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Review
. 2022 Apr 14;1(3):471-479.
doi: 10.1016/j.gastha.2022.02.015. eCollection 2022.

The Role of Race, Sex, and Age in Circadian Disruption and Metabolic Disorders

Clark Zhang  1 , Christopher Tait  2   3 , Carlos D Minacapelli  2   3 , Abhishek Bhurwal  2   3 , Kapil Gupta  2   3 , Rajan Amin  2   3 , Vinod K Rustgi  2   3
Affiliations
Review

The Role of Race, Sex, and Age in Circadian Disruption and Metabolic Disorders

Clark Zhang et al. Gastro Hep Adv. .

Abstract

Circadian rhythms are 24-hour internal biological cycles that play an important role in metabolism, and their disruption has been implicated in the development of diseases such as diabetes mellitus type 2, obesity, coronary artery disease, hypertension, and metabolic syndrome. This phenomenon is illustrated by increased rates of risk factors for cardiovascular disease in night shift workers. Race, sex, and age are factors that play a role in circadian rhythms and metabolic disorders. The focus of this review article is to assess the link between circadian rhythm physiology and metabolic disorders from a race, sex, and age perspective. Black Americans were noted to have shorter free-running circadian periods, or tau, increased cortisol levels, and poorer sleep habits compared to white Americans, possibly contributing to increased rates of obesity, hypertension, and hyperlipidemia. Women were also noted to have shorter tau, increased levels of proinflammatory gut bacteria, and reduced sleep quality compared to men, possibly leading to higher rates of obesity, metabolic syndrome, hypertension (in postmenopausal women), and nonalcoholic fatty liver disease. Older people were noted to have decreased expression of anti-inflammatory clock genes compared to younger people, possibly leading to increased rates of obesity, diabetes, hyperlipidemia, and hypertension. Groups that are at a higher risk for metabolic disorders such as black Americans, women, and the elderly may have internal time keeping systems that place them at a higher risk for developing abnormal hormonal and/or inflammatory pathways.

Keywords: Circadian Rhythms; Hypertension; Metabolic Syndrome; Obesity.

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Figures

Figure 1
Figure 1
(A) The central pacemaker is entrained by the light/dark cycle. Metabolic homeostasis is dependent on the phase match between the social and environmental clocks. Metabolic dysfunction happens when there is a phase mismatch between social and environmental rhythms. Library of Science & Medical Illustrations were utilized in part to create this figure. https://creativecommons.org/licenses/by-nc-sa/4.0. (B) Representation of the effect of circadian rhythm disturbances on body systems. Sleep disturbances among shift workers are due to a desynchronization between the light-dark phase ultimately affecting different body systems. Library of Science & Medical Illustrations were utilized in part to create this figure. https://creativecommons.org/licenses/by-nc-sa/4.0.
Figure 2
Figure 2
tau = free-running circadian period. Effect of race on circadian rhythm patterns. African-Americans were reported to display a shorter tau than European-Americans by approximately 0.25 hours. This leads to a shorter phase delay on average for African-Americans by approximately 1.2 hours when subjects underwent a 9-hour phase delay of the light-dark/sleep-wake cycle (mimics flying west). Shorter phase delays are associated with longer jet lag and are less adaptive for shift work. Library of Science & Medical Illustrations were utilized in part to create this figure. https://creativecommons.org/licenses/by-nc-sa/4.
Figure 3
Figure 3
Effect of sex on circadian rhythm patterns. Women were reported to have lower satiety and higher hunger hormones than men after undergoing 2 8-day lab protocols that simulated circadian alignment and misalignment. This leads to reduced fullness for women on average, increasing the risk for obesity and development of NAFLD. Library of Science & Medical Illustrations were utilized in part to create this figure. https://creativecommons.org/licenses/by-nc-sa/4.0.
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