Association between circadian syndrome and biological age acceleration among Chinese middle-aged and older adults: evidence from CHARLS

Abstract

Circadian syndrome (CircS), characterized by circadian rhythm disruption and metabolic abnormalities, has been associated with various adverse health outcomes. However, its association with biological age acceleration remains unclear. This study aimed to investigate the association between CircS and biological age acceleration and the potential mediating role of estimated glucose disposal rate (eGDR) using data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 8,703 participants were included in the cross-sectional analysis and 3,075 participants in the longitudinal analysis. CircS was defined as the presence of at least four of seven predefined components. Biological aging was assessed using Klemera-Doubal method biological age (KDM-BA), and biological age acceleration was calculated as biological age minus chronological age. Multivariable linear regression and Cox proportional hazards models were applied to evaluate the associations of CircS with biological age acceleration in cross-sectional and longitudinal analyses, respectively. Restricted cubic spline (RCS), exploratory mediation analysis, subgroup analyses, and sensitivity analyses were additionally performed. CircS was significantly associated with biological age acceleration in both cross-sectional and longitudinal analyses. In the fully adjusted cross-sectional model, CircS was associated with a 1.61-year increase in biological age acceleration (β = 1.61, 95% CI: 1.37–1.85). In the longitudinal analysis, CircS was associated with a 55% higher risk of incident biological age acceleration (HR = 1.55, 95% CI: 1.36–1.77). Increasing numbers of CircS components were associated with progressively higher levels and risks of biological age acceleration (all P for trend < 0.001). Exploratory mediation analysis showed that baseline eGDR partially mediated the association between CircS and incident biological age acceleration during follow-up, with an estimated mediated proportion of 47.8%. CircS was significantly associated with biological age acceleration among Chinese middle-aged and older adults in both cross-sectional and longitudinal analyses. Exploratory mediation analysis suggested that eGDR may partially account for this association. These findings suggest CircS may represent an important risk factor for biological aging and underscore the potential importance of maintaining circadian rhythm and metabolic health in slowing biological aging.

The authors' abstract, as published at the source. Scientific Reports, 2026 · DOI ↗