Non-traditional metabolic indices predict incident circadian syndrome in middle-aged and older Chinese adults: a nationwide prospective cohort study and machine learning analysis.

Reversing the causal ordering (hs-CRP → index → CircS) changed the picture: both the CHG index and METS-IR produced clearly significant indirect effects (both ACME P < 0.001), pointing toward a model in which systemic inflammation feeds into CircS risk partly by perturbing atherogenic lipid handling and insulin homeostasis.

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