I2 = 60), intervention periods (I2 = 70), exercise forms (I2 = 70), and practice methods (I2 = 70) had moderate heterogeneity. The most significant effect sizes were found for intervention frequency of 3 times/week (SMD = -0.57, P < 0.001); intervention duration of 70-90 min/session (SMD = -0.64, P = 0.004); intervention period of 8-10 weeks (SMD = -0.59, P = 0.35); and exercise form of static exercise ( SMD = -0.55, P = 0.003); and the practice mode was an individual exercise with the most significant effect size (SMD = -0.66, P < 0.01). CONCLUSION Low- and medium-intensity aerobic exercise intervention for sleep disorders in menopausal women has a good effect, but it is affected by training factors such as intervention frequency, intervention time, intervention period, exercise form, and practice mode; the best effect is achieved by adopting the dosage of 3 times/week, 70-90 min/times, and lasting for 8-10 weeks; aerobic intervention in the form of static exercise is the most effective; the best intervention effect is achieved by adopting the mode of individual exercise; but a group exercise approach improved exercise persistence in menopausal women.
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Affiliation(s)
- Yan Jing
- College of Physical Education, Wuhan Sports University, Wuhan, 430079, Hubei, China
- China Youth Sports and the Integration of Sports and Education Public Policy Research Center, Wuhan Sports University, Wuhan, 430079, Hubei, China
| | - Mingyi Liu
- China Youth Sports and the Integration of Sports and Education Public Policy Research Center, Wuhan Sports University, Wuhan, 430079, Hubei, China.
- College of Sports Training, Wuhan Sports University, Wuhan, 430079, Hubei, China.
| | - Honglin Tang
- College of Physical Education, Wuhan Sports University, Wuhan, 430079, Hubei, China
| | - Nianxin Kong
- China Youth Sports and the Integration of Sports and Education Public Policy Research Center, Wuhan Sports University, Wuhan, 430079, Hubei, China
- College of Sports Training, Wuhan Sports University, Wuhan, 430079, Hubei, China
| | - Jingjie Cai
- China Youth Sports and the Integration of Sports and Education Public Policy Research Center, Wuhan Sports University, Wuhan, 430079, Hubei, China
- College of Sports Training, Wuhan Sports University, Wuhan, 430079, Hubei, China
| | - Zikang Yin
- China Youth Sports and the Integration of Sports and Education Public Policy Research Center, Wuhan Sports University, Wuhan, 430079, Hubei, China
- College of Sports Training, Wuhan Sports University, Wuhan, 430079, Hubei, China
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Savvidis C, Kallistrou E, Kouroglou E, Dionysopoulou S, Gavriiloglou G, Ragia D, Tsiama V, Proikaki S, Belis K, Ilias I. Circadian rhythm disruption and endocrine-related tumors. World J Clin Oncol 2024; 15:818-834. [PMID: 39071458 PMCID: PMC11271730 DOI: 10.5306/wjco.v15.i7.818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 06/20/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024] Open
Abstract
This review delved into the intricate relationship between circadian clocks and physiological processes, emphasizing their critical role in maintaining homeostasis. Orchestrated by interlocked clock genes, the circadian timekeeping system regulates fundamental processes like the sleep-wake cycle, energy metabolism, immune function, and cell proliferation. The central oscillator in the hypothalamic suprachiasmatic nucleus synchronizes with light-dark cycles, while peripheral tissue clocks are influenced by cues such as feeding times. Circadian disruption, linked to modern lifestyle factors like night shift work, correlates with adverse health outcomes, including metabolic syndrome, cardiovascular diseases, infections, and cancer. We explored the molecular mechanisms of circadian clock genes and their impact on metabolic disorders and cancer pathogenesis. Specific associations between circadian disruption and endocrine tumors, spanning breast, ovarian, testicular, prostate, thyroid, pituitary, and adrenal gland cancers, are highlighted. Shift work is associated with increased breast cancer risk, with PER genes influencing tumor progression and drug resistance. CLOCK gene expression correlates with cisplatin resistance in ovarian cancer, while factors like aging and intermittent fasting affect prostate cancer. Our review underscored the intricate interplay between circadian rhythms and cancer, involving the regulation of the cell cycle, DNA repair, metabolism, immune function, and the tumor microenvironment. We advocated for integrating biological timing into clinical considerations for personalized healthcare, proposing that understanding these connections could lead to novel therapeutic approaches. Evidence supports circadian rhythm-focused therapies, particularly chronotherapy, for treating endocrine tumors. Our review called for further research to uncover detailed connections between circadian clocks and cancer, providing essential insights for targeted treatments. We emphasized the importance of public health interventions to mitigate lifestyle-related circadian disruptions and underscored the critical role of circadian rhythms in disease mechanisms and therapeutic interventions.
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Affiliation(s)
- Christos Savvidis
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | - Efthymia Kallistrou
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | - Eleni Kouroglou
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | - Sofia Dionysopoulou
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | | | - Dimitra Ragia
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | - Vasiliki Tsiama
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | - Stella Proikaki
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | - Konstantinos Belis
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
| | - Ioannis Ilias
- Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
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Barber LE, McCullough LE, Johnson DA. Eyes Wide Open: Sleep as a Potential Contributor to Racial and Ethnic Disparities in Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:471-479. [PMID: 38270540 PMCID: PMC10990828 DOI: 10.1158/1055-9965.epi-23-1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/05/2023] [Accepted: 01/22/2024] [Indexed: 01/26/2024] Open
Abstract
U.S. racial and ethnic minoritized groups face disproportionate cancer burdens compared to White Americans. Investigating modifiable factors, such as sleep, that are socially patterned and inequitably distributed by race and ethnicity may advance understanding of cancer disparities and provide intervention opportunities. Emerging data suggest poor sleep health is associated with cancer. Yet, its contribution to racial and ethnic cancer disparities is understudied. In this narrative review, we explored the sleep-cancer relation through a disparities lens. We (i) summarized literature reporting on associations between sleep and cancer among racial and ethnic minority populations; (ii) examined potential sleep-cancer mechanisms; and (iii) discussed future directions. We identified five studies reporting on sleep-cancer associations among minoritized groups. Poor sleep health was associated with aggressive breast cancer among Black women, increased breast cancer risk among Asian women, and increased risk of breast and total cancer among Hispanic/Latinx Americans. Sleep and cancer disparities have similar socioeconomic and behavioral determinants, suggesting racial and ethnic minoritized groups may be vulnerable to poor sleep health and its adverse health impacts. Evidence indicates that the sleep-cancer disparities relation is an emerging, but important area of research that warrants further investigation, as sleep may be an avenue for reducing cancer disparities.
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Affiliation(s)
- Lauren E. Barber
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Lauren E. McCullough
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Dayna A. Johnson
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Papantoniou K, Konrad P, Haghayegh S, Strohmaier S, Eliassen AH, Schernhammer E. Rotating Night Shift Work, Sleep, and Thyroid Cancer Risk in the Nurses' Health Study 2. Cancers (Basel) 2023; 15:5673. [PMID: 38067376 PMCID: PMC10705158 DOI: 10.3390/cancers15235673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 02/12/2024] Open
Abstract
Night shift work has been associated with breast, prostate, and colorectal cancer, but evidence on other types of cancer is limited. We prospectively evaluated the association of rotating night shift work, sleep duration, and sleep difficulty with thyroid cancer risk in the Nurses' Health Study 2 (NHS2). We assessed rotating night shift work duration (years) at baseline and throughout follow-up (1989-2015) and sleep characteristics in 2001. Cox proportional hazard models, adjusted for potential confounders, were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for (a) shift work duration, (b) sleep duration, and (c) difficulty falling or staying asleep. We stratified the analyses of night shift work by sleep duration and sleep difficulty. Over 26 years of follow-up, 588 incident cases were identified among 114,534 women in the NHS2 cohort. We observed no association between night shift work and the risk of thyroid cancer. Difficulty falling or staying asleep was suggestively associated with a higher incidence of thyroid cancer when reported sometimes (HR 1.26, 95% CI 0.95, 1.66) and all or most of the time (HR 1.35, 95% CI 1.00, 1.81). Night shift workers (10+ years) with sleep difficulty all or most of the time (HR 1.47; 0.58-3.73) or with >7 h of sleep duration (HR 2.17; 95% CI, 1.21-3.92) had a higher risk of thyroid cancer. We found modest evidence for an increased risk of thyroid cancer in relation to sleep difficulty, which was more pronounced among night shift workers.
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Affiliation(s)
- Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - Peter Konrad
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - Shahab Haghayegh
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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7
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Shang H, Hendryx M, Liang X, Shadyab AH, Luo J. A Longitudinal Study of Sleep Habits and Leukemia Incidence Among Postmenopausal Women. Am J Epidemiol 2023; 192:1315-1325. [PMID: 37191332 DOI: 10.1093/aje/kwad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 02/27/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023] Open
Abstract
We sought to assess the relationship between sleep duration, sleep disturbance, and leukemia incidence among postmenopausal women. This study included 130,343 postmenopausal women aged 50-79 years who were enrolled in the Women's Health Initiative (WHI) during 1993-1998. Information on self-reported typical sleep duration and sleep disturbance was obtained by questionnaire at baseline, and sleep disturbance level was defined according to the Women's Health Initiative Insomnia Rating Scale (WHIIRS). WHIIRS scores of 0-4, 5-8, and 9-20 comprised 37.0%, 32.6%, and 30.4% of all women, respectively. After an average of 16.4 years (2,135,109 cumulative person-years) of follow-up, 930 of the participants were identified as having incident leukemia. Compared with women with the lowest level of sleep disturbance (WHIIRS score 0-4), women with higher sleep disturbance levels (WHIIRS scores of 5-8 and 9-20) had 22% (95% confidence interval (CI): 1.04, 1.43) and 18% (95% CI: 1.00, 1.40) excess risks of leukemia, respectively, after multivariable adjustment. A significant dose-response trend was found for the association between sleep disturbance and leukemia risk (P for trend = 0.048). In addition, women with the highest level of sleep disturbance had a higher risk of myeloid leukemia (for WHIIRS score 9-20 vs. WHIIRS score 0-4, hazard ratio = 1.39, CI: 1.05, 1.83). Higher sleep disturbance level was associated with increased risk of leukemia, especially for myeloid leukemia among postmenopausal women.
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8
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Putilov AA, Budkevich EV, Budkevich RO. A Review of Evidence for the Involvement of the Circadian Clock Genes into Malignant Transformation of Thyroid Tissue. Clocks Sleep 2023; 5:384-398. [PMID: 37489438 PMCID: PMC10366820 DOI: 10.3390/clockssleep5030029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
(1) Background: In 2013, the results of a pioneer study on abnormalities in the levels and circadian rhythmicity of expression of circadian clock genes in cancerous thyroid nodules was published. In the following years, new findings suggesting the involvement of circadian clockwork dysfunction into malignant transformation of thyroid tissue were gradually accumulating. This systematic review provides an update on existing evidence regarding the association of these genes with thyroid tumorigenesis. (2) Methods: Two bibliographic databases (Scopus and PubMed) were searched for articles from inception to 20 March 2023. The reference lists of previously published (nonsystematic) reviews were also hand-searched for additional relevant studies. (3) Results: Nine studies published between 2013 and 2022 were selected. In total, 9 of 12 tested genes were found to be either up- or downregulated. The list of such genes includes all families of core circadian clock genes that are the key components of three transcriptional-translational feedback loops of the circadian clock mechanism (BMAL1, CLOCK, NPAS2, RORα, REV-ERBα, PERs, CRYs, and DECs). (4) Conclusions: Examination of abnormalities in the levels and circadian rhythmicity of expression of circadian clock genes in thyroid tissue can help to reduce the rate of inadequate differential preoperative diagnosis for thyroid carcinoma.
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Affiliation(s)
- Arcady A Putilov
- Laboratory of Nanobiotechnology and Biophysics, North-Caucasus Federal University, 355029 Stavropol, Russia
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - Elena V Budkevich
- Laboratory of Nanobiotechnology and Biophysics, North-Caucasus Federal University, 355029 Stavropol, Russia
| | - Roman O Budkevich
- Laboratory of Nanobiotechnology and Biophysics, North-Caucasus Federal University, 355029 Stavropol, Russia
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Sircu V, Colesnic SI, Covantsev S, Corlateanu O, Sukhotko A, Popovici C, Corlateanu A. The Burden of Comorbidities in Obstructive Sleep Apnea and the Pathophysiologic Mechanisms and Effects of CPAP. Clocks Sleep 2023; 5:333-349. [PMID: 37366660 PMCID: PMC10297352 DOI: 10.3390/clockssleep5020025] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/22/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Micro-arousals and the repeated desaturation of oxyhemoglobin, which are typical in obstructive sleep apnea syndrome (OSAS), have adverse effects on the health of patients, leading to a wide range of complications such as cardiovascular (arterial hypertension, pulmonary hypertension, chronic heart failure, arrhythmias, myocardial infarction), cerebrovascular (strokes), metabolic (insulin resistance, obesity, diabetes mellitus, metabolic syndrome), gastrointestinal (non-alcoholic liver disease), urinary (chronic renal failure), and neuropsychiatric complications as well as a wide range of malignancies. These, in turn, have multilateral effects on familial, occupational, and social life, as well as increasing the risks of road traffic accidents and accidents at the workplace. Awareness, timely screening, and the prevention of complications play important roles in diagnosing and treating comorbid conditions. This review focuses on comorbidities in OSAS and the effect of Continuous Positive Airway Pressure (CPAP) therapy on their prognoses.
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Affiliation(s)
- Victoria Sircu
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova; (V.S.); (S.-I.C.); (C.P.)
| | - Silvia-Iaroslava Colesnic
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova; (V.S.); (S.-I.C.); (C.P.)
| | - Serghei Covantsev
- Department of Clinical Research and Development, Botkin Hospital, 125284 Moscow, Russia;
- Department of Emergency Medicine № 76, Botkin Hospital, 125284 Moscow, Russia
| | - Olga Corlateanu
- Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova;
| | - Anna Sukhotko
- Department of General Oncology № 71, Botkin Hospital, 125284 Moscow, Russia;
| | - Cristian Popovici
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova; (V.S.); (S.-I.C.); (C.P.)
| | - Alexandru Corlateanu
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova; (V.S.); (S.-I.C.); (C.P.)
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10
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Zhang X, Lai Y, Bai X, Wu B, Xiang W, Zhang C, Geng G, Miao W, Xia Q, Wu Q, Yang H, Wang Y, Tian W, Cao Y, Liu X, Li H, Tian Y, Song Z, Zhao Z, Huang Z, Cheng X, Han X, Li Y, Shi B. Determining the spatial non-stationarity underlying social and natural environment in thyroid cancer in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 870:162009. [PMID: 36737014 DOI: 10.1016/j.scitotenv.2023.162009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Light at night (LAN) is a physiological environmental factor related to thyroid cancer (TC). The spatial relationship between the number of TC incident cases, LAN, air pollution and other macro social factors and stationarity needs to be further examined to provide evidence for regional control of TC. METHODS Spatial econometrics methods for spatial nonstationarity were used to explore the impacts of LAN, air pollutants, economic factors, and population size on the number of TC incident cases in 182 Chinese prefecture-level cities and the local coefficients were further tested for nonstationarity. Temporally weighted regression (TWR), geographically weighted regression (GWR), and geographically and temporally weighted regression (GTWR) were compared in this study for model selection. RESULTS Based on the ordinary least squares (OLS), LAN, air pollutants, and urbanization all significantly affected the number of TC incident cases. GWR had the best goodness of fit, and the coefficients of all the variables passed the nonstationarity test. The strong positive impact of LAN was mainly concentrated in North China, air pollutants in Central China and neighboring regions, and urbanization in the eastern coast of China. CONCLUSIONS The locational factors of the prefecture-level city influence the spatial pattern of the number of TC incident cases. Governments should pay attention to this influence, adhere to the Health in All Policies principle, and formulate region-specific policies based on regional characteristics, which this study provides updated evidence for.
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Affiliation(s)
- Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Chenxi Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Wenqing Miao
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qi Xia
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huiying Yang
- The second affiliated hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanjie Wang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Wanxin Tian
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yu Cao
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Xinwei Liu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongyu Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yulu Tian
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhe Song
- The second affiliated hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ziwen Zhao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhipeng Huang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiaonan Cheng
- The second affiliated hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinhao Han
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China.
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11
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Yan Y, Wang X, Wu H, Chen C, Li X, Yang R, Li F, Yan L, Mu M, Xu M. Short night-time sleep duration is associated with thyroid nodules: A community-based survey from Guangzhou, China. Postgrad Med 2023; 135:290-295. [PMID: 36268949 DOI: 10.1080/00325481.2022.2139485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sleep plays a critical role in maintaining human health. This study aimed to explore the association between sleep status and thyroid nodules. METHODS A total of 2414 individuals aged 18 or older with euthyroidism were enrolled in this community-based survey. Sleep status was self-reported. Thyroid ultrasonography was performed to measure nodules. Multiple logistic analyses were applied to adjust for confounding factors. RESULTS The percentages of thyroid nodules among individuals who slept <5 hours, 5-8 hours, and >8 hours per night were 57.79% (115/199), 44.19% (833/1885) and 42.73% (141/330), respectively (p = 0.001). Individuals who slept <5 hours per night had a significantly higher percentage of thyroid nodules than those who slept 5-8 hours per night (57.79% vs. 44.19%, p = 0.001) or >8 hours per night (57.79% vs. 42.73%, P < 0.001). However, no similar result was shown between individuals who slept >8 hours and 5-8 hours per night (42.73% vs. 44.19%, p = 0.621). Multiple logistic analysis showed that a sleep duration of <5 hours per night was significantly associated with thyroid nodules (odds ratio (OR) 1.643, 95% confidence interval (CI) 1.084-2.490, p = 0.019) when compared to a sleep duration of >8 hours per night. However, a sleep duration of <5 hours per night was not associated with thyroid nodules compared to a sleep duration of 5-8 hours (OR 1.294, 95% CI 0.918-1.824, p = 0.141). Similarly, no significant differences were seen among sleep duration per day, time of falling asleep, habit of daytime napping or thyroid nodules in multiple logistic analyses (all p > 0.05). CONCLUSIONS Short nighttime sleep duration was associated with thyroid nodules in our community-based population. Screening for thyroid nodules among these individuals is recommended.
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Affiliation(s)
- Yuerong Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Xiaoyi Wang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Hongshi Wu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Caixia Chen
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Xiaohui Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Rongxue Yang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Muchao Mu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
| | - Mingtong Xu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
- Guang Dong Clinical Research Center for Metabolic Diseases
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12
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Miro C, Docimo A, Barrea L, Verde L, Cernea S, Sojat AS, Marina LV, Docimo G, Colao A, Dentice M, Muscogiuri G. "Time" for obesity-related cancer: The role of the circadian rhythm in cancer pathogenesis and treatment. Semin Cancer Biol 2023; 91:99-109. [PMID: 36893964 DOI: 10.1016/j.semcancer.2023.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023]
Abstract
The circadian rhythm is regulated by an intrinsic time-tracking system, composed both of a central and a peripheral clock, which influences the cycles of activities and sleep of an individual over 24 h. At the molecular level, the circadian rhythm begins when two basic helix-loop-helix/Per-ARNT-SIM (bHLH-PAS) proteins, BMAL-1 and CLOCK, interact with each other to produce BMAL-1/CLOCK heterodimers in the cytoplasm. The BMAL-1/CLOCK target genes encode for the repressor components of the clock, cryptochrome (Cry1 and Cry2) and the Period proteins (Per1, Per2 and Per3). It has been recently demonstrated that the disruption of circadian rhythm is associated with an increased risk of developing obesity and obesity-related diseases. In addition, it has been demonstrated that the disruption of the circadian rhythm plays a key role in tumorigenesis. Further, an association between the circadian rhythm disruptions and an increased incidence and progression of several types of cancer (e.g., breast, prostate, colorectal and thyroid cancer) has been found. As the perturbation of circadian rhythm has adverse metabolic consequences (e.g., obesity) and at the same time tumor promoter functions, this manuscript has the aim to report how the aberrant circadian rhythms affect the development and prognosis of different types of obesity-related cancers (breast, prostate, colon rectal and thyroid cancer) focusing on both human studies and on molecular aspects.
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Affiliation(s)
- Caterina Miro
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy
| | - Annamaria Docimo
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia ed Andrologia, Università Federico II, Naples, Italy
| | - Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, 80143 Naples, Italy
| | - Ludovica Verde
- Department of Public Health, University of Federico II, 80131 Naples, Italy
| | - Simona Cernea
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures/Internal Medicine I, Târgu Mureş, Romania; Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, Târgu Mureş, Romania
| | - Antoan Stefan Sojat
- National Centre for Infertility and Endocrinology of Gender, Clinic for Endocrinology Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Serbia
| | - Ljiljana V Marina
- National Centre for Infertility and Endocrinology of Gender, Clinic for Endocrinology Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Serbia
| | - Giovanni Docimo
- Department of Medical and Advanced Surgical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia ed Andrologia, Università Federico II, Naples, Italy; UNESCO Chair "Education for Health and Sustainable Development", University of Naples "Federico II", Naples, Italy
| | - Monica Dentice
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia ed Andrologia, Università Federico II, Naples, Italy; UNESCO Chair "Education for Health and Sustainable Development", University of Naples "Federico II", Naples, Italy.
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13
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Jalali N, Khalili P, Jamali Z, Jalali Z, Moghadam-Ahmadi A, Vakilian A, Ayoobi F. Sleep duration, hypnotic drug use, and risk factors: cross- sectional study. Sci Rep 2023; 13:3459. [PMID: 36859460 PMCID: PMC9977908 DOI: 10.1038/s41598-023-30501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Both short sleep duration (SSD) and long sleep duration (LSD) are associated with an increased risk of morbidity and mortality. Here, we aimed to assess the prevalence of sleep duration disturbances among adults in association with demographic, medication use, personal habits, and chronic diseases, while also considering the impact of hypnotic drug use. We performed a cross-sectional study of 9991 adult participants of the Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN). Multivariate logistic regression analyses were conducted to assess the association between short (< 6 h) and long (> 9 h) sleep duration with demographic and lifestyle parameters and common non-communicable diseases. Additionally, we performed stratified analysis to investigate the association of sleep duration with the abovementioned factors and diseases, in groups with and without hypnotic drug use. We found higher odds of SSD significantly associated with age (P < 0.001), BMI (P < 0.001), physical activity (P < 0.001), and depression (P = 0.023). LSD displayed a positive association with the female sex (P < 0.001), opium consumption (P < 0.001), and history of MI (P = 0.045), and a reverse connection with education (P = 0.007), physical activity (P < 0.001) and alcohol consumption (P = 0.027). Stratifying for the hypnotic drug use, our sensitivity analyses indicated that in hypnotic drug users, education (P = 0.034) and physical activity (P < 0.001) were associated with LSD, in this group, significantly increased odds ratio of LSD were associated with opium consumption (P = 0.046) and thyroid dysfunction (P = 0.037). Our findings demonstrated the demographic and lifestyle factors and diseases associated with long and short sleep duration in the population of the RCS. Additionally, after stratifying for hypnotic drug use, our results indicated that some diseases are only associated with abnormal sleep duration upon using hypnotic drugs.
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Affiliation(s)
- Nazanin Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Epidemiology, School of Public Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amir Moghadam-Ahmadi
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neuro-Immunology Research Scholar, Neurological Research Laboratory, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alireza Vakilian
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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14
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Ho KKN, Skarpsno ES, Nilsen KB, Ferreira PH, Pinheiro MB, Hopstock LA, Johnsen MB, Steingrímsdóttir ÓA, Nielsen CS, Stubhaug A, Simic M. A bidirectional study of the association between insomnia, high-sensitivity C-reactive protein, and comorbid low back pain and lower limb pain. Scand J Pain 2023; 23:110-125. [PMID: 35420264 DOI: 10.1515/sjpain-2021-0197] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/08/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To examine the possible bidirectional association between insomnia and comorbid chronic low back pain (LBP) and lower limb pain and to explore whether high-sensitivity C-reactive protein (hsCRP) amplifies these associations. METHODS We calculated adjusted risk ratios (RR) with 95% confidence intervals (CI) for the development of insomnia and mild-to-severe chronic LBP and lower limb pain at 11 years follow-up in participants aged ≥32 years and with hsCRP ≤10 mg/L at baseline in 2007-2008: 3,714 without chronic LBP or lower limb pain (sample 1) and 7,892 without insomnia (sample 2). RESULTS Compared to participants without chronic pain, participants with comorbid chronic LBP and lower limb pain had a RR of insomnia of 1.37 (95% CI 1.12-1.66). Compared with participants without insomnia, participants with insomnia did not have an increased risk of comorbid chronic LBP and lower limb pain (RR: 1.06, 95% CI 0.76-1.46); however, participants with insomnia had a RR of chronic LBP of 1.20 (95% CI 1.02-1.42). There was no strong amplifying effect of elevated hsCRP (3.00-10.0 mg/L) on these associations. CONCLUSIONS These findings suggest that elevated hsCRP does not amplify the associations between insomnia and mild-to-severe chronic LBP and lower limb pain. Further research using data on the temporal relation between insomnia, chronic pain, and inflammatory responses are required to fully understand the causal pathways.
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Affiliation(s)
- Kevin K N Ho
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Eivind S Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Kristian B Nilsen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Division of Clinical Neuroscience, Oslo, Norway
| | - Paulo H Ferreira
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Marina B Pinheiro
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Ólöf A Steingrímsdóttir
- Department of Chronic Diseases, Norwegian Institute of Public Heath, Oslo, Norway
- Department of Research and Development, Oslo University Hospital, Oslo, Norway
| | - Christopher S Nielsen
- Department of Chronic Diseases, Norwegian Institute of Public Heath, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Milena Simic
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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15
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Effect of sleep disorders on the risks of cancers and site-specific cancers. Sleep Med 2022; 100:254-261. [PMID: 36122507 DOI: 10.1016/j.sleep.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/03/2022] [Accepted: 08/21/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE Whether preexisting sleep disorder is an independent risk factor for cancer remains unclear. Therefore, we performed this propensity score-matched population-based cohort study to compare the incidence rate ratios (IRRs) of specific cancers between patients with and without sleep disorders. PATIENTS AND METHODS Patients were categorized into two groups on the basis of the presence or absence of sleep disorders and matched at a 1:1 ratio. RESULTS Propensity score matching yielded a final cohort of 289,162 patients (i.e., 144,581 and 144,581 in the sleep disorder and nonsleep disorder groups, respectively) who were eligible for further analysis. In multivariate Cox regression analysis, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) of cancer risk in the sleep disorder group compared with the nonsleep disorder group was 1.07 (1.04-1.12; P = 0.0001). Furthermore, the adjusted IRRs (95% CIs) for all cancers, breast cancer, and ovarian cancer in the patients with sleep disorders were 1.08 (1.02-1.18), 1.20 (1.08-1.32), and 1.30 (1.10-1.52), respectively. CONCLUSION The results suggested that sleep disorders are a significant risk factor for all cancers, breast cancer, and ovarian cancer.
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16
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O’Brien K, Ried K, Binjemain T, Sali A. Integrative Approaches to the Treatment of Cancer. Cancers (Basel) 2022; 14:5933. [PMID: 36497414 PMCID: PMC9740147 DOI: 10.3390/cancers14235933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
A significant proportion of cancer patients use forms of complementary medicine or therapies. An integrative approach to cancer management combines conventional medicine with evidence-based complementary medicines/therapies and lifestyle interventions, for the treatment and prevention of disease and the optimisation of health. Its basis is a holistic one; to treat the whole person, not just the disease. It makes use of adjunct technologies which may assist the clinician in diagnosis of early carcinogenesis and monitoring of treatment effectiveness. Many factors contribute to the development of cancer including some which are largely modifiable by the patient and which oncologists may be in a position to advise on, such as stress, poor nutrition, lack of physical activity, poor sleep, and Vitamin D deficiency. An integrative approach to addressing these factors may contribute to better overall health of the patient and better outcomes. Evidence-based complementary medicine approaches include the use of supplements, herbal medicine, various practices that reduce stress, and physical therapies. Individualised to the patient, these can also help address the symptoms and signs associated with cancer and its orthodox treatment.
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Affiliation(s)
- Kylie O’Brien
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia
| | - Karin Ried
- National Institute of Integrative Medicine, Hawthorn, VIC 3122, Australia
| | - Taufiq Binjemain
- National Institute of Integrative Medicine, Hawthorn, VIC 3122, Australia
| | - Avni Sali
- National Institute of Integrative Medicine, Hawthorn, VIC 3122, Australia
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17
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Scher N, Guetta L, Draghi C, Yahiaoui S, Terzioglu M, Butaye E, Henriques K, Alavoine M, Elharar A, Guetta A, Toledano A. Sleep Disorders and Quality of Life in Patients With Cancer: Prospective Observational Study of the Rafael Institute. JMIR Form Res 2022; 6:e37371. [PMID: 36422866 PMCID: PMC9732755 DOI: 10.2196/37371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/22/2022] [Accepted: 09/29/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sleep disorders are a common occurrence in the general population. Yet today, it is clearly agreed that sleep disorders represent both a cancer risk factor and a biological consequence of the of the activation of the immuno-inflammatory system induced by cancer itself. OBJECTIVE The aim of this study was to assess the impact of sleep disorders on quality of life and identify the type of disorder and its causes in order to offer an adapted and personalized care plan. METHODS In a survey completed during the COVID-19 lockdown, 2000 hours of interviews were collected by remote consultations. During these calls, we administered a sleep questionnaire. This questionnaire was inspired by the STOP-BANG questionnaire and enquired about 6 items. The demographic details of each patient (eg, age and sex), the nature of the pathology, their past treatments, the ongoing cancer treatment, the mood, whether or not the patient is anxious or depressed, and the use of sleeping drug pills were analyzed. A univariate analysis was performed according to the presence or absence of fatigue. Chi-square test was applied to assess possible differences of variables' link to sleep disturbance between patients complaining of fatigue and those without fatigue. The same test was then used to analyze patients on hormone therapy and those with no hormone therapy for 2 types of cancer-breast cancer and prostate cancer. RESULTS A total of 905 patients were prospectively included in this study. The average age was 66.7 (5 SD) years, and 606 (67%) patients were women; 142 patients declared being overweight. Breast cancer was the most frequently reported cancer. Nocturnal awakening was reported by 70% (n=633), fatigue by 50% (n=452), difficulty falling asleep by 38% (n=343), snoring reported by an independent observer in 38% (n=343), and apnea reported by an independent observer in 9% (n=81) of the patients. The univariate analysis showed that the feeling of tiredness was significantly greater in patients reporting difficulty falling asleep (P≥.99), pain (P<.001), and frequent awakening (P<.001), as well as in patients who were not receiving cancer treatment (P<.001). The univariate analysis showed that patients who were receiving breast cancer treatment and were under hormone therapy reported difficulty falling asleep (P=.04) and pain (P=.05). In a univariate analysis of patients treated for prostate cancer, being overweight was the only factor reported that had a statistically significant value. CONCLUSIONS Our preliminary data support and are consistent with data in the literature regarding the importance of sleep disorders in oncology. This justifies the usefulness of a diagnosis and early treatment of sleep disorders in patients with cancer. The Rafael Institute sleep observatory will enable patients to be identified and treated.
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Affiliation(s)
- Nathaniel Scher
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
- Hartmann Oncology Radiotherapy Group, Hartmann Radiotherapy Institute, Levallois Perret, France
| | - Liath Guetta
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
| | - Clément Draghi
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
| | - Safia Yahiaoui
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
- Department of Radiotherapy, Institut Salah Azaiz, Tunis, Tunisia
| | | | - Emilie Butaye
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
| | - Kathy Henriques
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
| | - Marie Alavoine
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
| | - Ayala Elharar
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
| | - Andre Guetta
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
| | - Alain Toledano
- Integrative Medicine, Rafael Institute, Levallois-Perret, France
- Department of Integrative Medicine, National Conservatory of Arts and Crafts, Paris, France
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18
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Koo DL, Park Y, Nam H, Chai YJ. Sleep quality of patients with papillary thyroid carcinoma: a prospective longitudinal study with 5-year follow-up. Sci Rep 2022; 12:18823. [PMID: 36335214 PMCID: PMC9637156 DOI: 10.1038/s41598-022-23549-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022] Open
Abstract
We evaluated the pre- and postoperative sleep quality of patients with newly diagnosed papillary thyroid carcinoma (PTC) who underwent thyroid surgery, and investigated the factors associated with persistent poor sleep quality. The Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale, and Stanford sleepiness scale were used to estimate sleep quality and daytime sleepiness. Face-to-face surveys were conducted preoperatively, and 1, 4, and 10 months after thyroid surgery. The PSQI was administered during a telephone interview about after 5 years after surgery. Forty-six patients (mean age 47.3 ± 10.1 years) with PTC (11 males, 35 females) were included in this study. Twenty-one participants underwent lobectomy and 25 underwent total thyroidectomy. Preoperatively, 35 (76.1%) patients showed poor sleep quality. PSQI scores at postoperative 1, 4, and 10 months were significantly lower than preoperative scores (p < 0.001). Postoperative 5-year PSQI scores decreased significantly compared to the preoperative scores (p < 0.001). Patients newly diagnosed with PTC suffered from sleep disturbance before and after surgery for at least 10 months, recovering to a comparable rate of sleep disturbance with the general population by 5 years after surgery. Higher preoperative PSQI score was at risk for prolonged poor sleep quality in patients with PTC.
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Affiliation(s)
- Dae Lim Koo
- grid.31501.360000 0004 0470 5905Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center and Seoul National University College of Medicine, Seoul, South Korea
| | - Yangmi Park
- grid.31501.360000 0004 0470 5905Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center and Seoul National University College of Medicine, Seoul, South Korea
| | - Hyunwoo Nam
- grid.31501.360000 0004 0470 5905Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center and Seoul National University College of Medicine, Seoul, South Korea
| | - Young Jun Chai
- grid.412479.dDepartment of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 39 Boramae-Gil, Dongjak-Gu, Seoul, 156-707 South Korea ,grid.412484.f0000 0001 0302 820XTransdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, South Korea
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Li Y, Xia G, Tan Y, Shuai J. Expression profile of circular RNAs in continuous light-induced ovarian dysfunction. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 242:113861. [PMID: 35835072 DOI: 10.1016/j.ecoenv.2022.113861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study aims to elucidate the underlying relationship between the expression profiles of circular RNAs (circRNAs) and the ovarian dysfunction induced by continuous light. METHODS High-throughput sequencing was used to profile the transcriptome of differentially expressed circRNAs (DEcircRNAs) in rat ovary under continuous light exposure (12 h:12 h light/light cycle, L/L group) and a control cycle (12 h:12 h light/dark cycle, L/D group). Gene ontology (GO) enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and circRNAs-microRNAs-messenger RNAs networks were performed to predict the role of DEcircRNAs in biological processes and pathways. A quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) assay was conducted to verify the high-throughput sequencing results and the expression level of circadian rhythm genes. RESULTS In total, 305 circRNAs were differentially expressed between the L/L and L/D groups. Among these, 211 circRNAs were up regulated, while 94 were down regulated. Eight candidate circRNAs from 305 DEcircRNAs were verified by qRT-PCR. Further bioinformatics analysis revealed that interactions between DEcircRNAs and a set of microRNAs involved in ovarian dysfunction-related pathways, such as regulation of androgen receptors, gonadotrophin releasing hormone signaling pathway, endocrine resistance, etc. Subsequently, we identified rno_circ:chr2:86868285-86964272 and rno_circ:chr1:62330221-62360073 may participate in the pathophysiology of ovarian dysfunction by constructing circRNAs-microRNAs-messenger RNAs networks. Meanwhile, constant light reduced the expression of circadian rhythm genes CLOCK, BAML1, PER1, and PER2 compared with that of controls. Caspase3 and Bax were up regulated in the L/L group compared with the L/D group, while Bcl-2 was down regulated. CONCLUSIONS In summary, the results reveal that the expression profiles and potential functions of DEcircRNAs in rat ovaries may play important roles in continuous light-induced ovarian dysfunction. These findings provide novel clues and molecular targets for studying the mechanisms and clinical therapy of ovarian dysfunction.
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Affiliation(s)
- Yuling Li
- Nanjing University of Chinese Medicine, Nanjing 210029, China; Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Guicheng Xia
- Nanjing University of Chinese Medicine, Nanjing 210029, China; Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Yong Tan
- Nanjing University of Chinese Medicine, Nanjing 210029, China; Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
| | - Jiaqi Shuai
- Bachelor of Medicine, University of Antwerp, Antwerp, Belgium
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20
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Afrashteh S, Fararouei M, Parad MT, Mirahmadizadeh A. Sleep quality, stress and thyroid cancer: a case-control study. J Endocrinol Invest 2022; 45:1219-1226. [PMID: 35112324 DOI: 10.1007/s40618-022-01751-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Stress and sleep disturbance have been found to be associated with numerous adverse health outcomes, including cancer. Our study aimed to measure the association between quality of sleep, short-temperedness, and stress in life with the risk of thyroid cancer. METHODS The present study is conducted on 361 newly diagnosed TC patients and 347 sex-age frequency matched controls. Control and case participants were registered with the same health centers. We used multiple logistic regression to investigate the association between TC risk and the interested factors. RESULTS Based on the results of the multivariate analysis, stress (ORalways stressful/often calm = 3.07, 95% CI 1.42-6.63) and short-temperedness (ORnervous/calm = 2.00, 95% CI 1.28-3.11) were directly associated with the risk of TC. On the other hand having a quality sleep (ORsometimes/never = 0.36, 95% CI 0.16-0.79) and quality sleep (ORoften/no = 0.45, 95% CI 0.21-0.96, P = 0.041) seems to be a protective factor. CONCLUSIONS Some community-based interventions, e.g., lowering stress levels and improving sleep quality, may help in preventing different types of cancer, including TC. We suggest further evaluation of these important findings in the prevention of TC cancer.
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Affiliation(s)
- S Afrashteh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Fararouei
- HIV/AIDs Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - M T Parad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A Mirahmadizadeh
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Zhang Y, Chen C, Lu L, Knutson KL, Carnethon MR, Fly AD, Luo J, Haas DM, Shikany JM, Kahe K. Association of magnesium intake with sleep duration and sleep quality: findings from the CARDIA study. Sleep 2022; 45:zsab276. [PMID: 34883514 PMCID: PMC8996025 DOI: 10.1093/sleep/zsab276] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/27/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES As an antagonist of calcium (Ca), magnesium (Mg) has been implicated in the regulation of sleep. We aimed to examine the longitudinal associations of Mg intake and Ca-to-Mg intake ratio (Ca:Mg) with sleep quality and duration. METHODS The study sample consisted of 3,964 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary and supplementary intake of Mg were obtained using the CARDIA Dietary History at baseline (1985-1986), exam years 7 and 20. Self-reported sleep outcomes were measured at years 15 and 20. Sleep quality was rating from 1 (very good) to 5 (very bad). We categorized sleep duration to <7, 7-9, and >9 h. Generalized estimating equation was used to examine the associations of interest as repeated measures at the two time points. RESULTS After adjustment for potential confounders, Mg intake was borderline associated with better sleep quality [highest quartile (Q4) vs. intake quartile (Q1): odds ratio (OR) = 1.23; 95% CI = 0.999, 1.50, ptrend = 0.051]. Participants in Q4 were also less likely to have short sleep (<7 h) compared to those in Q1 (OR = 0.64; 95% CI = 0.51, 0.81, ptrend = 0.012). The observed association with short sleep persisted among participants without depressive disorders (Q4 vs. Q1: OR = 0.64; 95% CI = 0.49, 0.82, ptrend < 0.001), but not among individuals with depressive disorder. Ca:Mg was not associated with either outcomes, regardless of depression status. CONCLUSIONS Mg intake was associated with both sleep outcomes in this longitudinal analysis. Randomized controlled trials with objective measures of sleep are warranted to establish the potential causal inference.
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Affiliation(s)
- Yijia Zhang
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University, New York, NY, USA
| | - Cheng Chen
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University, New York, NY, USA
| | - Liping Lu
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University, New York, NY, USA
| | - Kristen L Knutson
- Department of Neurology and Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alyce D Fly
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, IN, USA
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James M Shikany
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ka Kahe
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University, New York, NY, USA
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22
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Muscogiuri G, Zanata I, Barrea L, Cozzolino A, Filice E, Messina E, Colao A, Faggiano A. A practical nutritional guideline to manage neuroendocrine neoplasms through chronotype and sleep. Crit Rev Food Sci Nutr 2022; 63:7546-7563. [PMID: 35285728 DOI: 10.1080/10408398.2022.2047882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Chronotype is the attitude of subjects to carry out their daily activities mainly in the morning ("lark") or in the evening ("owl"). The intermediate chronotype is located between these two categories. It has been demonstrated that chronotype can influence the incidence, course and response to treatments of tumors. In particular patients diagnosed with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) and evening chronotype are characterized by unhealthy lifestyle, obesity, metabolic syndrome, a worsen cardiometabolic profile, a poor prognosis with a progressive disease and the development of metastasis. In addition, evening chronotype has been associated with sleep disturbances, which in turn have been related to tumor development and progression of tumors. There is a strict connection between sleep disturbances and NENs because of the hyperactivation of proangiogenic factors that caused aberrant neoangiogenesis. A nutritional tailored approach could represent a tool to align subjects with evening chronotype to physiological biological rhythms based on the properties of some macro and micronutrients of being substrate for melatonin synthesis. Thus, we aimed to provide an overview on the association of chronotype categories and sleep disturbances with NENs and to provide nutritional advices to manage subjects with NENs and these disturbances of circadian rhythm.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile,", Università Federico II di Napoli, Naples, Italy
| | - Isabella Zanata
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Naples, Italy
| | - Alessia Cozzolino
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Emanuele Filice
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Erika Messina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile,", Università Federico II di Napoli, Naples, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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23
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Teliti M, Monti E, Comina M, Conte L, Vera L, Gay S, Saccomani G, Ferone D, Giusti M. A comparative cross-sectional study on sleep quality in patients with a history of differentiated thyroid carcinoma and its correlation with quality of life. Endocrine 2021; 73:347-357. [PMID: 33537955 PMCID: PMC8263451 DOI: 10.1007/s12020-020-02591-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 12/09/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate sleep quality in differentiated thyroid carcinoma (DTC) patients and correlate sleep disturbances with quality of life (QoL). METHODS 119 DTC patients were enrolled (DTC group). The Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) inventories were administered. The Thyroid-specific Patient-Reported Outcome (ThyPRO) questionnaire, the Billewicz scale (BS) and an ad-hoc visual analogic scale (VAS) were used to measure QoL and subjective therapy-related complaints. The same examinations were conducted in 53 subjects (control group) who had undergone surgery for benign thyroid pathology. RESULTS L-T4 dosages and TSH levels differed between the groups. BS and VAS scores were comparable. PSQI documented a similar percentage of poor sleepers in the DTC (74%) and control (62%) groups. ISI showed no difference in subjects without clinically significant insomnia: DTC (43%) and controls (48%). ThyPRO showed significantly worse scores in DTC than control subjects. In DTC patients, PSQI (P = 0.002) and ISI (P = 0.04) correlated significantly with age. In control subjects, TSH displayed a significant positive association with PSQI (P = 0.02) and ISI (P < 0.05). The ThyPRO general score correlated significantly with PSQI in DTC patients. In both groups, ISI correlated significantly with several ThyPRO scales and the ThyPRO general score. "Anxiety" and "emotional susceptibility" were the scales most significantly related with PSQI and ISI. CONCLUSION In disease-free DTC patients and subjects who undergo thyroid surgery for benign pathology, abnormal sleep components and insomnia are similar. The ThyPRO questionnaire closely reflects sleep disturbances in all subjects. Recognising and treating sleep disturbances might improve QoL.
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Affiliation(s)
- Marsida Teliti
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Eleonora Monti
- Endocrinology Unit, Department of Internal Medicine & Medical Specialties (DiMI), University of Genoa, Genoa, Italy
| | - Martina Comina
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucia Conte
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lara Vera
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefano Gay
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giorgia Saccomani
- Endocrinology Unit, Department of Internal Medicine & Medical Specialties (DiMI), University of Genoa, Genoa, Italy
| | - Diego Ferone
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
- Endocrinology Unit, Department of Internal Medicine & Medical Specialties (DiMI), University of Genoa, Genoa, Italy.
| | - Massimo Giusti
- Endocrinology Unit, Department of Internal Medicine & Medical Specialties (DiMI), University of Genoa, Genoa, Italy
- Centro Diagnostico Priamar, Savona, Italy
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24
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Lou X, Wang H, Tu Y, Tan W, Jiang C, Sun J, Bao Z. Alterations of sleep quality and circadian rhythm genes expression in elderly thyroid nodule patients and risks associated with thyroid malignancy. Sci Rep 2021; 11:13682. [PMID: 34211057 PMCID: PMC8249375 DOI: 10.1038/s41598-021-93106-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/10/2021] [Indexed: 01/05/2023] Open
Abstract
To study the alterations of sleep quality and circadian rhythm genes expressions upon elderly thyroid nodule patients, the risk factors associated with thyroid malignancies, and the potential relationship involved. The elderly people enrolled in our study were divided into three groups according to the thyroid histopathology: malignant nodule group, benign nodule group, and normal group, and the clinical data and sleep quality were collected. Among the patients of surgery, 56 fresh thyroid tissues were collected for real-time PCR, immunohistochemistry and western blotting analysis of CLOCK, BMAL1, CRYs and PERs. Poor sleep quality, sleep latency and daytime dysfunction were the independent risk factors of malignant nodule after adjusted by other impacts. The expression levels of CLOCK, BMAL1 and PER2 in thyroid malignant group were significantly higher than benign and normal groups, while CRY2 was decreased, p < 0.05. In addition, CLOCK and BMAL1 protein levels were positively correlated with PSQI of corresponding patients and CRY2 was negatively correlated. Circadian rhythm genes mainly altered in malignant nodules, and sleep disorders may be involved in the occurrence of elderly thyroid malignancy through the high expressions of CLOCK and BMAL1, and low expression of CRY2.
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Affiliation(s)
- Xudan Lou
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China.,The Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People's Republic of China
| | - Haidong Wang
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China. .,The Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People's Republic of China.
| | - Yanyuan Tu
- The Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People's Republic of China.,Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China
| | - Wen Tan
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China.,The Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People's Republic of China
| | - Cuiping Jiang
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China.,The Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People's Republic of China
| | - Jiao Sun
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China.,The Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People's Republic of China
| | - Zhijun Bao
- The Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, 200040, People's Republic of China. .,Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China. .,Research Center On Aging and Medicine, Fudan University, Shanghai, 200040, People's Republic of China. .,Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China.
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25
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Zhu GH, Li J, Li J, Xu BW, Wang HP, Wang XM, Hu JQ, Dai MH. The characteristics and related factors of insomnia among postoperative patients with gastric cancer: a cross-sectional survey. Support Care Cancer 2021; 29:7315-7322. [PMID: 34046726 PMCID: PMC8550093 DOI: 10.1007/s00520-021-06295-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/14/2021] [Indexed: 01/30/2023]
Abstract
Purpose This study aims to explore the characteristics and related factors of insomnia of patients after operation for gastric cancer. Methods A cross-sectional survey was carried out and finally 115 patients with insomnia after operation for gastric cancer were included. The general information, gastric cancer-related information, sleep quality, and other symptoms were investigated. Results ① The Pittsburgh sleep quality index score of most insomnia patients after gastric cancer surgery was 11-15 points, and the sleep quality rating was “poor”. ② The sleep quality of patients with insomnia after surgery for gastric cancer is related to the number of chemotherapy cycles, fatigue, and depression. ③ The probability of reduced sleep quality with the number of chemotherapy cycles >6 is 3.640 times that of ≤6. The probability of reduced sleep quality during moderate to severe fatigue was 4.390 times that of patients with no or mild fatigue. Conclusion Attention to related factors may be associated with improvement of sleep quality in patients with gastric cancer after surgery. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06295-6.
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Affiliation(s)
- Guang-Hui Zhu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Ge Street, Xicheng District, Beijing, 100053, China.,Graduate School, Beijing University of Chinese Medicine, No. 11, Beisanhuan Dong Road, Chaoyang District, Beijing, 100029, China
| | - Juan Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Ge Street, Xicheng District, Beijing, 100053, China.,Graduate School, Beijing University of Chinese Medicine, No. 11, Beisanhuan Dong Road, Chaoyang District, Beijing, 100029, China
| | - Jie Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Ge Street, Xicheng District, Beijing, 100053, China.
| | - Bo-Wen Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Ge Street, Xicheng District, Beijing, 100053, China.,Graduate School, Beijing University of Chinese Medicine, No. 11, Beisanhuan Dong Road, Chaoyang District, Beijing, 100029, China
| | - He-Ping Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Ge Street, Xicheng District, Beijing, 100053, China
| | - Xin-Miao Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Ge Street, Xicheng District, Beijing, 100053, China
| | - Jia-Qi Hu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Ge Street, Xicheng District, Beijing, 100053, China.,Graduate School, Beijing University of Chinese Medicine, No. 11, Beisanhuan Dong Road, Chaoyang District, Beijing, 100029, China
| | - Ming-Hao Dai
- Peking University Health Science Center, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
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26
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Song C, Zhang R, Wang C, Fu R, Song W, Dou K, Wang S. Sleep quality and risk of cancer: findings from the English longitudinal study of aging. Sleep 2021; 44:5909274. [PMID: 32954418 DOI: 10.1093/sleep/zsaa192] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/28/2020] [Indexed: 12/23/2022] Open
Abstract
STUDY OBJECTIVE To prospectively examine the association between sleep quality and incident cancer risk in the elderly. METHODS A total of 10,036 participants aged ≥50 years free of cancer at baseline from the English Longitudinal Study of Ageing at wave 4 (2008) were included, and followed up until 2016. The primary endpoint was new onset physician-diagnosed cancer. Sleep quality was assessed by four questions regarding the frequency of sleep problems and overall subjective feeling of sleep quality in the last month, with higher score denoting poorer sleep quality. The multivariable Cox regression model was used to calculate hazard ratio (HR) with 95% confidence interval (CI) for incident cancer risk according to sleep quality. RESULTS At 8-year follow-up, a total of 745 (7.4%) participants developed cancer. Compared with good sleep quality at baseline, HR (95% CI) for incident cancer risk was 1.328 (1.061, 1.662) for intermediate quality, 1.586 (1.149, 2.189) for poor quality. Similarly, compared with maintaining good sleep quality in the first 4 years, HR (95% CI) for incident cancer risk was 1.615 (1.208, 2.160) for maintaining intermediate quality and 1.608 (1.043, 2.480) for maintaining poor quality. The exclusion of participants with family history of cancer or abnormal sleep duration yielded consistent results. CONCLUSIONS Poor sleep quality is positively associated with the long-term risk of developing cancer in an elderly cohort. Both medical staffs and the general public should pay more attention to improving sleep hygiene.
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Affiliation(s)
- Chenxi Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chunyue Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui Fu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weihua Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kefei Dou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Wang
- Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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27
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Abstract
OBJECTIVES To study thyroid alterations in health care workers according to their working status. METHODS We performed a retrospective study including 299 hospital employers who underwent in 2016 a periodic health surveillance checks in the Service of Occupational Medicine. According to the working status (rotating night-shift working [no. 160] vs day-working [no. 139]), we divided participant's clinical, anthropometric, and thyroid echographic characteristics. RESULTS Respect to day workers, rotating night-shift workers were slightly older and more frequently male whereas had similar thyroid stimulating hormone, Ft3, Ft4 levels, and autoimmunity (anti-TPO levels more than 30). Univariate and multivariate regression analysis revealed that rotating night shift work is associated to a significantly increased number of thyroid nodules. CONCLUSIONS This retrospective report suggests that the alteration in the molecular clocks typical of rotating night-shift workers harbors a higher risk of thyroid nodule development compared with diurnal workers. This novel result deserves replication in larger cohorts since thyroid nodules not rarely can represent thyroid cancers.
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28
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Relationship between the night shift work and thyroid disorders: A systematic review and meta-analysis. Endocr Regul 2021; 54:64-70. [PMID: 32597144 DOI: 10.2478/enr-2020-0008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The night shift workers were reported to have health consequences, ranging from mild, as cluster headache, to severe, as heart attacks and hormonal irregularities. This study is aimed to perform a systematic review and meta-analyze of the association between the night shift work and the thyroid disorders. METHODS We comprehensively searched eight databases, including PubMed and Google Scholar for the relevant articles. This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. RESULTS We finally included six papers involving 4074 participants. Four papers were eligible for meta-analysis involving 1864 night shift workers and 2017 day shift workers. We against found that thyroid stimulating hormone (TSH) is significantly higher in the night shift group compared to the day shift group. CONCLUSIONS The higher TSH among the night shift workers is attributed to disruption of the circadian rhythm and sleep/wake cycle, with subsequent eating disorders. We proposed that more attention should be paid to the working pattern and the related health consequences.
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29
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Yang HY, Chen CR, Lee SY, Tsai WC, Hsu YH. The Cancer Risk among Physicians in Taiwan, a Population-Based Propensity Score Matched Cohort Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:297-305. [PMID: 33747993 PMCID: PMC7956082 DOI: 10.18502/ijph.v50i2.5344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background The field of physician health is gaining increasing attention; however, most research and interventions have concentrated on factors such as job stress, mental health, and substance abuse. The risks of major cancers in physicians remain unclear. We used a propensity score-matched analysis to investigate the risk of cancer in physicians relative to the general population who had no healthcare-related professional background. Methods Data were obtained from the National Health Insurance system in Taiwan. The physician cohort contained 29,713 physicians, and each physician was propensity score-matched with a person from the general population. Results The physicians demonstrated a 0.90-fold lower risk of all-cancers (95% confidence interval [CI] = 0.83 - 0.96) when compared with the general population. Female physicians had a higher risk of cancer than male physicians (adjusted hazard ratio [HR] = 1.59; 95% CI = 1.28 - 1.96). Physicians had higher risks of prostate (HR = 1.26; 95% CI = 1.00 - 1.59) and thyroid cancers (HR = 3.16; 95% CI = 1.69 - 5.90) when compared with the general population. Conclusion Physicians have lower rates of overall cancer risk than the general population. Female physicians have higher cancer risks than male physicians. Male physicians have higher risks of thyroid and prostate cancer relative to the general population.
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Affiliation(s)
- Hsin-Yi Yang
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Cheng-Ren Chen
- Department of Internal Medicine, Ditmansion Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Shih-Yu Lee
- Department of Internal Medicine, Ditmansion Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung City, Taiwan
| | - Yueh-Han Hsu
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.,Department of Internal Medicine, Ditmansion Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung City, Taiwan.,Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan
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30
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Zhang D, Jones RR, James P, Kitahara CM, Xiao Q. Associations between artificial light at night and risk for thyroid cancer: A large US cohort study. Cancer 2021; 127:1448-1458. [PMID: 33554351 DOI: 10.1002/cncr.33392] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Light at night (LAN) inhibits nighttime secretion of melatonin and may cause circadian disruption, which may be a risk factor for cancer. Recent studies have linked high LAN exposure with elevated breast cancer risk. Given that breast cancer may share a common hormone-dependent etiology with thyroid cancer and that circadian rhythms play a role in regulating thyroid function, the authors hypothesized that exposure to LAN is positively associated with thyroid cancer incidence. METHODS This study examined the association between LAN and thyroid cancer incidence in the National Institutes of Health-American Association of Retired Persons Diet and Health Study. LAN exposure was estimated from satellite data and was linked to residential addresses at the baseline. Incident thyroid cancer cases were ascertained via linkage to state cancer registries. Cox regression was used to determine the relationship between LAN and thyroid cancer risk, with adjustments made for sociodemographic, lifestyle, and other environmental factors. RESULTS Among 464,371 participants, a positive association was found between LAN and thyroid cancer risk. Specifically, in comparison with the lowest quintile of LAN, the highest quintile was associated with a 55% increase in risk (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.18-2.02). The association was primarily driven by papillary thyroid cancer and was stronger in women (HR, 1.81; 95% CI, 1.26-2.60) than men (HR, 1.29; 95% CI, 0.86-1.94). In women, the association was stronger for localized cancer, whereas in men, the association was stronger for a more advanced stage. Results were consistent across different tumor sizes. CONCLUSIONS LAN was positively associated with thyroid cancer risk. Future studies are needed to confirm this association and identify underlying biological mechanisms.
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Affiliation(s)
- Dong Zhang
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
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Wang M, Gong WW, He QF, Hu RY, Yu M. Menstrual, reproductive and hormonal factors and thyroid cancer: a hospital-based case-control study in China. BMC WOMENS HEALTH 2021; 21:13. [PMID: 33407401 PMCID: PMC7789638 DOI: 10.1186/s12905-020-01160-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 12/23/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND There have been considerable studies on the effects of reproductive factors on thyroid cancer risk, while findings are inconsistent. In this analysis, we aimed to investigate the associations between menstrual, reproductive and hormonal factors with thyroid cancer occurrence in a population of Chinese women. METHODS Using data from a 1:1 matched case-control study performed between 2015 and 2017 in Zhejiang Province of China, a second analysis of 2261 pairs of female subjects was conducted. The possible effects for thyroid cancer were evaluated in logistic regression models by odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Later age at first pregnancy (for > 25 vs. ≦ 20 years, OR: 0.47, 95% CI 0.23-0.96) and longer duration of breast feeding (for 6-12 vs. ≦ 6 months, OR: 0.49, 95% CI 0.24-0.98) were significantly associated with decreased occurrence of thyroid cancer, while no trend was observed. Stratified by age at enrollment, only the association with duration of breast feeding remained significant, but limited to younger women (≦ 50 years). CONCLUSIONS Our results suggested that women with later age at first pregnancy or longer breast feeding duration were less likely to have thyroid cancer. These findings supported an influence role of reproductive factors in thyroid cancer risk.
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Affiliation(s)
- Meng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Wei-Wei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Qing-Fang He
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Ru-Ying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
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Malaguarnera R, Ledda C, Filippello A, Frasca F, Francavilla VC, Ramaci T, Parisi MC, Rapisarda V, Piro S. Thyroid Cancer and Circadian Clock Disruption. Cancers (Basel) 2020; 12:E3109. [PMID: 33114365 PMCID: PMC7690860 DOI: 10.3390/cancers12113109] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/18/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022] Open
Abstract
Thyroid cancer (TC) represents the most common malignancy of the endocrine system, with an increased incidence across continents attributable to both improvement of diagnostic procedures and environmental factors. Among the modifiable risk factors, insulin resistance might influence the development of TC. A relationship between circadian clock machinery disfunction and TC has recently been proposed. The circadian clock machinery comprises a set of rhythmically expressed genes responsible for circadian rhythms. Perturbation of this system contributes to the development of pathological states such as cancer. Several clock genes have been found deregulated upon thyroid nodule malignant transformation. The molecular mechanisms linking circadian clock disruption and TC are still unknown but could include insulin resistance. Circadian misalignment occurring during shift work, jet lag, high fat food intake, is associated with increased insulin resistance. This metabolic alteration, in turn, is associated with a well-known risk factor for TC i.e., hyperthyrotropinemia, which could also be induced by sleep disturbances. In this review, we describe the mechanisms controlling the circadian clock function and its involvement in the cell cycle, stemness and cancer. Moreover, we discuss the evidence supporting the link between circadian clockwork disruption and TC development/progression, highlighting its potential implications for TC prevention, diagnosis and therapy.
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Affiliation(s)
- Roberta Malaguarnera
- School of Human and Social Sciences, “Kore” University of Enna, 94100 Enna, Italy; (R.M.); (V.C.F.); (T.R.); (M.C.P.)
| | - Caterina Ledda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, 95100 Catania, Italy;
| | - Agnese Filippello
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi-Nesima Hospital, University of Catania, 95122 Catania, Italy; (A.F.); (S.P.)
| | - Francesco Frasca
- Endocrinology Unit, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Hospital, University of Catania, 95122 Catania, Italy;
| | - Vincenzo Cristian Francavilla
- School of Human and Social Sciences, “Kore” University of Enna, 94100 Enna, Italy; (R.M.); (V.C.F.); (T.R.); (M.C.P.)
| | - Tiziana Ramaci
- School of Human and Social Sciences, “Kore” University of Enna, 94100 Enna, Italy; (R.M.); (V.C.F.); (T.R.); (M.C.P.)
| | - Maria Chiara Parisi
- School of Human and Social Sciences, “Kore” University of Enna, 94100 Enna, Italy; (R.M.); (V.C.F.); (T.R.); (M.C.P.)
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, 95100 Catania, Italy;
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi-Nesima Hospital, University of Catania, 95122 Catania, Italy; (A.F.); (S.P.)
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Huang T, Zeleznik OA, Poole EM, Clish CB, Deik AA, Scott JM, Vetter C, Schernhammer ES, Brunner R, Hale L, Manson JE, Hu FB, Redline S, Tworoger SS, Rexrode KM. Habitual sleep quality, plasma metabolites and risk of coronary heart disease in post-menopausal women. Int J Epidemiol 2020; 48:1262-1274. [PMID: 30371783 DOI: 10.1093/ije/dyy234] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Epidemiologic studies suggest a strong link between poor habitual sleep quality and increased cardiovascular disease risk. However, the underlying mechanisms are not entirely clear. Metabolomic profiling may elucidate systemic differences associated with sleep quality that influence cardiometabolic health. METHODS We explored cross-sectional associations between sleep quality and plasma metabolites in a nested case-control study of coronary heart disease (CHD) in the Women's Health Initiative (WHI; n = 1956) and attempted to replicate the results in an independent sample from the Nurses' Health Study II (NHSII; n = 209). A sleep-quality score (SQS) was derived from self-reported sleep problems asked in both populations. Plasma metabolomics were assayed using LC-MS with 347 known metabolites. General linear regression was used to identify individual metabolites associated with continuous SQS (false-discovery rate <0.05). Using least absolute shrinkage and selection operator (LASSO) algorithms, a metabolite score was created from replicated metabolites and evaluated with CHD risk in the WHI. RESULTS After adjusting for age, race/ethnicity, body mass index (BMI) and smoking, we identified 69 metabolites associated with SQS in the WHI (59 were lipids). Of these, 16 were replicated in NHSII (15 were lipids), including 6 triglycerides (TAGs), 4 phosphatidylethanolamines (PEs), 3 phosphatidylcholines (PCs), 1 diglyceride (DAG), 1 lysophosphatidylcholine and N6-acetyl-L-lysine (a product of histone acetylation). These metabolites were consistently higher among women with poorer sleep quality. The LASSO selection resulted in a nine-metabolite score (TAGs 45: 1, 48: 1, 50: 4; DAG 32: 1; PEs 36: 4, 38: 5; PCs 30: 1, 40: 6; N6-acetyl-L-lysine), which was positively associated with CHD risk (odds ratio per SD increase in the score: 1.16; 95% confidence interval: 1.05, 1.28; p = 0.0003) in the WHI after adjustment for matching factors and conventional CHD risk factors. CONCLUSIONS Differences in lipid metabolites may be an important pathogenic pathway linking poor habitual sleep quality and CHD risk.
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Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Oana A Zeleznik
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Amy A Deik
- Broad Institute of MIT and Harvard, Boston, MA, USA
| | | | - Céline Vetter
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, CO, USA
| | - Eva S Schernhammer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Center for Public Health, University of Vienna, Vienna, Austria
| | | | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook Medicine, Stony Brook, NY, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan Redline
- Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shelley S Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Kathryn M Rexrode
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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34
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Beverly Hery CM, Hale L, Naughton MJ. Contributions of the Women's Health Initiative to understanding associations between sleep duration, insomnia symptoms, and sleep-disordered breathing across a range of health outcomes in postmenopausal women. Sleep Health 2019; 6:48-59. [PMID: 31699635 DOI: 10.1016/j.sleh.2019.09.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/05/2019] [Accepted: 09/17/2019] [Indexed: 01/20/2023]
Abstract
The Women's Health Initiative (WHI), a longitudinal study of more than 161,000 postmenopausal women across the United States, provides an opportunity to investigate the link between sleep health and healthy aging. The purpose of this paper was to systematically review all published WHI articles examining sleep as a predictor of health outcomes and health behaviors/quality of life outcomes. A strength of the WHI is that for most participants, sleep measures were completed before a major health diagnosis, with a significant portion of participants also providing sleep measures after diagnosis. Twenty-three WHI articles were identified and examined for this review. The combination of sleep duration and insomnia symptoms was the most commonly investigated sleep measure. The results indicated that both short (≤6 hours) and long (≥9 hours) sleep duration were associated with a higher risk of cardiovascular disease, colorectal cancer, mortality, cognitive decline, and poor diet. Insomnia symptoms, frequent snoring, and risk of sleep-disordered breathing (SDB) were also associated with increased risk for ischemic stroke and cardiovascular disease. However, many significant results were attenuated after multivariable adjustment. Limitations of these WHI examinations include the use of different categories for sleep measures across studies and a lack of examination by race/ethnicity. Owing to the longitudinal study design, large sample size, and long-term follow-up for health outcomes, the WHI serves as a rich resource for examining associations between sleep characteristics, demographics, and health in postmenopausal women.
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Affiliation(s)
- Chloe M Beverly Hery
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210.
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, NY 11794-8338
| | - Michelle J Naughton
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH 43210
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Shi T, Min M, Sun C, Zhang Y, Liang M, Sun Y. Does insomnia predict a high risk of cancer? A systematic review and meta‐analysis of cohort studies. J Sleep Res 2019; 29:e12876. [DOI: 10.1111/jsr.12876] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/01/2019] [Accepted: 04/25/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Tingting Shi
- Department of Epidemiology and Health Statistics School of Public Health Anhui Medical University Hefei China
| | - Min Min
- Department of Epidemiology and Health Statistics School of Public Health Anhui Medical University Hefei China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago Chicago Illinois
| | - Yun Zhang
- Department of Epidemiology and Health Statistics School of Public Health Anhui Medical University Hefei China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics School of Public Health Anhui Medical University Hefei China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics School of Public Health Anhui Medical University Hefei China
- Center for Evidence‐Based Practice Anhui Medical University Hefei China
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36
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Hoang HTX, Molassiotis A, Chan CW, Nguyen TH, Liep Nguyen V. New-onset insomnia among cancer patients undergoing chemotherapy: prevalence, risk factors, and its correlation with other symptoms. Sleep Breath 2019; 24:241-251. [PMID: 31016572 DOI: 10.1007/s11325-019-01839-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/26/2019] [Accepted: 03/30/2019] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES Although insomnia is common among cancer patients, its prevalence remains variable, and its risk factors and correlation with other cancer-related symptoms are not fully explored in the literature. This study aims to determine the prevalence and severity of insomnia as well as risk factors and sleep-related symptom clusters in a sample of cancer patients. METHODS A cross-sectional survey was conducted collecting data from 213 cancer patients undergoing chemotherapy (age = 53.1 ± 11.3 years, 60% female). Insomnia was measured using the Insomnia Severity Index, a sleep log, and Actigraph, while symptoms were assessed using the Memorial Symptom Assessment Scale and the Hospital Anxiety and Depression Scale. Quality of life was measured with the Functional Assessment of Cancer Therapy-General. RESULTS Of the participants, 42.8% reported insomnia, with 31.9% of those with insomnia reporting severe insomnia. Insomnia occurrence and severity were not correlated with the participants' characteristics, cancer-related or treatment-related factors, only with the participants' anxiety/depression scores. Principal component analysis showed that insomnia, depression, and anxiety formed a symptom cluster (p < 0.001). There was no difference between sleep parameters measured by Actigraphy in insomnia and non-insomnia participants. CONCLUSION This study demonstrated that the prevalence of insomnia was high and indicated a symptom cluster of insomnia, depression, and anxiety. Therefore, interventions to reduce this symptom cluster may benefit cancer patients who are trying to manage these symptoms.
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Affiliation(s)
- Huong Thi Xuan Hoang
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR.,Faculty of Nursing, Phenikaa University, Hanoi, Vietnam
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR.
| | - Choi Wan Chan
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR
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37
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Yuan X, Zhu C, Wang M, Mo F, Du W, Ma X. Night Shift Work Increases the Risks of Multiple Primary Cancers in Women: A Systematic Review and Meta-analysis of 61 Articles. Cancer Epidemiol Biomarkers Prev 2019; 27:25-40. [PMID: 29311165 DOI: 10.1158/1055-9965.epi-17-0221] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/27/2017] [Accepted: 10/11/2017] [Indexed: 02/05/2023] Open
Abstract
A growing number of studies have examined associations between night shift work and the risks of common cancers among women, with varying conclusions. We did a meta-analysis to identify whether long-term night shift work increased the risks of common cancers in women. We enrolled 61 articles involving 114,628 cases and 3,909,152 participants from Europe, North America, Asia, and Australia. Risk estimates were performed with a random-effect model or a fixed-effect model. Subgroup analyses and meta-regression analyses about breast cancer were conducted to explore possible sources of heterogeneity. In addition, we carried out a dose-response analysis to quantitatively estimate the accumulative effect of night shift work on the risk of breast cancer. A positive relationship was revealed between long-term night shift work and the risks of breast [OR = 1.316; 95% confidence interval (CI), 1.196-1.448], digestive system (OR = 1.177; 95% CI, 1.065-1.301), and skin cancer (OR = 1.408; 95% CI, 1.024-1.934). For every 5 years of night shift work, the risk of breast cancer in women was increased by 3.3% (OR = 1.033; 95% CI, 1.012-1.056). Concerning the group of nurses, long-term night shift work presented potential carcinogenic effect in breast cancer (OR = 1.577; 95% CI, 1.235-2.014), digestive system cancer (OR = 1.350; 95% CI, 1.030-1.770), and lung cancer (OR = 1.280; 95% CI, 1.070-1.531). This systematic review confirmed the positive association between night shift work and the risks of several common cancers in women. We identified that cancer risk of women increased with accumulating years of night shift work, which might help establish and implement effective measures to protect female night shifters. Cancer Epidemiol Biomarkers Prev; 27(1); 25-40. ©2018 AACR.
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Affiliation(s)
- Xia Yuan
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, P.R. China
| | - Chenjing Zhu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, P.R. China
| | - Manni Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, P.R. China
| | - Fei Mo
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, P.R. China
| | - Wei Du
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, P.R. China
| | - Xuelei Ma
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, P.R. China.
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38
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Circadian regulation of endocrine systems. Auton Neurosci 2019; 216:1-8. [DOI: 10.1016/j.autneu.2018.10.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/18/2018] [Accepted: 10/20/2018] [Indexed: 01/05/2023]
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39
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McNeil J, Barberio AM, Friedenreich CM, Brenner DR. Sleep and cancer incidence in Alberta’s Tomorrow Project cohort. Sleep 2018; 42:5253578. [DOI: 10.1093/sleep/zsy252] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/27/2018] [Accepted: 12/18/2018] [Indexed: 02/02/2023] Open
Affiliation(s)
- Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada
| | - Amanda M Barberio
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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40
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Chen Y, Tan F, Wei L, Li X, Lyu Z, Feng X, Wen Y, Guo L, He J, Dai M, Li N. Sleep duration and the risk of cancer: a systematic review and meta-analysis including dose-response relationship. BMC Cancer 2018; 18:1149. [PMID: 30463535 PMCID: PMC6249821 DOI: 10.1186/s12885-018-5025-y] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/31/2018] [Indexed: 12/31/2022] Open
Abstract
Background The effect of sleep duration on cancer risk remains controversial. We aimed to quantify the available evidence on this relationship using categorical and dose–response meta-analyses. Methods Population-based cohort studies and case-control studies with at least three categories of sleep duration were identified by searching PubMed, EMBASE, and the Cochrane Library database up to July 2017. Results Sixty-five studies from 25 articles were included, involving 1,550,524 participants and 86,201 cancer cases. The categorical meta-analysis revealed that neither short nor long sleep duration was associated with increased cancer risk (short: odds ratio [OR] = 1.01, 95% confidence intervals [CI] = 0.97–1.05; long: OR = 1.02, 95% CI = 0.97–1.07). Subgroup analysis revealed that short sleep duration was associated with cancer risk among Asians (OR = 1.36; 95% CI: 1.02–1.80) and long sleep duration significantly increased the risk of colorectal cancer (OR = 1.21; 95% CI: 1.08–1.34). The dose–response meta-analysis showed no significant relationship between sleep duration and cancer risk. When treated as two linear piecewise functions with a cut point of 7 h, similar nonsignificant associations were found (per 1-h reduction: OR = 1.02, 95% CI = 0.98–1.07; per 1-h increment: OR = 1.003, 95% CI = 0.97–1.03). Conclusion Categorical meta-analysis indicated that short sleep duration increased cancer risk in Asians and long sleep duration increased the risk of colorectal cancer, but these findings were not consistent in the dose–response meta-analysis. Long-term randomized controlled trials and well-designed prospective studies are needed to establish causality and to elucidate the mechanism underlying the association between sleep duration and cancer risk. Electronic supplementary material The online version of this article (10.1186/s12885-018-5025-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuheng Chen
- Cancer Foundation of China, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Luopei Wei
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xin Li
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Zhangyan Lyu
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiaoshuang Feng
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yan Wen
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Lanwei Guo
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.,Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Min Dai
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Ni Li
- Office for Cancer Early Diagnosis and Treatment, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Beverly CM, Naughton MJ, Pennell ML, Foraker RE, Young G, Hale L, Feliciano EMC, Pan K, Crane TE, Danhauer SC, Paskett ED. Change in longitudinal trends in sleep quality and duration following breast cancer diagnosis: results from the Women's Health Initiative. NPJ Breast Cancer 2018; 4:15. [PMID: 29978034 PMCID: PMC6026122 DOI: 10.1038/s41523-018-0065-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 11/16/2022] Open
Abstract
Breast cancer survivors frequently report sleep problems, but little research has studied sleep patterns longitudinally. We examined trends in sleep quality and duration up to 15 years before and 20 years after a diagnosis of breast cancer, over time among postmenopausal women participating in the Women's Health Initiative (WHI). We included 12,098 participants who developed invasive breast cancer after study enrollment. A linear mixed-effects model was used to determine whether the time trend in sleep quality, as measured by the WHI Insomnia Rating Scale (WHIIRS), a measure of perceived insomnia symptoms from the past 4 weeks, changed following a cancer diagnosis. To examine sleep duration, we fit a logistic regression model with random effects for both short (<6 h) and long (≥9 h) sleep. In addition, we studied the association between depressive symptoms and changes in WHIIRS and sleep duration. There was a significantly slower increase in the trend of WHIIRS after diagnosis (β = 0.06; p = 0.03), but there were non-significant increases in the trend of the probability of short or long sleep after diagnosis. The probability of depressive symptoms significantly decreased, though the decrease was more pronounced after diagnosis (p < 0.01). Trends in WHIIRS worsened at a relatively slower rate following diagnosis and lower depression rates may explain the slower worsening in WHIIRS. Our findings suggest that over a long period of time, breast cancer diagnosis does not adversely affect sleep quality and duration in postmenopausal women compared to sleep pre-diagnosis, yet both sleep quality and duration continue to worsen over time.
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Affiliation(s)
- Chloe M. Beverly
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210 USA
| | - Michelle J. Naughton
- Division of Population Sciences, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210 USA
| | - Michael L. Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210 USA
| | - Randi E. Foraker
- Institute for Informatics, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108 USA
| | - Gregory Young
- Center for Biostatistics, The Ohio State University, Columbus, OH 43210 USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY 11794 USA
| | | | - Kathy Pan
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, University of California, Los Angeles, Torrance, CA 90509 USA
| | - Tracy E. Crane
- College of Nursing, University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724 USA
| | - Suzanne C. Danhauer
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Electra D. Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210 USA
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Kabat GC, Xue X, Kamensky V, Zaslavsky O, Stone KL, Johnson KC, Wassertheil-Smoller S, Shadyab AH, Luo J, Hale L, Qi L, Cauley JA, Brunner RL, Manson JE, Rohan TE. The association of sleep duration and quality with all-cause and cause-specific mortality in the Women's Health Initiative. Sleep Med 2018; 50:48-54. [PMID: 29982090 DOI: 10.1016/j.sleep.2018.05.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/30/2018] [Accepted: 05/22/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND/OBJECTIVE Many studies have shown a U-shaped association of sleep duration with mortality; however, this association is difficult to interpret owing to possible reverse causation, residual confounding, and measurement issues. We used data from the Women's Health Initiative to examine the associations of sleep duration, insomnia, and use of sleep aids with death from cardiovascular disease (CVD), cancer, "other" causes, and all causes combined. METHODS Cox proportional hazards models were used in the analysis of baseline data and in time-dependent analyses of repeated measures to estimate associations of sleep-related factors with mortality. Among 158,203 women with information regarding sleep, 30,400 total deaths, 8857 CVD deaths, 9284 cancer deaths, and 11,928 other deaths were ascertained over a median of 17.8 years. RESULTS In both baseline and time-dependent analyses, both short (≤5 h) and long sleep (≥9 h) durations were associated with increased risk of total, CVD, and "other" deaths, but not with cancer deaths. Insomnia showed no association with mortality, whereas use of sleep medications was associated with an increased mortality risk. CONCLUSIONS While our findings showed a small but robust association of sleep duration with mortality in postmenopausal women, studies including objective measurements of sleep quality and efficiency are needed to clarify these associations.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Victor Kamensky
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Oleg Zaslavsky
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Katie L Stone
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee, Memphis, TN, USA
| | | | - Aladdin H Shadyab
- Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, University of Indiana, Bloomington, IN, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Jane A Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert L Brunner
- Department of Family and Community Medicine, University of Nevada School of Medicine, Reno, NV, USA
| | - JoAnn E Manson
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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Dao-Tran TH, Seib C. Prevalence and correlates of sleep disturbance among older women in Vietnam. J Clin Nurs 2017; 27:3307-3313. [PMID: 28926205 DOI: 10.1111/jocn.14080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore prevalence and correlates of sleep disturbance among women aged 60 and over in Vietnam. BACKGROUND Sleep disturbance can negatively influence human's health. Sleep disturbance is likely to increase with age, and women appear to be more likely to experience sleep disturbance than men. Knowledge about sleep disturbance in women aged 60 and over in Vietnam is under-researched. DESIGN The study presents results from a cross-sectional survey of 440 women aged 60 and over from 16 rural and urban suburbs in Vietnam from August 2014-January 2015 METHODS: Structured questionnaires were used to gather data about residence, age, marital status, educational attainment, employment status, income, body mass index, physical activity, exercise, perceived stress, general health status, number of chronic diseases and sleep disturbance. Descriptive analysis, bivariate correlation and binary logistic generalised linear model were used for data analysis. RESULTS Among older women in Vietnam, (i) the prevalence of sleep disturbance was 38.9%; (ii) the most commonly problem was difficulty maintaining sleep, followed by sleep latency, reduced sleep quality, early waking and daytime sleepiness, (iii) body mass index and physical health were significantly associated with sleep disturbance status. CONCLUSIONS Sleep disturbance was relatively common among older women in Vietnam. Overweight increased their sleep disturbance while physical health was negatively associated with their sleep disturbance. RELEVANCE TO CLINICAL PRACTICE This article provided evidence about sleep problems among older women in Vietnam and suggested that interventions targeting weight control and physical health promotion would be useful to improve their sleep problems.
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Affiliation(s)
- Tiet-Hanh Dao-Tran
- Center for Work, Organisation, and Well-being, Griffith University, Brisbane, Qld, Australia.,Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at, Ho Chi Minh City, Vietnam
| | - Charrlotte Seib
- School of Nursing and Midwifery, Griffith University, Gold Coast, Qld, Australia
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Chen TY, Hsu CC, Feng IJ, Wang JJ, Su SB, Guo HR, Huang CC, Lin HJ. Higher risk for thyroid diseases in physicians than in the general population: a Taiwan nationwide population-based secondary analysis study. QJM 2017; 110:163-168. [PMID: 27521582 DOI: 10.1093/qjmed/hcw140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Physicians have high work stress, responsibility for night shifts and chances of exposure to medical radiation, which may increase the risk for thyroid diseases. AIM We conducted this study to assess the risk for thyroid diseases in physicians, which remain unclear. DESIGN We used a secondary analysis of the Taiwan National Health Insurance Research Database for this study. METHODS After excluding thyroid diseases occurring before 2006 and residents, physicians and general population were identified by matching with age and sex in 2009 in a 1:2 ratio. The risk for thyroid diseases was compared between the physicians and general population and among physicians by tracing their medical histories between 2006 and 2012. RESULTS In total, 28,649 physicians and 57,298 general population were identified. Physicians had a higher risk for overall thyroid diseases than the general population [odds ratio (OR): 1.27; 95% confidence interval (CI): 1.10-1.47], including individual thyroid disease: thyroid cancer (OR: 1.89; 95% CI: 1.22-2.95), hypothyroidism (OR: 1.64; 95% CI: 1.23-2.18) and thyroiditis (OR: 1.48; 95% CI: 1.00-2.19). CONCLUSIONS We showed that physicians had a significantly higher risk for thyroid diseases than the general population. This reminds us to pay more attention to thyroid diseases in physicians. Further studies about the underlying mechanisms are warranted.
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Affiliation(s)
- T-Y Chen
- From the Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan 710, Taiwan
- Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan 711, Taiwan
| | - C-C Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
| | - I-J Feng
- Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
| | - J-J Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
| | - S-B Su
- Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Medical Research, Chi-Mei Medical Center, Liouying, Tainan 736, Taiwan
| | - H-R Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - C-C Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Bachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
- Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan 710, Taiwan
| | - H-J Lin
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
- Department of Emergency Medicine, Taipei Medical University, Taipei 110, Taiwan
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Moon SH, Lee BJ, Kim SJ, Kim HC. Relationship between thyroid stimulating hormone and night shift work. Ann Occup Environ Med 2016; 28:53. [PMID: 27761265 PMCID: PMC5054581 DOI: 10.1186/s40557-016-0141-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 09/28/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Night shift work has well-known adverse effects on health. However, few studies have investigated the relationship between thyroid diseases and night shift work. This study aimed to examine night shift workers and their changes in thyroid stimulating hormones (TSH) levels over time. METHODS Medical check-up data (2011-2015) were obtained from 967 female workers at a university hospital in Incheon, Korea. Data regarding TSH levels were extracted from the records, and 2015 was used as a reference point to determine night shift work status. The relationships between TSH levels and night shift work in each year were analyzed using the general linear model (GLM). The generalized estimating equation (GEE) was used to evaluate the repeated measurements over the 5-year period. RESULTS The GEE analysis revealed that from 2011 to 2015, night shift workers had TSH levels that were 0.303 mIU/L higher than the levels of non-night shift workers (95 % CI: 0.087-0.519 mIU/L, p = 0.006) after adjusting for age and department. When we used TSH levels of 4.5 ≥ mIU/L to identify subclinical hypothyroidism, night shift workers exhibited a 1.399 fold higher risk of subclinical hypothyroidism (95 % CI: 1.050-1.863, p = 0.022), compared to their non-night shift counterparts. CONCLUSIONS This result of this study suggests that night shift workers may have an increased risk of thyroid diseases, compared to non-night shift workers.
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Affiliation(s)
- So-Hyun Moon
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea ; Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, Republic of Korea
| | - Bum-Joon Lee
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Seong-Jin Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea ; Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea ; Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon, Republic of Korea
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Gu F, Xiao Q, Chu LW, Yu K, Matthews CE, Hsing AW, Caporaso NE. Sleep Duration and Cancer in the NIH-AARP Diet and Health Study Cohort. PLoS One 2016; 11:e0161561. [PMID: 27611440 PMCID: PMC5017779 DOI: 10.1371/journal.pone.0161561] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 08/08/2016] [Indexed: 12/15/2022] Open
Abstract
Background Very few studies have examined sleep duration in relation to cancer incidence with the exception of breast cancer. Methods We assessed the associations between sleep duration and incidences of total and 18 site-specific cancers in the NIH-AARP Health and Diet Study cohort, with 173,327 men and 123,858 women aged 51–72 years at baseline. Self-reported sleep duration categories were assessed via questionnaire. We used multivariable Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI), using 7–8 hours/night as the reference. Results We observed a significantly increased risk of stomach cancer among male short sleepers (multivariable HR5-6 vs. 7–8 hours = 1.29; 95%CI: 1.05, 1.59; Ptrend = 0.03). We also observed suggestive associations in either short or long sleepers, which did not reach overall significance (Ptrend >0.05), including increased risks in male short sleepers for cancers of head and neck (HR<5vs.7-8 hours = 1.39; 95%CI:1.00–1.95), bladder (HR5-6vs.7-8 hours = 1.10; 95%CI:1.00–1.20), thyroid (HR<5 vs. 7–8 hours = 2.30; 95%CI:1.06, 5.02), Non-Hodgkin Lymphoma (NHL) (HR5-6vs.7-8 hours = 1.17; 95%CI:1.02–1.33), and myeloma (HR<5vs.7-8 hours = 2.06; 95%CI:1.20–3.51). In women, the suggestive associations include a decreased total cancer risk (HR<5vs.7-8 hours = 0.9; 95%CI:0.83–0.99) and breast cancer risk (HR<5vs.7-8 hours = 0.84; 95%CI:0.71–0.98) among short sleepers. A decreased ovarian cancer risk (HR≥ 9 vs. 7–8 hours = 0.50; 95%CI:0.26–0.97) and an increased NHL risk (HR≥ 9 vs. 7–8 hours = 1.45; 95%CI:1.00–2.11) were observed among long sleepers. Conclusion In an older population, we observed an increased stomach cancer risk in male short sleepers and suggestive associations with short or long sleep duration for many cancer risks in both genders.
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Affiliation(s)
- Fangyi Gu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States of America
- * E-mail: ,
| | - Qian Xiao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States of America
| | - Lisa W. Chu
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Stanford Cancer Institute, Palo Alto, CA, United States of America
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States of America
| | - Charles E. Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States of America
| | - Ann W. Hsing
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Stanford Cancer Institute, Palo Alto, CA, United States of America
- Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, CA, United States of America
| | - Neil E. Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States of America
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Phipps AI, Bhatti P, Neuhouser ML, Chen C, Crane TE, Kroenke CH, Ochs-Balcom H, Rissling M, Snively BM, Stefanick ML, Treggiari MM, Watson NF. Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival. J Clin Sleep Med 2016; 12:495-503. [PMID: 26612513 PMCID: PMC4795275 DOI: 10.5664/jcsm.5674] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/02/2015] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES Poor sleep quality and short sleep duration have been associated with elevated risk for several cancer types; however, the relationship between sleep and cancer outcomes has not been well characterized. We assessed the association between pre-diagnostic sleep attributes and subsequent cancer survival within the Women's Health Initiative (WHI). METHODS We identified WHI participants in whom a first primary invasive cancer had been diagnosed during follow-up (n = 21,230). Participants provided information on sleep characteristics at enrollment. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between these pre-diagnostic sleep characteristics and cancer-specific survival for all cancers combined and separately for common cancers. Analyses were adjusted for age, study arm, cancer site, marital status, income, smoking, physical activity, and time to diagnosis. RESULTS No individual pre-diagnostic sleep characteristics were found to be significantly associated with cancer survival in analyses of all cancer sites combined; however, women who reported short sleep duration (≤ 6 h sleep/night) combined with frequent snoring (≥ 5 nights/w experienced significantly poorer cancer-specific survival than those who reported 7-8 h of sleep/night and no snoring (HR = 1.32, 95% CI: 1.14-1.54). Short sleep duration (HR = 1.46, 95% CI: 1.07-1.99) and frequent snoring (HR = 1.34, 95% CI: 0.98-1.85) were each associated with poorer breast cancer survival; those reporting short sleep combined with frequent snoring combined had substantially poorer breast cancer survival than those reporting neither (HR = 2.14, 95% CI: 1.47-3.13). CONCLUSIONS Short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent cancer survival, particularly breast cancer survival.
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Affiliation(s)
- Amanda I. Phipps
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Epidemiology Department, School of Public Health, University of Washington, Seattle, WA
| | - Parveen Bhatti
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Epidemiology Department, School of Public Health, University of Washington, Seattle, WA
| | - Marian L. Neuhouser
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Chu Chen
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Tracy E. Crane
- Health Promotion Sciences Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Candyce H. Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Heather Ochs-Balcom
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | | | - Beverly M. Snively
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Marcia L. Stefanick
- Stanford Prevention Research Center, Stanford University, School of Medicine, Palo Alto, CA
| | - Miriam M. Treggiari
- Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR
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48
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Marcum ZA, Wirtz HS, Pettinger M, LaCroix AZ, Carnahan R, Cauley JA, Bea JW, Gray SL. Anticholinergic medication use and falls in postmenopausal women: findings from the women's health initiative cohort study. BMC Geriatr 2016; 16:76. [PMID: 27038789 PMCID: PMC4818856 DOI: 10.1186/s12877-016-0251-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/24/2016] [Indexed: 11/29/2022] Open
Abstract
Background Results from studies assessing the association between anticholinergic use and falls are mixed, and prior studies are limited in their ability to control for important potential confounders. Thus, we sought to examine the association between anticholinergic medication use, including over-the-counter medications, and recurrent falls in community-dwelling older women. Methods We analyzed data from a prospective cohort study of women aged 65 to 79 years from the Women’s Health Initiative Observational Study and Clinical Trials. Women were recruited between 1993 and 1998, and analyses included 61,451 women with complete information. Medications with moderate or strong anticholinergic effects were ascertained directly from drug containers during face-to-face interviews. The main outcome measure was recurrent falls (≥2 falls in previous year), which was determined from self-report within 1.5 years subsequent to the medication assessment. Results At baseline, 11.3 % were using an anticholinergic medication, of which antihistamines (commonly available over-the-counter) were the most common medication class (received by 45.2 % of individuals on anticholinergic medication). Using multivariable GEE models and controlling for potential confounders, the adjusted odds ratio for anticholinergic medication use was 1.51 (95 % CI, 1.43–1.60) for recurrent falls. Participants using multiple anticholinergic medications had a 100 % increase in likelihood of recurrent falls (adjusted odds ratio 2.00, 95 % CI 1.73–2.32). Results were robust to sensitivity analysis. Conclusions Anticholinergic medication use was associated with increased risk for recurrent falls. Our findings reinforce judicious use of anticholinergic medications in older women. Public health efforts should emphasize educating older women regarding the risk of using over-the-counter anticholinergics, such as first-generation antihistamines. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0251-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zachary A Marcum
- School of Pharmacy, University of Washington, 1959 NE Pacific St, H375G, Box 357630, Seattle, WA, 98195-7630, USA.
| | - Heidi S Wirtz
- Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - Mary Pettinger
- WHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Andrea Z LaCroix
- Division of Epidemiology, UC San Diego, 9500 Gilman Dr #0725, La Jolla, CA, 92093, USA
| | - Ryan Carnahan
- College of Public Health, Department of Epidemiology, University of Iowa, 145 N Riverside Dr, 100 CPHB, Iowa City, IA, 52242, USA
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, A510 Crabtree Hall, Pittsburgh, PA, 15261, USA
| | - Jennifer W Bea
- Departments of Medicine and Nutritional Sciences, University of Arizona Cancer Center, 1515 N Campbell Ave, PO Box 245024, Tucson, AZ, 85724, USA
| | - Shelly L Gray
- School of Pharmacy, University of Washington, 1959 NE Pacific St, H375G, Box 357630, Seattle, WA, 98195-7630, USA
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Erren T, Morfeld P, Foster R, Reiter R, Groß J, Westermann I. Sleep and cancer: Synthesis of experimental data and meta-analyses of cancer incidence among some 1,500,000 study individuals in 13 countries. Chronobiol Int 2016; 33:325-50. [DOI: 10.3109/07420528.2016.1149486] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Hurley S, Goldberg D, Bernstein L, Reynolds P. Sleep duration and cancer risk in women. Cancer Causes Control 2015; 26:1037-45. [PMID: 25924583 PMCID: PMC4466005 DOI: 10.1007/s10552-015-0579-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 04/11/2015] [Indexed: 01/07/2023]
Abstract
PURPOSE The objective was to conduct an analysis of sleep duration and risk of selected site-specific and groups of cancer among a large prospective cohort of California women. METHODS The study population was comprised of 101,609 adult females participating in the California Teachers Study. All sites of invasive cancer prospectively diagnosed from baseline (1995-1996) through 2011 were identified through linkage to the California Cancer Registry (n = 12,322). Site-specific analyses focused on the following cancers: breast (n = 5,053), colorectal (n = 983), lung (n = 820), melanoma (n = 749), and endometrial (n = 957). Additionally, we evaluated a group of estrogen-mediated cancers consisting of breast, endometrial, and ovarian cancer (n = 6,458). Sleep duration was based on self-report of average time sleeping in the year prior to baseline. Cox proportional hazard models were used to calculate adjusted hazard ratios and 95 % confidence intervals (HRs, 95 % CI). RESULTS Point estimates for all sites and site-specific cancers generally were near or below one for short sleepers (<6 h/night) and above one for long sleepers (10+ h/night); confidence intervals, however, were wide and included unity. Compared to average sleepers (7-9 h/night), long sleepers had an increased risk of the group of estrogen-mediated cancers (HR 1.22, 95 % CI 0.97-1.54, p (trend) = 0.04). CONCLUSIONS These analyses suggest that longer sleep may be associated with increased risks of estrogen-mediated cancers. Further studies with more refined measures of sleep duration and quality are warranted.
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Affiliation(s)
- Susan Hurley
- Cancer Prevention Institute of California, 2001 Center Street, Suite 700, Berkeley, CA, 94704, USA,
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