Abstract:
That disruptions of the body\'s internal clockwork can lead to negative health consequences, including cancer, is a plausible hypothesis. Yet, despite strong mechanistic and animal support, the International Agency for Research on Cancer (IARC) experts considered epidemiological evidence as limited regarding the carcinogenicity of \"shift-work involving circadian disruption\" (2007) and \"night shift work\" (2019). We use directed acyclic graphs (DAGs) to outline a concept of circadian causes that discloses challenges when choosing appropriate exposure variables. On this basis, we propose to move beyond shift-work alone as a direct cause of disease. Instead, quantifying chronodisruption as individual doses can lead to interpretable circadian epidemiology. The hypothesis is that doses of chronodisruption cause disrupted circadian organisation by leading to desynchronization of circadian rhythms. Chronodisruption can be conceptualized as the split physiological nexus of internal and external times. Biological (or internal) night - an individual\'s intrinsically favoured sleep time window - could be the backbone of circadian epidemiology. In practice, individual doses that cause disrupted circadian organisation are derived from the intersection of time intervals of being awake and an individual\'s biological night. After numerous studies counted work shifts, chronobiology may now advance circadian epidemiology with more specific dose estimation - albeit with greater challenges in measurement (time-dependent individual data) and analysis (time-dependent confounding).
摘要:
身体内部发条的中断会导致负面的健康后果,包括癌症,是一个合理的假设。然而,尽管有强大的机械和动物支持,国际癌症研究机构(IARC)专家认为,关于“涉及昼夜节律中断的轮班工作”(2007年)和“夜班工作”(2019年)的致癌性,流行病学证据有限。我们使用有向无环图(DAG)来概述昼夜节律原因的概念,该概念在选择适当的暴露变量时揭示了挑战。在此基础上,我们建议超越轮班工作作为疾病的直接原因。相反,将时间中断量化为个体剂量可以导致可解释的昼夜节律流行病学。假设是,时间中断的剂量会导致昼夜节律的不同步,从而导致昼夜节律的失调。时间中断可以概念化为内部和外部时间的分裂生理联系。生物(或内部)夜晚-个人内在偏爱的睡眠时间窗-可能是昼夜节律流行病学的支柱。在实践中,导致昼夜节律组织紊乱的个体剂量来源于清醒的时间间隔和个体的生物夜晚的交叉点。经过大量研究统计工作班次,时间生物学现在可以通过更具体的剂量估计来推进昼夜节律流行病学-尽管在测量(时间依赖性个体数据)和分析(时间依赖性混杂)方面存在更大的挑战.