Abnormalities in the 24‐hour rhythm of skin temperature in cirrhosis: Sleep‐wake and general clinical implications
Open accessAbstract
Background & Aims: Sleep preparation/onset are associated with peripheral vasodilatation and a decrease in body temperature. The hyperdynamic syndrome exhibited by patients with cirrhosis may impinge on sleep preparation, thus contributing to their difficulties falling asleep. The aim of this study was the assessment of skin temperature, in relation to sleep‐wake patterns, in patients with cirrhosis. Methods: Fifty‐three subjects were initially recruited, and 46 completed the study. Of the final 46, 12 were outpatients with cirrhosis, 13 inpatients with cirrhosis, 11 inpatients without cirrhosis and 10 healthy volunteers. All underwent baseline sleep‐wake evaluation and blood sampling for inflammatory markers and morning melatonin levels. Distal/proximal skin temperature and their gradient (DPG) were recorded for 24 hours by a wireless device. Over this period subjects kept a sleep‐wake diary. Results: Inpatients with cirrhosis slept significantly less well than the other groups. Inpatients and outpatients with cirrhosis had higher proximal temperature and blunted rhythmicity compared to the other groups. Inpatients with/without cirrhosis had higher distal temperature values and blunted rhythmicity compared to the other groups. Inpatients and outpatients with cirrhosis had significantly lower DPG values compared to the other groups, and DPG reached near‐zero values several hours later. Significant correlations were observed between temperature and sleep‐wake variables and inflammatory markers. Conclusions: Alterations of distal/proximal skin temperature, their gradient and their time‐course were observed in patients with cirrhosis, which may contribute to their sleep disturbances.
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The association between low wrist temperature amplitude and NAFLD corroborates the known loss in diurnal variance of distal skin temperature in cohorts of patients with liver cirrhosis compared to controls.
“This corroborates the known loss in diurnal variance of distal skin temperature in cohorts of patients with liver cirrhosis compared to controls28.”
From Diurnal rhythms of wrist temperature are associated with future disease risk in the UK Biobank (2023) · cites this paper as [28]
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Diurnal rhythms of wrist temperature are associated with future disease risk in the UK Biobank
Brooks, T. G., Lahens, N. F., Grant, G. R., Sheline, Y. I., FitzGerald, G. A., & Skarke, C. (2023) · Nature Communications · doi:10.1038/s41467-023-40977-5 · Cited by 57 · see citing works
- Authors
- Garrido, M., Saccardo, D., De Rui, M., Vettore, E., Verardo, A., Carraro, P., Di Vitofrancesco, N., Mani, A. R., Angeli, P., Bolognesi, M., & Montagnese, S.
- Affiliations
- Department of Medicine University of Padova Padova Italy
- University of Padua (IT)
- Laboratorio Analisi Azienda ULSS 12 Veneziana Mestre Italy
- Department of Laboratory Medicine University Hospital Padova Italy
- University College London (GB)
- Corresponding author
- Montagnese, Sara
- Venue
- Liver International
- Publisher
- Wiley
- Published
- 2017-08-12
- Volume
- 37
- Issue
- 12
- Pages
- 1833-1842
- ISSN
- 0106-9543 (ISSN-L)
- 1478-3223
- 1478-3231
- OpenAlex
- W2739252637
- Cited by
- 38
- References
- 41
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 2 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 3
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Liver International (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Funders
- Italian Ministry of Health (GR 2009-1604309)
- Gobierno de Extremadura (PO14013)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- liver cirrhosis, skin temperature, circadian rhythm, sleep-wake patterns, sleep disorders, hyperdynamic circulation, peripheral vasodilation, inflammatory markers, melatonin, sleep onset
- MeSH terms
- Aged, Circadian Rhythm, Female, Humans, Liver Cirrhosis, Male, Middle Aged, Skin Temperature, Sleep, Case-Control Studies
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