{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:01:01Z","timestamp":1785330061702,"version":"3.55.0"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronotype and sleep quality are related but non-identical dimensions of sleep health. We examined whether later chronotype is associated with subclinical visceral adiposity and atherogenic dyslipidaemia independently of perceived sleep quality, and whether this association differs by sex, in adults without previously diagnosed chronic disease. Materials and Methods: This single-centre cross-sectional study included 282 adults without previously diagnosed chronic disease or regular medication use. Chronotype was assessed with the Morningness\u2013Eveningness Questionnaire (MEQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Composite cardiometabolic indices were calculated from routine anthropometric and biochemical data. Primary dependent variables were log-transformed Visceral Adiposity Index (log[VAI]) and Atherogenic Index of Plasma (AIP). Multivariable linear models used heteroscedasticity-consistent type 3 (HC3) robust standard errors and adjusted for age, sex, education, physical activity, and PSQI; body mass index (BMI) was additionally included in the AIP model. Sex \u00d7 MEQ interactions, false-discovery-rate (FDR) correction, and glycaemic sensitivity analyses were performed. Results: Median age was 28.0 years; 50.4% were women, 25.9% were evening type, and 51.8% had poor sleep quality. Higher MEQ score (greater morningness) was independently associated with lower log(VAI) (B = \u22120.0096; 95% confidence interval (CI), \u22120.0159 to \u22120.0033; \u03b2 = \u22120.190; p = 0.003) and AIP (B = \u22120.0035; 95% CI, \u22120.0063 to \u22120.0008; \u03b2 = \u22120.160; p = 0.011), whereas PSQI was not independently associated with either outcome. Sex \u00d7 MEQ interactions were nominally significant and estimates were stronger in women, but interaction terms did not survive FDR correction. Associations persisted after excluding diabetes-range glycaemia but attenuated in strictly normoglycaemic participants. Conclusions: Later chronotype was associated with a less favourable subclinical adiposity\u2013atherogenic profile independently of perceived sleep quality. Findings are cross-sectional, and the sex-specific pattern is hypothesis-generating. Prospective studies with objective circadian, sleep, dietary-timing, behavioural, and hormonal measures are required.<\/jats:p>","DOI":"10.3390\/medicina62081472","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:45:14Z","timestamp":1785325514000},"page":"1472","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronotype and Atherogenic\u2013Adiposity Indices in Adults Without Previously Diagnosed Chronic Disease: A Sex-Aware Cross-Sectional Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-9663","authenticated-orcid":false,"given":"Kemal Ozan","family":"Lule","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7541-202X","authenticated-orcid":false,"given":"Serpil","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-6383","authenticated-orcid":false,"given":"Nezihe","family":"Otay Lule","sequence":"additional","affiliation":[{"name":"Nutrition and Dietetics Department, Faculty of Health Sciences, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9783-173X","authenticated-orcid":false,"given":"Mert Deniz","family":"Savcilioglu","sequence":"additional","affiliation":[{"name":"Cardiology Department, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7858-5123","authenticated-orcid":false,"given":"Hamit","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Marhefkov\u00e1, N., Sl\u00e1dek, M., Sumov\u00e1, A., and Dubsk\u00fd, M. (2024). Circadian dysfunction and cardio-metabolic disorders in humans. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1328139"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1002\/oby.23666","article-title":"Associations between circadian disruption and cardiometabolic disease risk: A review","volume":"31","author":"Knutson","year":"2023","journal-title":"Obesity"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1093\/advances\/nmac093","article-title":"Chronotype differences in body composition, dietary intake and eating behavior outcomes: A scoping systematic review","volume":"13","author":"Kruger","year":"2022","journal-title":"Adv. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1002\/oby.23749","article-title":"Evening types as determined by subjective and objective measures are more emotional eaters","volume":"31","author":"Garaulet","year":"2023","journal-title":"Obesity"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/advances\/nmab115","article-title":"Chronotype differences in energy intake, cardiometabolic risk parameters, cancer, and depression: A systematic review with meta-analysis of observational studies","volume":"13","author":"Lotti","year":"2022","journal-title":"Adv. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zhang, R., Cai, X., Lin, C., Yang, W., Lv, F., Wu, J., and Ji, L. (2022). The association between metabolic parameters and evening chronotype and social jetlag in non-shift workers: A meta-analysis. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1008820"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"De Amicis, R., Galasso, L., Leone, A., Vignati, L., De Carlo, G., Foppiani, A., Montaruli, A., Roveda, E., C\u00e8, E., and Esposito, F. (2020). Is abdominal fat distribution associated with chronotype in adults independently of lifestyle factors?. Nutrients, 12.","DOI":"10.3390\/nu12030592"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5831","DOI":"10.2147\/IJGM.S563616","article-title":"Sleep and cardiometabolic health: A narrative review of epidemiological evidence, mechanisms, and interventions","volume":"18","author":"Direksunthorn","year":"2025","journal-title":"Int. J. Gen. Med."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"He, J., Fan, Y., Zhang, L., Li, C., Guo, F., Zhu, J., Guo, P., Zhang, B., Zhang, M., and Zhang, M. (2023). Habitual night sleep duration is associated with general obesity and visceral obesity among Chinese women, independent of sleep quality. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1053421"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/occmed\/kqae121","article-title":"The Pittsburgh Sleep Quality Index: A brief review","volume":"75","author":"Carpi","year":"2025","journal-title":"Occup. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6593","DOI":"10.1111\/ejn.16551","article-title":"Chronotype, sleep quality, depression and pre-sleep rumination: A diary and actigraphy study","volume":"60","author":"Lamprou","year":"2024","journal-title":"Eur. J. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"H38","DOI":"10.1152\/ajpheart.00051.2024","article-title":"Chronotype and metabolic syndrome in midlife: Findings from the Northern Finland Birth Cohort 1966","volume":"327","author":"Lappalainen","year":"2024","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1001\/jamapediatrics.2019.3089","article-title":"Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence","volume":"173","author":"Quante","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e1351","DOI":"10.1210\/clinem\/dgae580","article-title":"Circadian alignment, cardiometabolic disease, and sex-specific differences in adults with overweight\/obesity","volume":"110","author":"Shafer","year":"2025","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Alexandre, M., Po\u00ednhos, R., Oliveira, B., and Correia, F. (2025). Chronotype, lifestyles, and anthropometric and biochemical indices for cardiovascular risk assessment among obese individuals. Nutrients, 17.","DOI":"10.3390\/nu17111858"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Thomas, J.M., Kern, P.A., Bush, H.M., Robbins, S.J., Black, W.S., Pendergast, J.S., and Clasey, J.L. (2024). Exploring the role of sex in the association of late chronotype on cardiorespiratory fitness. Physiol. Rep., 12.","DOI":"10.14814\/phy2.15924"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"De Morais, N.S., Azevedo, F.M., de Freitas Rocha, A.R., Morais, D.C., Ribeiro, S.A.V., Gon\u00e7alves, V.S.S., do Carmo Castro Franceschini, S., and Priore, S.E. (2023). Body fat is superior to body mass index in predicting cardiometabolic risk factors in adolescents. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20032074"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"920","DOI":"10.2337\/dc09-1825","article-title":"Visceral adiposity index: A reliable indicator of visceral fat function associated with cardiometabolic risk","volume":"33","author":"Amato","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kahn, H.S. (2005). The \u201clipid accumulation product\u201d performs better than the body mass index for recognizing cardiovascular risk: A population-based comparison. BMC Cardiovasc. Disord., 5.","DOI":"10.1186\/1471-2261-5-26"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0009-9120(01)00263-6","article-title":"The plasma parameter log (TG\/HDL-C) as an atherogenic index: Correlation with lipoprotein particle size and esterification rate inapob-lipoprotein-depleted plasma","volume":"34","author":"Frohlich","year":"2001","journal-title":"Clin. Biochem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1002\/oby.20408","article-title":"Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model","volume":"21","author":"Thomas","year":"2013","journal-title":"Obesity"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1038\/s41366-023-01388-0","article-title":"Waist-to-height ratio as a simple tool for predicting mortality: A systematic review and meta-analysis","volume":"47","author":"Hosseinpour","year":"2023","journal-title":"Int. J. Obes."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Liu, L., Luo, Y., Liu, M., Tang, C., Liu, H., Feng, G., Wang, M., Wu, J., and Zhang, W. (2024). Triglyceride glucose-related indexes and lipid accumulation products\u2014Reliable markers of insulin resistance in the Chinese population. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1373039"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_26","first-page":"97","article-title":"A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms","volume":"4","author":"Horne","year":"1976","journal-title":"Int. J. Chronobiol."},{"key":"ref_27","first-page":"40","article-title":"A Reliability study of the Turkish version of the Morningness\u2013Eveningness Questionnaire","volume":"16","author":"Ercan","year":"2005","journal-title":"Turk. Psikiyatr. Derg."},{"key":"ref_28","first-page":"107","article-title":"The validity and reliability of the Pittsburgh Sleep Quality Index","volume":"7","author":"Kara","year":"1996","journal-title":"Turk. Psikiyatr. Derg."},{"key":"ref_29","first-page":"1001","article-title":"Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients","volume":"85","author":"Onodera","year":"1984","journal-title":"Nihon Geka Gakkai Zasshi"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"806","DOI":"10.17826\/cumj.1309925","article-title":"Effects of sleep quality and insomnia severity on metabolic and anthropometric parameters in elderly individuals","volume":"48","author":"Mete","year":"2023","journal-title":"Cukurova Med. J."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Agius, R., Pace, N.P., and Fava, S. (2024). Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight. Diabetes Metab. Res. Rev., 40.","DOI":"10.1002\/dmrr.3725"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kim, S.H., Cho, Y.K., Kim, Y.-J., Jung, C.H., Lee, W.J., Park, J.-Y., Huh, J.H., Kang, J.G., Lee, S.J., and Ihm, S.-H. (2022). Association of the atherogenic index of plasma with cardiovascular risk beyond the traditional risk factors: A nationwide population-based cohort study. Cardiovasc. Diabetol., 21.","DOI":"10.1186\/s12933-022-01522-8"},{"key":"ref_33","first-page":"1045","article-title":"Associations between chronotype, morbidity and mortality in the UK Biobank cohort","volume":"35","author":"Knutson","year":"2018","journal-title":"Chronobiol. Int."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Li, Y., Feng, Y., Li, S., Ma, Y., Lin, J., Wan, J., and Zhao, M. (2023). The atherogenic index of plasma (AIP) is a predictor for the severity of coronary artery disease. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1140215"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1007\/s00125-020-05238-w","article-title":"Chrono-nutrition for the prevention and treatment of obesity and type 2 diabetes: From mice to men","volume":"63","author":"Hawley","year":"2020","journal-title":"Diabetologia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1080\/07420528.2023.2180385","article-title":"The relationship between chronotype and obesity: A systematic review","volume":"40","author":"Sert","year":"2023","journal-title":"Chronobiol. Int."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Wang, Y., Wang, X., and Zeng, L. (2024). Lipid accumulation product as a predictor of prediabetes and diabetes: Insights from NHANES data (1999\u20132018). J. Diabetes Res., 2024.","DOI":"10.1155\/2024\/2874122"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Witarto, B.S., Witarto, A.P., Visuddho, V., Wungu, C.D.K., Maimunah, U., Rejeki, P.S., and Oceandy, D. (2024). Gender-specific accuracy of lipid accumulation product index for the screening of metabolic syndrome in general adults: A meta-analysis. Lipids Health Dis., 23.","DOI":"10.1186\/s12944-024-02190-1"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Zhang, X., Ma, N., Lin, Q., Chen, K., Zheng, F., Wu, J., Dong, X., and Niu, W. (2024). Body roundness index and all-cause mortality among US adults. JAMA Netw. Open, 7.","DOI":"10.1001\/jamanetworkopen.2024.15051"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Xu, J., Zhang, L., Wu, Q., Zhou, Y., Jin, Z., Li, Z., and Zhu, Y. (2021). Body roundness index is a superior indicator to associate with the cardio-metabolic risk: Evidence from a cross-sectional study with 17,000 Eastern-China adults. 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