Mota Maria Carliana, Waterhouse Jim, De-Souza Daurea Abadia, Rossato Luana Thomazetto, Silva Catarina Mendes, Araújo Maria Bernadete Jeha, Tufik Sérgio, de Mello Marco Túlio, Crispim Cibele Aparecida
Faculty of Medicine of the Federal University of Uberlândia , Minas Gerais , Brazil .
Chronobiol Int. 2014 Dec;31(10):1130-8. doi: 10.3109/07420528.2014.957300. Epub 2014 Sep 18.
Shift work and long hours of work are common in medical training and have been associated with a higher propensity for developing nutritional problems and obesity. Changes in leptin and ghrelin concentrations - two hormones that contribute importantly to the central regulation of food intake - are poorly described in this population. The aim of this study was to identify possible negative associations between sleep patterns, nutritional status and serum levels of adipokines. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables, fasting metabolism, physical activity level, sleep quality and sleepiness. Resident physicians with poor sleep quality reported greater weight gain after the beginning of residency (5.1 and 3.0 kg, respectively; p = 0.01) and higher frequency of abnormal waist circumference (44.2 and 17.6%, respectively; p = 0.04) than those with better sleep quality. Mean ghrelin concentration was greater in volunteers with poor sleep quality (64.6 ± 67.8 and 26.2 ± 25.0 pg/mL, respectively; p = 0.04). Women identified as having excessive daytime sleepiness had lower levels of leptin (9.57 ± 10.4 ng/mL versus 16.49 ± 11.4 ng/mL, respectively; p = 0.03) than those without excessive sleepiness. Furthermore, correlations were found between hours of additional work per week and: intake of cereals, bread and pasta (r = 0.22, p = 0.01); intake of servings of fruits (r = -0.20; p = 0.02) and beans (r = -0.21; p = 0.01); and global score for Adapted Healthy Eating Index (r = -0.23; p = 0.008; Table 3). The sleep quality total score correlated with servings of beans (r = -0.22; p = 0.01) and servings of oils (r = 0.23; p = 0.008). Significant correlations were found between mean of time of sleep and servings of cereals, bread and pasta (r = 0.20; p = 0.02), servings of meat (r = -0.29; p = 0.02) and cholesterol levels (r = 0.27; p = 0.03). These observations indicate that sleep patterns and long working hours of resident physicians are negatively associated with biological markers related to central food control, the lipid profile, cholesterol levels and eating healthy foods. These factors may predispose these shift workers to become overweight and develop metabolic disorders.
轮班工作和长时间工作在医学培训中很常见,并且与出现营养问题和肥胖的较高倾向有关。瘦素和胃饥饿素浓度的变化——这两种对食物摄入的中枢调节起重要作用的激素——在这一人群中鲜有描述。本研究的目的是确定睡眠模式、营养状况和脂肪因子血清水平之间可能存在的负相关关系。该研究纳入了72名住院医师(52名女性和20名男性),他们接受了以下评估:营养评估(通过改良健康饮食指数评估的3天饮食回顾)、人体测量变量、空腹代谢、身体活动水平、睡眠质量和嗜睡情况。睡眠质量差的住院医师报告称,住院开始后体重增加更多(分别为5.1千克和3.0千克;p = 0.01),腰围异常的频率更高(分别为44.2%和17.6%;p = 0.04),高于睡眠质量较好的住院医师。睡眠质量差的志愿者的平均胃饥饿素浓度更高(分别为64.6±67.8和26.2±25.0 pg/mL;p = 0.04)。被确定为白天过度嗜睡的女性的瘦素水平低于没有过度嗜睡的女性(分别为9.57±10.4 ng/mL和16.49±11.4 ng/mL;p = 0.03)。此外,发现每周额外工作小时数与以下各项之间存在相关性:谷物、面包和面食的摄入量(r = 0.22,p = 0.01);水果份数的摄入量(r = -0.20;p = 0.02)和豆类摄入量(r = -0.21;p = 0.01);以及改良健康饮食指数的总体得分(r = -0.23;p = 0.008;表3)。睡眠质量总分与豆类份数(r = -0.22;p = 0.01)和油类份数(r = 0.23;p = 0.008)相关。睡眠时间平均值与谷物、面包和面食份数(r = 0.20;p = 0.02)、肉类份数(r = -0.29;p = 0.02)和胆固醇水平(r = 0.27;p = 0.03)之间存在显著相关性。这些观察结果表明,住院医师的睡眠模式和长时间工作与与中枢食物控制、血脂谱、胆固醇水平和健康饮食相关的生物标志物呈负相关。这些因素可能使这些轮班工作者易患超重和代谢紊乱。