Vimalananda Varsha G, Palmer Julie R, Gerlovin Hanna, Wise Lauren A, Rosenzweig James L, Rosenberg Lynn, Ruiz Narváez Edward A
Center for Health Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial VA Medical Center (152), 200 Springs Road, Bedford, MA, 01730, USA,
Diabetologia. 2015 Apr;58(4):699-706. doi: 10.1007/s00125-014-3480-9. Epub 2015 Jan 14.
AIMS/HYPOTHESIS: The aim of this study was to assess shift work in relation to incident type 2 diabetes in African-American women.
In the Black Women's Health Study (BWHS), an ongoing prospective cohort study, we followed 28,041 participants for incident diabetes during 2005-2013. They answered questions in 2005 about having worked a night shift. We estimated HR and 95% CIs for incident diabetes using Cox proportional hazards models. The basic multivariable model included age, time period, family history of diabetes, education and neighbourhood socioeconomic status. In further models, we controlled for lifestyle factors and BMI.
Over the 8 years of follow-up, there were 1,786 incident diabetes cases. Relative to never having worked the night shift, HRs (95% CI) for diabetes were 1.17 (1.04, 1.31) for 1-2 years of night-shift work, 1.23 (1.06, 1.41) for 3-9 years and 1.42 (1.19, 1.70) for ≥ 10 years (p-trend < 0.0001). The monotonic positive association between night-shift work and type 2 diabetes remained after multivariable adjustment (p-trend = 0.02). The association did not vary by obesity status, but was stronger in women aged <50 years.
CONCLUSIONS/INTERPRETATION: Long duration of shift work was associated with an increased risk of type 2 diabetes. The association was only partially explained by lifestyle factors and BMI. A better understanding of the mechanisms by which shift work may affect the risk of diabetes is needed in view of the high prevalence of shift work among workers in the USA.
目的/假设：本研究旨在评估非裔美国女性中轮班工作与2型糖尿病发病之间的关系。
在“黑人女性健康研究”（BWHS）这一正在进行的前瞻性队列研究中，我们在2005年至2013年期间对28,041名参与者进行随访以观察糖尿病发病情况。她们在2005年回答了有关是否曾上过夜班的问题。我们使用Cox比例风险模型估计糖尿病发病的风险比（HR）和95%置信区间（CI）。基本多变量模型包括年龄、时间段、糖尿病家族史、教育程度和邻里社会经济地位。在进一步的模型中，我们对生活方式因素和体重指数（BMI）进行了控制。
在8年的随访期间，有1,786例糖尿病发病病例。与从未上过夜班相比，上夜班1 - 2年的糖尿病HR（95%CI）为1.17（1.04, 1.31），3 - 9年为1.23（1.06, 1.41），≥10年为1.42（1.19, 1.70）（P趋势<0.0001）。多变量调整后，夜班工作与2型糖尿病之间的单调正相关仍然存在（P趋势=0.02）。该关联不因肥胖状况而有所不同，但在年龄<50岁的女性中更强。
结论/解读：长时间轮班工作与2型糖尿病风险增加相关。生活方式因素和BMI仅部分解释了这种关联。鉴于美国工人中轮班工作的高患病率，需要更好地了解轮班工作可能影响糖尿病风险的机制。
