脂质代谢昼夜节律机制及其对脑卒中发病的影响综述

doi:10.3969/j.issn.1674-8115.2026.05.014

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (5): 672-679.doi: 10.3969/j.issn.1674-8115.2026.05.014

• 综述 • 上一篇

脂质代谢昼夜节律机制及其对脑卒中发病的影响综述

李北¹^,², 李婧晨², 郭熙朗², 於原思渡², 罗亦弘², 胡琴³(), 高丽¹()

^1.上海交通大学医学院附属仁济医院神经内科，上海 200127
^2.上海交通大学医学院仁济临床医学院，上海 200127
^3.上海交通大学医学院附属仁济医院神经外科，上海 200127

收稿日期:2025-12-20 接受日期:2026-02-02 出版日期:2026-05-28 发布日期:2026-05-28
通讯作者: 高　丽，副主任医师，博士；电子信箱：gaoli246619@126.com
胡　琴，研究员，博士；电子信箱：huqinle20010709@126.com。
基金资助:
上海交通大学“交大之星”医工交叉项目(YG2023QNB10);上海交通大学医学院大学生创新训练计划(20260241);仁济医院国自然推进项目(RJTJ26-MS-017)

Review of circadian rhythm mechanism of lipid metabolism and its impact on the incidence of stroke

Li Bei¹^,², Li Jingchen², Guo Xilang², Yu Yuansidu², Luo Yihong², Hu Qin³(), Gao Li¹()

^1.Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
^2.Renji Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
^3.Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China

Received:2025-12-20 Accepted:2026-02-02 Online:2026-05-28 Published:2026-05-28
Contact: Gao Li, E-mail: gaoli246619@126.com
Hu Qin, E-mail: huqinle20010709@126.com.
Supported by:
Fundamental Research Funds for the Central Universities(YG2023QNB10);Innovative Training Program for College Students of Shanghai Jiao Tong University School of Medicine(20260241);National Natural Science Foundation of China Promotion Project of Renji Hospital, Shanghai Jiao Tong University School of Medicine(RJTJ26-MS-017)

摘要/Abstract

摘要：

脑卒中作为一种以局灶性或全脑功能损害为核心临床特征的脑血管病，具有高发病率、高致残率与高死亡率的特征，其发病具有一定的昼夜节律性。随着现代生活节奏加快以及科技的发展，夜班工作、跨时区出行增多，同时电子产品使用时长与娱乐时间的延长，致使昼夜节律紊乱的人群增加。已有研究证实，昼夜节律紊乱与代谢综合征、心脑血管疾病等多种疾病的发病风险显著相关，但其具体机制尚未明晰。脂质代谢异常是脑卒中，特别是缺血性脑卒中发病的重要危险因素。机体内脂质的消化、吸收、运输、合成、分解及氧化过程，均受到中枢和外周分子钟的精确调控，呈现出显著的时序特征。昼夜节律紊乱与脂质代谢异常、动脉粥样硬化密切相关。该文对昼夜节律调控脂质代谢的机制，及其在脑卒中发病与进展中的作用进行综述，并基于此提出脑卒中“时间疗法”的新策略。

关键词: 脑卒中, 昼夜节律, 脂质代谢, 分子钟, 时间疗法, 动脉粥样硬化, 血脂异常

Abstract:

Stroke, a cerebrovascular disease characterized by focal or global brain function impairment as its core clinical feature, is associated with high incidence, disability, and mortality rates. Its onset exhibits a certain circadian rhythmicity. With the acceleration of modern life rhythms and the development of science and technology, the prevalence of night-shift work and cross-time-zone travel has increased. Meanwhile, prolonged use of electronic products and extended entertainment time have led to an increase in the number of people with circadian rhythm disorders. Existing studies have confirmed that circadian rhythm disorders are significantly associated with the risk of various diseases, such as metabolic syndrome and cardiovascular and cerebrovascular diseases. However, the specific mechanisms remain unclear. Abnormal lipid metabolism is an important risk factor for stroke, especially ischemic stroke. The processes of lipid digestion, absorption, transport, synthesis, decomposition, and oxidation in the body are precisely regulated by central and peripheral molecular clocks, showing significant temporal characteristics. Circadian rhythm disorders are closely related to abnormal lipid metabolism and atherosclerosis. This article reviews the mechanisms by which circadian rhythms regulate lipid metabolism and their role in the onset and progression of stroke, and based on this, proposes new targets for stroke chronotherapy.

Key words: stroke, circadian rhythm, lipid metabolism, molecular clock, chronotherapy, atherosclerosis, dyslipidemia

中图分类号:

R743.3

李北, 李婧晨, 郭熙朗, 於原思渡, 罗亦弘, 胡琴, 高丽. 脂质代谢昼夜节律机制及其对脑卒中发病的影响综述[J]. 上海交通大学学报（医学版）, 2026, 46(5): 672-679.

Li Bei, Li Jingchen, Guo Xilang, Yu Yuansidu, Luo Yihong, Hu Qin, Gao Li. Review of circadian rhythm mechanism of lipid metabolism and its impact on the incidence of stroke[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(5): 672-679.

图/表 2

图1 现代生活方式导致的昼夜节律紊乱与脑卒中发病的相关性Note： GLUT4—glucose transporter type 4; NO—nitric oxide; VLDL—very-low-density lipoprotein; LDL—low-density lipoprotein; ROS—reactive oxygen species.

Fig 1 Association between modern lifestyle-induced circadian rhythm disruption and the incidence of stroke

图2 外周组织脂质代谢的昼夜节律分子机制Note： SCN—suprachiasmatic nucleus; CLOCK—circadian locomotor output cycles kaput; Per1/2/3—period circadian regulator 1/2/3; INSIG—insulin induced gene; DGAT-2—diacylglycerol O-acyltransferase 2; ACAD11—acyl-CoA dehydrogenase family member 11; Cry—cryptochrome; Pparα—peroxisome proliferator-activated receptor α; ATGL—adipose triglyceride lipase; HSL—hormone-sensitive lipase; SREBP1c—sterol regulatory element-binding protein 1c.

Fig 2 Molecular mechanisms of circadian rhythm regulation in peripheral lipid metabolism

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脂质代谢昼夜节律机制及其对脑卒中发病的影响综述

Review of circadian rhythm mechanism of lipid metabolism and its impact on the incidence of stroke

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