Do circadian factors improve mortality risk prediction? A dual-cohort analysis of metabolic and circadian syndromes
Authors' conclusion
CircS may provide a more comprehensive and interpretable framework for mortality risk prediction than MetS. Its potential incorporation into clinical and public health practice warrants further investigation.
Study context
- Population
- NHANES adults aged ≥ 20 years (n = 14,727 for metabolic syndrome (MetS); 13,799 for CircS) and UK Biobank adults aged ≥ 40 years (n = 404,028 for MetS; 376,236 for CircS)two cohorts
- Exposure
- MetS vs CircS as predictors of mortality
- Outcome
- All-cause, cardiovascular and cancer mortality
Methodological detailsdual-cohort analysis (NHANES and UK Biobank), Cox proportional hazards models, fully adjusted models
- Dual-cohort analysis (NHANES and UK Biobank)
- Cox proportional hazards models
- Fully adjusted models
Main finding
As reported in the abstract
All-cause mortality, UKB, fully adjusted
Hazard ratio (95 % CI)
MetS
1.30(1.26–1.33)
CircS
1.42(1.38–1.46)
%
- NHANES: MetS associated with increase in all-cause mortality
- 21
- NHANES: CircS associated with increase in all-cause mortality
- 34
Observational data: associations, not effects.
Further findings
Heart diseases mortality
| HR (95 % CI) | ||
|---|---|---|
| MetSUKB · fully adjusted models | 1.68 (1.58–1.79) | |
| CircSUKB · fully adjusted models | 1.78 (1.66–1.90) | |
| 0.512Hazard ratio (log scale) |
Cancer mortality, UKB
| HR (95 % CI) | ||
|---|---|---|
| MetS | 1.19 (1.15–1.24) | |
| CircS | 1.24 (1.19–1.29) | |
| 0.512Hazard ratio (log scale) |
CVD mortality, UKB
| HR (95 % CI) | ||
|---|---|---|
| MetS | 1.56 (1.48–1.64) | |
| CircS | 1.66 (1.56–1.75) | |
| 0.512Hazard ratio (log scale) |
Ischemic heart disease mortality, UKB
| HR (95 % CI) | ||
|---|---|---|
| MetS | 1.81 (1.68–1.96) | |
| CircS | 1.93 (1.79–2.09) | |
| 0.512Hazard ratio (log scale) |
Stroke mortality, UKB
| HR (95 % CI) | ||
|---|---|---|
| MetS | 1.36 (1.21–1.53) | |
| CircS | 1.42 (1.24–1.61) | |
| 0.512Hazard ratio (log scale) |
- Heart diseases mortality — NHANES: CircS associated with increase in heart diseases mortality
- 65 %
Prevalence
%
- NHANES MetS prevalence
- 41.1
- NHANES CircS prevalence
- 31.7
- UKB MetS prevalence
- 29.9
- UKB CircS prevalence
- 17.6
Subgroups by age
- Stronger associations in middle-aged adults, weaker in those ≥ 70 years
Model performance
- CircS-based models consistently outperformed MetS-based models in AIC and BIC
Original publication
Do circadian factors improve mortality risk prediction? A dual-cohort analysis of metabolic and circadian syndromes. Diabetes Res Clin Pract. Published 22 September 2025. doi:10.
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