The circadian syndrome predicts cardiovascular disease better than metabolic syndrome in Chinese adults

Z. Shi, J. Tuomilehto, N. Kronfeld-Schor, G. K. Alberti, N. Stern, A. El-Osta, C. Bilu, H. Einat, P. Zimmet

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: To compare the predictive value of the circadian syndrome (CircS) and Metabolic syndrome (MetS) for cardiovascular disease. Method: We used the data of 9360 Chinese adults aged ≥40 years from the 2011 China Health and Retirement Longitudinal Study (CHARLS). Of the participants, 8253 people were followed in the 2015 survey. MetS was defined using the harmonized criteria. CircS was based on the components of the International Diabetes Federation (IDF) MetS plus short sleep and depression. The cut-off for CircS was set as ≥4. Multivariable logistic regression analysis was used to examine the associations. Results: The prevalence of CircS and MetS was 39.0% and 44.7%. Both MetS and CircS were directly associated with prevalent CVD. The odds ratios for prevalent CVD comparing CircS with MetS, respectively, were 2.83 (95%CI 2.33–3.43) and 2.34 (1.93–2.83) in men, and 2.33 (1.98–2.73) and 1.79 (1.53–2.10) in women. Similar associations were found for incident CVD. The five-year incidence of CVD was 15.1% in CircS and 14.0% in MetS. The number of CircS components has a better predictive power for both prevalent and incident CVD than those of Mets components as indicated by the area under the ROC (AUC). AUC values for CVD in 2011 were higher for CircS than MetS in both men (0.659 (95%CI 0.634–0.684) vs 0.635 (95%CI 0.610–0.661)) and women (0.652 (95%CI 0.632–0.672) vs 0.619 (95%CI 0.599–0.640)). Conclusion: The circadian syndrome is a strong and better predictor for CVD than the metabolic syndrome in Chinese adults.

Original languageEnglish
Pages (from-to)851-860
Number of pages10
JournalJournal of Internal Medicine
Issue number6
StatePublished - 1 Jun 2021
Externally publishedYes


  • adults
  • cardiovascular disease
  • Chinese
  • circadian syndrome
  • metabolic syndrome

ASJC Scopus subject areas

  • Internal Medicine


Dive into the research topics of 'The circadian syndrome predicts cardiovascular disease better than metabolic syndrome in Chinese adults'. Together they form a unique fingerprint.

Cite this