{
  "abstract": "Objectives The objectives were to examine the associations between accelerometer-measured circadian rest–activity rhythm (CRAR), the most prominent circadian rhythm in humans and the risk of mortality from all-cause, cancer and cardiovascular disease (CVD) in patients with cancer.Methods 7456 cancer participants from the UK Biobank were included. All participants wore accelerometers from 2013 to 2015 and were followed up until 24 January 2024, with a median follow-up of 9.00 years. The multidimensional parameters of the CRAR were calculated using the 7-day accelerometer data collected under free-living conditions. Cox proportional hazard models were used to evaluate the associations between CRAR and all-cause, cancer and CVD mortality.Results Among 7456 cancer patients (mean age: 65.7±6.87 years; 58.85% women) aged 44–79 years, 934 (12.5%) deaths occurred over 9.00 years (64 525 person-years). CRAR disruptions, including low amplitude, low mesor and high fragmentation, were significantly associated with an increased risk of all-cause mortality (adjusted HR range, 1.30–2.00), cancer (adjusted HR range, 1.46–1.83) and CVD mortality (adjusted HR range, 1.73–2.66) in patients with cancer.Discussion These associations were robust across various cancer types. In addition, CRAR disruptions, particularly low amplitude, exceeded multiple traditional risk factors such as poor sleep, smoking, alcohol consumption, obesity and unhealthy diet in predicting mortality.Conclusion CRAR parameters may serve as novel and robust predictors of mortality in patients with cancer.",
  "authors": [
    {
      "affiliations": [
        "Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Xionge Mei"
    },
    {
      "affiliations": [
        "Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Nana Zheng"
    },
    {
      "affiliations": [
        "Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Biao Li"
    },
    {
      "affiliations": [
        "Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "Yue Liu"
    },
    {
      "affiliations": [
        "Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China"
      ],
      "name": "Lulu Yang"
    },
    {
      "affiliations": [
        "Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Tong Luo"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"
      ],
      "name": "Ngan Yin Chan"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"
      ],
      "name": "Joey Wy Chan"
    },
    {
      "affiliations": [
        "Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"
      ],
      "name": "Yaping Liu"
    },
    {
      "affiliations": [
        "Department of Big Data in Health Science, Zhejiang University School of Public Health and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "Department of Medical Sciences, Uppsala Universitet, Uppsala, Sweden"
      ],
      "name": "Xiao Tan"
    },
    {
      "affiliations": [
        "Molecular Neuropharmacology, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Christian Benedict"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China",
        "Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"
      ],
      "name": "Yun Kwok Wing"
    },
    {
      "affiliations": [
        "Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China"
      ],
      "name": "Jihui Zhang"
    },
    {
      "affiliations": [
        "Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China",
        "Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Hongliang Feng"
    }
  ],
  "title": "Wearable device-measured circadian rest–activity rhythm with mortality risk in patients with cancer",
  "uid": "59e66fac-fbc3-539c-a645-29444bafb36a"
}