Diurnal Variation of Oral Glucose Tolerance: a Possible Pointer to the Evolution of Diabetes Mellitus

Possible diurnal variation in the blood sugar response to oral glucose was studied by comparing, in the same individuals, the results of oral glucose tolerance tests performed in the morning and the afternoon. In a group of normal individuals the blood sugar levels were significantly higher in the afternoon. In hyperglycaemic individuals the diurnal variation decreased as the blood sugar levels reached during the morning test increased, so that in a group of grossly hyperglycaemic men the mean morning and afternoon tests were almost identical. The causes of this diurnal variation are not known.     

Insulin Secretion in Hypothalamic Obesity: Diurnal Variation and the Effect of Naloxone

This paper has tested the hypothesis that patients with hypothalamic obesity have altered mechanisms controlling insulin secretion when compared to obese patients without hypothalamic injury. Fasting glucose and insulin values were significantly higher in the morning than in the afternoon in the six control obese patients, but there was no diurnal difference in the six patients with hypothalamic obesity (n=6). The control obese subjects showed a diurnal variation in glucose-stimulated insulin secretion, whereas the patients with hypothalamic obesity did not, suggesting that hypothalamic injury had destroyed diurnal rhythms. Naloxone, an opioid antagonist, acutely suppressed fasting insulin in the six patients with essential obesity but had little effect on fasting insulin in the three patients with hypothalamic obesity or in five normal-weight controls. Naloxone increased insulin sensitivity in the obese control patients, but did not affect either insulin secretion or insulin sensitivity in patients with hypothalamic obesity or in normal weight subjects. Our results support the conclusion that hypothalamic obesity disrupts diurnal rhythms, with the suggestion that opioid peptides affect insulin secretion differently in patients with essential obesity as compared to normal weight subjects or those with hypothalamic obesity.     

Diurnal Variation in Mental Activities of French Pupils and Influence of Test Protocol

The aim of the study was to determine the influence of the test protocol (individual vs. group) on the diurnal variations in mental activity of 18 11-year-old pupils. Number cancellation, a spatial orientation test, and mathematical problems were tested four times on three successive Fridays at 08:45, 11:15, 13:45 and 16:45 h. On the first and third Fridays the tests were performed on the group of subjects, whereas individual subjects were tested on the second Friday. Results indicated a possible influence of the test protocol (individual vs. group) on intellectual rhythmicity. Only in the group protocol did we find the psychological profile which is normally observed, namely, a performance increase during the morning, a postlunch fall, and then an increase in the afternoon. We suggest the existence of some group effect in these performance tests.     

Diurnal Variation in Mental Activities of French Pupils and Influence of Test Protocol

The aim of the study was to determine the influence of the test protocol (individual vs. group) on the diurnal variations in mental activity of 18 11-year-old pupils. Number cancellation, a spatial orientation test, and mathematical problems were tested four times on three successive Fridays at 08:45, 11:15, 13:45 and 16:45 h. On the first and third Fridays the tests were performed on the group of subjects, whereas individual subjects were tested on the second Friday. Results indicated a possible influence of the test protocol (individual vs. group) on intellectual rhythmicity. Only in the group protocol did we find the psychological profile which is normally observed, namely, a performance increase during the morning, a postlunch fall, and then an increase in the afternoon. We suggest the existence of some group effect in these performance tests.     

Effect of time-of-day-specific strength training on serum hormone concentrations and isometric strength in men

A time-of-day influence on the neuromuscular response to strength training has been previously reported. However, no scientific study has examined the influence of the time of day when strength training is performed on hormonal adaptations. Therefore, the primary purpose of this study was to examine the effects of time-of-day-specific strength training on resting serum concentrations and diurnal patterns of testosterone (T) and cortisol (CORT) as well as maximum isometric strength of knee extensors. Thirty eight diurnally active healthy, previously untrained men (age 20-45 yrs) underwent a ten-week preparatory strength training period when sessions were conducted between 17:00-19:00 h. Thereafter, these subjects were randomized into either a morning (n=20, training times 07:00-09:00 h) or afternoon (n=18, 7:00-19:00 h) training group for another ten-week period of time-of-day-specific training (TST). Isometric unilateral knee extension peak torque (MVC) was measured at 07:00, 12:00, 17:00, and 20:30 h over two consecutive days (Day 1 & Day 2) before and after TST. Blood samples were obtained before each clock-time measurement to assess resting serum T and CORT concentrations. A matched control group (n=11) did not train but participated in the tests. Serum T and CORT concentrations significantly declined from 07:00 to 20:30 h on all test days (Time effect, p<.001). Serum CORT at 07:00 h was significantly higher on Day 1 than Day 2 in the control and afternoon group, both in Pre and Post conditions (Day x Time interaction, p<.01). In the morning group, a similar day-to-day difference was present in the Pre but not Post conditions (Time x Group interaction, p<.05). MVC significantly increased after TST in both the morning and afternoon groups (Pre to Post effect, p<.001). In both groups, a typical diurnal variation in MVC (Time effect, p<.001) was found, especially on Day 2 in the Pre condition, and this feature persisted from Pre to Post in the afternoon group. In the morning group, however, diurnal variation was reduced after TST on both Day 1 and Day 2 (Pre to PostxDay x TimexGroup interaction, p<.05). In conclusion, 10 weeks of morning time-of-day-specific strength training resulted in reduced morning resting CORT concentrations, presumably as a result of decreased masking effects of anticipatory psychological stress prior to the morning testing. The typical diurnal pattern of maximum isometric strength was blunted by the TST period in the morning but not the afternoon group. However, the TST period had no significant effect on the resting total T concentration and its diurnal pattern and on the absolute increase in maximum strength.     

Diurnal Variation in Glucose Tolerance: Associated Changes in Plasma Insulin,Growth Hormone,and Non-esterified

Oral glucose tolerance tests were performed in the morning and afternoon of separate days on 31 people derived from a normal population sample. Blood sugar levels were higher in the afternoon test from and including 60 minutes after the glucose load. The degree of diurnal variation was similar in men and women, but greater in the older half of the group. It was negatively correlated with the degree of obesity. The plasma insulin response was less at the 30 minute time point in the afternoon, but significantly exceeded the morning values at 120 and 150 minutes after the glucose load. Growth hormone levels were similar in morning and afternoon tests. Fasting non-esterified fatty acid levels were significantly higher before the afternoon test.The relatively impaired glucose tolerance in the afternoon is associated with a delayed insulin response to the glucose load. This seems unlikely to be the sole explanation, however, and increased non-esterified fatty acid metabolism with a consequent decrease in glucose disposal may also contribute.     

Effect of Time‐of‐Day‐Specific Strength Training on Serum Hormone Concentrations and Isometric Strength in Men

A time‐of‐day influence on the neuromuscular response to strength training has been previously reported. However, no scientific study has examined the influence of the time of day when strength training is performed on hormonal adaptations. Therefore, the primary purpose of this study was to examine the effects of time‐of‐day‐specific strength training on resting serum concentrations and diurnal patterns of testosterone (T) and cortisol (CORT) as well as maximum isometric strength of knee extensors. Thirty eight diurnally active healthy, previously untrained men (age 20–45 yrs) underwent a ten‐week preparatory strength training period when sessions were conducted between 17:00–19:00 h. Thereafter, these subjects were randomized into either a morning (n=20, training times 07:00–09:00 h) or afternoon (n=18, 7:00–19:00 h) training group for another ten‐week period of time‐of‐day‐specific training (TST). Isometric unilateral knee extension peak torque (MVC) was measured at 07:00, 12:00, 17:00, and 20:30 h over two consecutive days (Day 1 & Day 2) before and after TST. Blood samples were obtained before each clock‐time measurement to assess resting serum T and CORT concentrations. A matched control group (n=11) did not train but participated in the tests. Serum T and CORT concentrations significantly declined from 07:00 to 20:30 h on all test days (Time effect, p<.001). Serum CORT at 07:00 h was significantly higher on Day 1 than Day 2 in the control and afternoon group, both in Pre and Post conditions (Day×Time interaction, p<.01). In the morning group, a similar day‐to‐day difference was present in the Pre but not Post conditions (Time×Group interaction, p<.05). MVC significantly increased after TST in both the morning and afternoon groups (Pre to Post effect, p<.001). In both groups, a typical diurnal variation in MVC (Time effect, p<.001) was found, especially on Day 2 in the Pre condition, and this feature persisted from Pre to Post in the afternoon group. In the morning group, however, diurnal variation was reduced after TST on both Day 1 and Day 2 (Pre to Post×Day×Time×Group interaction, p<.05). In conclusion, 10 weeks of morning time‐of‐day‐specific strength training resulted in reduced morning resting CORT concentrations, presumably as a result of decreased masking effects of anticipatory psychological stress prior to the morning testing. The typical diurnal pattern of maximum isometric strength was blunted by the TST period in the morning but not the afternoon group. However, the TST period had no significant effect on the resting total T concentration and its diurnal pattern and on the absolute increase in maximum strength.     

Further Observations on the Diurnal Variation in Oral Glucose Tolerance

Diurnal variation in oral glucose tolerance was studied in 122 male volunteers aged 40 yearsand over who participated in a screening health examination. In those with screening blood sugar levels exceeding 110 mg./100 ml. the degree of diurnal variation was least in those with the highest morning glycaemia; the latter also tended to have lower afternoon fasting bloodsugar levels.In a group of 40 control subjects, afternoon glucose tolerance tests yielded significantly higher post-glucose blood sugar levels. The degree of diurnal variation was significantly and inversely related to the degree of obesity.     

Diurnal Variation in Response to Intravenous Glucose

Intravenous glucose tolerance tests (25 g) were performed in the morning and afternoon on 13 apparently normal persons. The individual K values (rate of decline of blood sugar) were all higher in the morning tests, and the mean values were significantly higher in the morning. Fasting blood sugar levels were slightly lower in the afternoon. There was no difference between the fasting morning and afternoon plasma insulin levels, but the levels after glucose were lower in the afternoon. Growth hormone levels were low at all times in non-apprehensive subjects and unaffected by glucose. The results suggest that the impaired afternoon intravenous glucose tolerance, like oral glucose tolerance, is associated with impaired insulin release and insulin resistance.     

Collegiate rowing crew performance varies by morningness-eveningness

During adolescence and early adulthood, most humans are predisposed developmentally, both biologically and socially, toward evening/night activity. The morningness-eveningness (M-E) tendency to be an evening-preferring (E-type) rather than a morning-preferring (M-type) or intermediate/neither (N-type) "chronotype" may affect athletic performance at various times of day. This study evaluated M-E effects on rowing performance of an intact, experienced, university club crew with near-daily early morning (0500-0700 hours) and late afternoon (1630-1800 hours) training schedules. The hypothesis tested was that chronotype would modify circadian effects during morning and afternoon performances. Eight men and eight women (mean age 19.6 +/- 1.5 years) were tested in a randomized, counterbalanced design. A standard qualifying 2000-m ergometer rowing sprint and a nonroutine standing broad jump task were measured during early morning and late afternoon, separated by 3 days of rest. Each subject's chronotype was determined using two standard self-rating M-E scales, resulting in eight E-type (three women/five men), four M-type (two women/two men), and four N-type (three women/one man) subjects. The rowing results show that E-type and N-type subjects did not differ between morning and afternoon rowing performances, whereas M-type subjects rowed significantly faster in the morning. In contrast, the standing broad jump showed no consistent time-of-day or chronotype effect. These findings suggest that basic performance timing in young athletes is determined to some extent by naturally occurring M-E predispositions. Further, modification of time-of-day influences may be possible by routine practice at the same time each day, as was suggested here by the absence of evening superiority in performances. Understanding their personal M-E tendencies could allow young athletes to arrange training schedules at specific times of day to help counteract any natural circadian influences that might work against their performance.     

Time-of-day effects on anaerobic muscular power in a moderately warm environment

This study evaluated the influence of a neutral vs. a moderately warm environment on the diurnal variation in muscular power. Twelve male subjects [27.0 (+/-4) years] performed two different jump tests [a squat jump (SJ) and a counter-movement jump (CMJ)] and a brief maximal sprint on cycle ergometer (CS) in four different conditions (morning/neutral, morning/moderately warm and humid, afternoon/neutral, and afternoon/moderately warm and humid). The morning experiments were conducted between 07:00 and 09:00 h, and the afternoon experiments were conducted between 17:00 and 19:00 h. The mean laboratory temperatures and humidity were 20 (+/-1) degrees C, 70 (+/-5)% and 29 (+/-1) degrees C, 57 (+/-4)% for the neutral and moderately warm and humid conditions, respectively. Rectal temperature and leg skin temperature were significantly dependent on both time-of-day and ambient temperature. An interaction effect (P < 0.05) was noted between time-of-day and ambient temperature for the power developed for the CMJ, the SJ, and half of a pedal revolution during the cycling sprint. In summary, (i) the same subjects were influenced by time-of-day differently, depending on the ambient temperature during testing; (ii) time-of-day affected muscular performance only in the neutral condition, (iii) the moderately warm and humid condition blunted the diurnal variation in muscular performance, and (iv) the effect of the ambient temperature was dependent on time-of-day.     

Diurnal variation of salivary cortisol in captive African elephants (Loxodonta africana) under routine management conditions and in relation to a translocation event

The present study assessed the diurnal variation in salivary cortisol in captive African elephants during routine management (baseline) and in relation to a potential stressor (translocation) to evaluate to what extent acute stress may affect diurnal cortisol patterns. Under baseline conditions, we collected morning and afternoon saliva samples of 10 animals (three zoos) on different days in two study periods (n = 3–10 per animal, daytime and period). Under stress conditions, we sampled the transported cow (newcomer) and the two cows of the destination zoo before and after the transport in the morning and afternoon (n = 3–9 per animal, daytime and transport phase), as well as after the first introduction of the newcomer to the bull (n = 1 per animal). Cortisol was measured in unextracted samples by enzyme immunoassay. Under baseline conditions, we observed the expected diurnal variation with higher cortisol levels in the morning than in the afternoon. Under stress conditions, neither a significant difference between pre- and posttransport, nor between morning and afternoon levels was found. The percentage difference between morning and afternoon cortisol after the transport, however, was remarkably lower than before the transport in the newcomer potentially indicating a stress response to familiarization. Saliva samples taken immediately after the introduction of the newcomer to the bull revealed a marked cortisol increase. Our findings indicate that stressors may disturb the diurnal cortisol rhythm. Furthermore, provided that samples can be collected promptly, salivary cortisol is a useful minimally invasive measure of physiological stress in the African elephant.     

α1-Adrenoreceptor activity does not explain lower morning endothelial-dependent, flow-mediated dilation in humans

Early morning reduction in endothelium-dependent, flow-mediated dilation (FMD) may contribute to the high incidence of sudden cardiac death at this time of day. The mechanisms underpinning diurnal variation in FMD are unclear, but potentially relate to a circadian rhythm in sympathetic nerve activity. We hypothesized that blockade of α(1)-mediated sympathetic nerve activity would act to attenuate the diurnal variation in FMD. In a randomized and placebo-controlled design, we measured brachial artery FMD in 12 participants (mean age = 26 yr, SD = 3) at 0600 and 1600 after ingestion of an α(1)-blocker (prazosin, 1 mg/20 kg body mass) or placebo. Arterial diameter and shear rate were assessed using edge-detection software. Heart rate and blood pressure were also measured. Data were analyzed using linear mixed modeling. Following placebo, FMD was 8 ± 2% in the morning compared with 10 ± 3% in the afternoon (P = 0.04). Blockade with prazosin led to a slight but nonsignificant increase in morning FMD (P = 0.24) and a significant (P = 0.04) decrease in afternoon FMD, resulting in no diurnal variation (P = 0.20). Shear rate did not differ in the morning or afternoon under either condition (P > 0.23). Blood pressure was lower following prazosin compared with placebo (P < 0.02), an effect that was similar at both times of day (P > 0.34). Heart rate and norepinephrine levels were higher in the afternoon following prazosin. These data indicate that α(1)-adrenoreceptor activity does not explain lower morning endothelium-dependent FMD.     

The effect of training at a specific time of day: a review

This article focuses on physical performances after training at a specific time of day. To date, although the effect of time of day on aerobic performances appears to be equivocal, during anaerobic exercises, the effect of time of day has been well established with early morning nadirs and peak performances in the late afternoon. These diurnal rhythms can be influenced by several factors such as the regular training at a specific time of day. Indeed, regular training in the morning hours may increase the lower morning performances to the same or even higher level as their normal diurnal peak typically observed in the late afternoon by a greater increase of performance in the evening. However, regular training in the evening hours may increase the morning-evening (i.e., amplitude of the rhythm) difference by a greater increase of performance in the late afternoon. Therefore, adaptations to training are greater at the time of day at which training is regularly performed than at other times. Nevertheless, although modifications in resting hormones concentrations could explain this time-of-day specific adaptations, precise information on the underlying mechanisms is lacking.     

Time-of-Day Effects on Anaerobic Muscular Power in a Moderately Warm Environment

This study evaluated the influence of a neutral vs. a moderately warm environment on the diurnal variation in muscular power. Twelve male subjects [27.0 (±4) years] performed two different jump tests [a squat jump (SJ) and a counter-movement jump (CMJ)] and a brief maximal sprint on cycle ergometer (CS) in four different conditions (morning/neutral, morning/moderately warm and humid, afternoon/neutral, and afternoon/moderately warm and humid). The morning experiments were conducted between 07:00 and 09:00 h, and the afternoon experiments were conducted between 17:00 and 19:00 h. The mean laboratory temperatures and humidity were 20 (±1)°C, 70 (±5)% and 29 (±1)°C, 57 (±4)% for the neutral and moderately warm and humid conditions, respectively. Rectal temperature and leg skin temperature were significantly dependent on both time-of-day and ambient temperature. An interaction effect (P < 0.05) was noted between time-of-day and ambient temperature for the power developed for the CMJ, the SJ, and half of a pedal revolution during the cycling sprint. In summary, (i) the same subjects were influenced by time-of-day differently, depending on the ambient temperature during testing; (ii) time-of-day affected muscular performance only in the neutral condition, (iii) the moderately warm and humid condition blunted the diurnal variation in muscular performance, and (iv) the effect of the ambient temperature was dependent on time-of-day.     

Diurnal variation in vascular function: role of sleep

Although vascular function is lower in the morning than afternoon, previous studies have not assessed the influence of prior sleep on this diurnal variation. The authors employed a semiconstant routine protocol to study the contribution of prior nocturnal sleep to the previously observed impairment in vascular function in the morning. Brachial artery vascular function was assessed using the flow-mediated dilation technique (FMD) in 9 healthy, physically active males (mean ± SD: 27 ± 9 yrs of age), at 08:00 and 16:00 h following, respectively, 3.29 ± .37 and 3.24 ± .57 h prior sleep estimated using actimetry. Heart rate and systolic and diastolic blood pressures were also measured. The data of the experimental sleep condition were compared with the data of the "normal" diurnal sleep condition, in which FMD measurements were obtained from 21 healthy individuals who slept only during the night, as usual, before the morning test session. The morning-afternoon difference in FMD was 1 ± 4% in the experimental sleep condition compared with 3 ± 4% in the normal sleep condition (p =?.04). This difference was explained by FMD being 3 ± 3% lower in afternoon following the prior experimental sleep (p =?.01). These data suggest that FMD is more dependent on the influence of supine sleep than the endogenous circadian timekeeper, in agreement with our previous finding that diurnal variation in FMD is influenced by exercise. These findings also raise the possibility of a lower homeostatic "set point" for vascular function following a period of sleep and in the absence of perturbing hemodynamic fluctuation.     

Ectoparasites: are they the proximate cause of cleaning interactions?

We tested the importance of ectoparasites in cleaning symbioses by comparing the activity of Caribbean cleaning gobies ( Elacatinus evelynae ) and of their clients during three daily periods (early morning, midday and late afternoon) in which ectoparasite availability varied naturally. Emergence from the benthos of gnathiid isopod larvae, the main target of cleaning goby predation, was higher at night, when cleaners are inactive, than during the day. Overall ectoparasite loads also tended to be higher on clients in the morning. This coincided with higher rates of visits to cleaning stations by client fish in the morning than at midday, but high rates of client visits were also recorded in the late afternoon. Clients were more likely to adopt stereotypical incitation poses, which increase the likelihood of being cleaned, in the morning than later in the day. Inspection bouts by cleaning gobies were longest in the morning. Cleaner and client behaviours therefore change predictably in response to natural diurnal variation in ectoparasite availability. These results add to a growing number of studies supporting the idea that cleaning symbioses are mutualisms dependent on ectoparasite removal.     

Circadian Variation of Myocardial Ischemia in Patients with Stable Coronary Artery Disease

The circadian variation of myocardial ischemia detected during 24-h ambulatory electrocardiographic monitoring (AEM) was analyzed in 123 patients with stable angina pectoris, positive exercise test, and angiographically proven coronary artery disease. A total of 437 ischemic episodes (ST-segment depression ≥ 1 mm and duration ≥ 1 min) were observed; 333 (76%) episodes remained asymptomatic, and only 104 (24%) episodes were accompanied by anginal pain. Ischemic episodes predominantly occurred during the morning hours, between 6 a.m. and noon, and another smaller peak was observed in the afternoon, between 4 and 5 p.m.; this diurnal pattern was influenced neither by the extent of coronary artery disease nor the degree of left ventricular dysfunction. The circadian variation was restricted to the 345 (78%) ischemic episodes preceded by increases in heart rate; the 92 (22%) episodes without prior heart rate changes occurred randomly throughout the day. The morning peak in ischemic episodes was not associated with less myocardial oxygen supply; in contrast, heart rate profile showed parallel increases during the morning and afternoon hours, indicating elevated myocardial demand during these periods. Ischemia-related ventricular arrhythmias were concentrated during the morning hours, but their overall prevalence was low–28 (6%) of 437 ischemic episodes. These findings may provide further insight into the pathomechanisms of acute clinical events in patients with coronary artery disease, since the circadian variation of myocardial ischemia is very similar to that observed for the onset of myocardial infarction and sudden cardiac death.     

Diurnal variations in tonic pain reactions in mice

Diurnal changes in the behavioural reactions to subcutaneous formalin injection (20 microl, 1%) into the dorsum of an hindpaw were examined in female CBA/J mice aged 70-75 days, maintained in a 12/12 dark/ light cycle (light on at 07.00 h; light off at 19.00 h). Mice showed higher pain scores, as expressed by the amount of time spent licking the injected paw and by the number of flinching episodes, when tested under red light at the beginning of the dark phase (19.00-22.00: Dark group) than when tested either under white or red light at the beginning of the light phase of the diurnal cycle (7.00-10.00). The increases in pain reactions at night were found both during the first (0-10 min) and the second (11-55 min) phase of the behavioural response to formalin injection. They were not due to aspecific increases in motor behaviour, since self-grooming actually decreased in the Dark group during the second phase of the response, and the amount of locomotor activity after the injection was similar to, or lower than, that found in mice tested in the morning under white or red light, respectively. In another group of female CBA/J mice tested in the hotplate apparatus (at a temperature of 52 degrees), paw-lick latencies were significantly higher in mice tested at dark during the night, whereas jump (escape) latencies were higher in the morning. These results demonstrate different diurnal variations in the reactions to brief or prolonged noxious stimulation in mice, with greater responses to tonic pain at the onset of the dark phase.     

Circadian Variation of Myocardial Ischemia in Patients with Stable Coronary Artery Disease

The circadian variation of myocardial ischemia detected during 24-h ambulatory electrocardiographic monitoring (AEM) was analyzed in 123 patients with stable angina pectoris, positive exercise test, and angiographically proven coronary artery disease. A total of 437 ischemic episodes (ST-segment depression ≥ 1 mm and duration ≥ 1 min) were observed; 333 (76%) episodes remained asymptomatic, and only 104 (24%) episodes were accompanied by anginal pain. Ischemic episodes predominantly occurred during the morning hours, between 6 a.m. and noon, and another smaller peak was observed in the afternoon, between 4 and 5 p.m.; this diurnal pattern was influenced neither by the extent of coronary artery disease nor the degree of left ventricular dysfunction. The circadian variation was restricted to the 345 (78%) ischemic episodes preceded by increases in heart rate; the 92 (22%) episodes without prior heart rate changes occurred randomly throughout the day. The morning peak in ischemic episodes was not associated with less myocardial oxygen supply; in contrast, heart rate profile showed parallel increases during the morning and afternoon hours, indicating elevated myocardial demand during these periods. Ischemia-related ventricular arrhythmias were concentrated during the morning hours, but their overall prevalence was low-28 (6%) of 437 ischemic episodes. These findings may provide further insight into the pathomechanisms of acute clinical events in patients with coronary artery disease, since the circadian variation of myocardial ischemia is very similar to that observed for the onset of myocardial infarction and sudden cardiac death.