Copertaro A, Bracci M, Barbaresi Mariella, Santarelli Lory
Servizio del Medico Competente, ASUR-Zona 7 Ancona.
Med Lav. 2008 Nov-Dec;99(6):444-53.
Shift work is associated with coronary heart disease (CHD). Metabolic syndrome (MS) is associated with an increased risk of cardiovascular disease (CVD). An association between shift work and MS has been reported in some studies.
The purpose of this study was to compare the criteria of the National Cholesterol Education Panel (NCEP), revised NCEP (NCPEP-R) and International Diabetes Federation (IDF) metabolic syndrome criteria for the diagnosis of MS, also to explore how metabolic risk factors for CVD differ between shift workers and day workers in a cohort of Italian workers.
The study population consisted of 552 workers (361 men, 191 women; mean age 40.4 years) and included 262 healthcare providers (130 rotating shift nurses and 132 day nurses), 204 forestry workers and 86 factory workers. Fasting blood sugar level, HDL-cholesterol, triglycerides, blood pressure, and waist circumference were measured.
Healthcare providers had greater waist circumference (p< 0.01), serum triglycerides (p< 0.01) and fasting plasma glucose (p< 0.001) compare with the other worker categories. In comparison with day workers, rotating shift nurses had greater waist circumference (p<0.001), higher serum triglycerides (p< 0. 001) and fasting plasma glucose (p< 0.05), and lower concentrations of HDL cholesterol (p<0.01) The prevalence of MS according to NCEP criteria was 8.3%, according to NCEP-R criteria 9.3% and 12% according to IDF criteria. No significant association between MS and shift work was found. Abdominal obesity and high serum triglycerides was significantly associated with shift work after adjusting for age, sex, smoking, alcohol consumption and job seniority, with an OR of 2.74; 95% CI: 1.43-5.26 for high serum triglycerides and an OR of 1.81; 95% CI: 1.0-3.2 for abdominal obesity assessed according to IDF criteria. No significant association with NCEP and NCEP-R criteria was observed.
The data show greater prevalence of cardiovascular risk factors among healthcare providers. Shift work was significantly associated with high triglycerides and abdominal obesity using IDF criteria. Measurement of waist circumference is a simple and non-invasive method to use in the evaluation of metabolic risk factor for CVD.
轮班工作与冠心病（CHD）有关。代谢综合征（MS）与心血管疾病（CVD）风险增加有关。一些研究报告了轮班工作与MS之间的关联。
本研究的目的是比较美国国家胆固醇教育计划（NCEP）、修订后的NCEP（NCPEP-R）和国际糖尿病联盟（IDF）代谢综合征标准在诊断MS方面的标准，同时探讨意大利一组工人中轮班工人和日班工人的心血管疾病代谢危险因素有何不同。
研究人群包括552名工人（361名男性，191名女性；平均年龄40.4岁），包括262名医护人员（130名轮班护士和132名日班护士）、204名林业工人和86名工厂工人。测量空腹血糖水平、高密度脂蛋白胆固醇、甘油三酯、血压和腰围。
与其他工人类别相比，医护人员的腰围更大（p<0.01）、血清甘油三酯更高（p<0.01）和空腹血糖更高（p<0.001）。与日班工人相比，轮班护士的腰围更大（p<0.001）、血清甘油三酯更高（p<0.001）和空腹血糖更高（p<0.05），高密度脂蛋白胆固醇浓度更低（p<0.01）。根据NCEP标准，MS的患病率为8.3%，根据NCEP-R标准为9.3%，根据IDF标准为12%。未发现MS与轮班工作之间存在显著关联。在调整年龄、性别、吸烟、饮酒和工作年限后，腹部肥胖和高血清甘油三酯与轮班工作显著相关，高血清甘油三酯的比值比为2.74；95%可信区间：1.43-5.26，根据IDF标准评估的腹部肥胖的比值比为1.81；95%可信区间：1.0-3.2。未观察到与NCEP和NCEP-R标准有显著关联。
数据显示医护人员中心血管危险因素的患病率更高。使用IDF标准，轮班工作与高甘油三酯和腹部肥胖显著相关。腰围测量是评估心血管疾病代谢危险因素的一种简单且无创的方法。
