Abstract：
BACKGROUND: Circadian health refers to individuals\' well-being and balance in terms of their circadian rhythm. It is influenced by external cues. In adults, a close relationship between circadian-related alterations and obesity has been described. However, studies in children are scarce, and circadian health and its association with obesity have not been evaluated globally. We aimed to assess whether circadian health differed between children with and without obesity as determined by a global circadian score (GCS) in a school-age population.
METHODS: Four hundred and thirty-two children (7-12 years) were recruited in Spain. Non-invasive tools were used to calculate the GCS: (1) 7-day rhythm of wrist temperature (T), activity (A), position (P), an integrative variable that combines T, A, and P (TAP); (2) cortisol; and (3) 7-day food and sleep records. Body mass index, body fat percentage, waist circumference (WC), melatonin concentration, and cardiometabolic marker levels were determined.
RESULTS: Circadian health, as assessed by the GCS, differed among children with obesity, overweight, and normal weight, with poorer circadian health among children with obesity. Children with obesity and abdominal obesity had 3.54 and 2.39 greater odds of having poor circadian health, respectively, than did those with normal weight or low WC. The percentage of rhythmicity, a marker of the robustness of the TAP rhythm, and the amplitude, both components of the GCS, decreased with increasing obesity. Different lifestyle behaviors were involved in the association between circadian health and obesity, particularly protein intake (P = 0.024), physical activity level (P = 0.076) and chronotype (P = 0.029).
CONCLUSIONS: The GCS can capture the relationship between circadian health and obesity in school-age children. Protein intake, physical activity level, and chronotype were involved in this association. Early intervention based on improving circadian health may help to prevent childhood obesity.
METHODS: Four hundred and thirty-two children (7-12 years) were recruited in Spain. Non-invasive tools were used to calculate the GCS: (1) 7-day rhythm of wrist temperature (T), activity (A), position (P), an integrative variable that combines T, A, and P (TAP); (2) cortisol; and (3) 7-day food and sleep records. Body mass index, body fat percentage, waist circumference (WC), melatonin concentration, and cardiometabolic marker levels were determined.
RESULTS: Circadian health, as assessed by the GCS, differed among children with obesity, overweight, and normal weight, with poorer circadian health among children with obesity. Children with obesity and abdominal obesity had 3.54 and 2.39 greater odds of having poor circadian health, respectively, than did those with normal weight or low WC. The percentage of rhythmicity, a marker of the robustness of the TAP rhythm, and the amplitude, both components of the GCS, decreased with increasing obesity. Different lifestyle behaviors were involved in the association between circadian health and obesity, particularly protein intake (P = 0.024), physical activity level (P = 0.076) and chronotype (P = 0.029).
CONCLUSIONS: The GCS can capture the relationship between circadian health and obesity in school-age children. Protein intake, physical activity level, and chronotype were involved in this association. Early intervention based on improving circadian health may help to prevent childhood obesity.
摘要：
背景：昼夜节律健康是指个体的健康和平衡。它受到外部线索的影响。在成年人中,已经描述了昼夜节律相关改变与肥胖之间的密切关系.然而,对儿童的研究很少，昼夜节律健康及其与肥胖的关系尚未在全球范围内得到评估。我们旨在评估是否有肥胖儿童和无肥胖儿童之间的昼夜节律健康差异，这是由学龄期人群的全球昼夜节律评分（GCS）决定的。
方法：在西班牙招募了4132名儿童（7-12岁）。使用非侵入性工具计算GCS：（1）腕部温度（T）的7天节律，活动（A），position(P),结合T的积分变量，A,和P（TAP）;（2）皮质醇;和（3）7天的食物和睡眠记录。身体质量指数,身体脂肪百分比，腰围（WC），褪黑素浓度，并测定心脏代谢标志物水平。
结果：昼夜节律健康，根据GCS的评估，肥胖儿童之间的差异，超重,正常体重,肥胖儿童的昼夜节律健康状况较差。肥胖和腹部肥胖的儿童有3.54和2.39更多的几率有不良的昼夜节律健康，分别,比体重正常或WC低的人多。有节奏的百分比，TAP节律鲁棒性的标志，和振幅，GCS的两个组成部分，随着肥胖的增加而减少。不同的生活方式行为参与了昼夜节律健康与肥胖之间的关系，特别是蛋白质摄入量（P=0.024），体力活动水平(P=0.076)和时间型(P=0.029)。
结论：GCS可以捕捉学龄儿童昼夜节律健康与肥胖之间的关系。蛋白质摄入量，身体活动水平,和时间型参与了这种关联。基于改善昼夜节律健康的早期干预可能有助于预防儿童肥胖。
方法：在西班牙招募了4132名儿童（7-12岁）。使用非侵入性工具计算GCS：（1）腕部温度（T）的7天节律，活动（A），position(P),结合T的积分变量，A,和P（TAP）;（2）皮质醇;和（3）7天的食物和睡眠记录。身体质量指数,身体脂肪百分比，腰围（WC），褪黑素浓度，并测定心脏代谢标志物水平。
结果：昼夜节律健康，根据GCS的评估，肥胖儿童之间的差异，超重,正常体重,肥胖儿童的昼夜节律健康状况较差。肥胖和腹部肥胖的儿童有3.54和2.39更多的几率有不良的昼夜节律健康，分别,比体重正常或WC低的人多。有节奏的百分比，TAP节律鲁棒性的标志，和振幅，GCS的两个组成部分，随着肥胖的增加而减少。不同的生活方式行为参与了昼夜节律健康与肥胖之间的关系，特别是蛋白质摄入量（P=0.024），体力活动水平(P=0.076)和时间型(P=0.029)。
结论：GCS可以捕捉学龄儿童昼夜节律健康与肥胖之间的关系。蛋白质摄入量，身体活动水平,和时间型参与了这种关联。基于改善昼夜节律健康的早期干预可能有助于预防儿童肥胖。
