{
  "abstract": "BackgroundCircadian syndrome (CircS) comprises metabolic abnormalities, short sleep, and depressive symptoms, and is associated with cardiovascular, liver, and lung diseases and mortality; evidence on digestive disease is scarce. We assessed its association with incident non-neoplastic digestive disease in Chinese adults.\n\nMethodsIn this prospective analysis of the China Health and Retirement Longitudinal Study (CHARLS), we included 2011 baseline participants aged [≥]45 years free of digestive disease, with follow-up to 2018. CircS ([≥]4 of 7 components) was analysed as a continuous score and as a binary exposure. Cox models estimated hazard ratios (HRs) adjusting for demographic factors, BMI, smoking, and alcohol use. We did dose-response, component, subgroup, and sensitivity analyses; hs-CRP mediation was explored.\n\nFindings907 (19{middle dot}0%) of 4 771 participants developed digestive disease over a median 84 months. Each additional CircS component raised the risk by 9{middle dot}1% (HR 1{middle dot}091, 95% CI 1{middle dot}041-1{middle dot}144, P<0{middle dot}001); CircS positivity (36{middle dot}1%) was associated with a 25{middle dot}7% higher risk (HR 1{middle dot}257, 1{middle dot}084-1{middle dot}456, P=0{middle dot}002). Risk rose approximately linearly to about 70% higher at 5-7 components. Short sleep (HR 1{middle dot}178, 1{middle dot}017-1{middle dot}365) and depressive symptoms (HR 1{middle dot}570, 1{middle dot}367-1{middle dot}803) were the only independently associated components; no metabolic component was associated. Results were robust across sensitivity analyses; hs-CRP did not mediate the association.\n\nInterpretationCircS is associated with incident non-neoplastic digestive disease, driven by its circadian-emotional rather than metabolic components. Sleep and mood may be targets for prevention.\n\nFundingThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology, 923th Hospital of PLA Joint Logistics Support Force, Nanning, China"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "L. Liu"
    },
    {
      "name": "L. Zhao"
    },
    {
      "name": "C. Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Y. Geng"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5y5sv8grkbx5h.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.24.26363842",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363842v1.full",
  "id": "5y5sv8grkbx5h",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363842v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "gastroenterology"
    ],
    [
      "openalex",
      "2807|Circadian rhythm and melatonin"
    ]
  ],
  "openalex": "W7214336389",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363842v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5y5sv8grkbx5h.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:25Z",
      "native_id": "10.64898/2026.09.24.26363842",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.24.26363842v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2807|Circadian rhythm and melatonin",
      "subfield": "physiology"
    }
  ],
  "title": "Circadian syndrome and incident non-neoplastic digestive disease in middle-aged and older Chinese adults: a prospective cohort study",
  "title_text": "Circadian syndrome and incident non-neoplastic digestive disease in middle-aged and older Chinese adults: a prospective cohort study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:25Z",
  "url": "https://research.draconitic.com/paper/5y5sv8grkbx5h",
  "venue": "medRxiv",
  "versions": []
}