Silva-Costa Aline, Rotenberg Lucia, Coeli Claudia Medina, Nobre Aline Araújo, Griep Rosane Härter
a National School of Public Health , FIOCRUZ , Rio de Janeiro , Brazil.
b Oswaldo Cruz Foundation , Laboratory of Health and Environment Education , Rio de Janeiro , Brazil.
Chronobiol Int. 2016;33(1):64-72. doi: 10.3109/07420528.2015.1115765. Epub 2016 Jan 5.
Night work has been suggested as a risk factor for diabetes. Individuals with high triglyceride levels, high LDL cholesterol, low HDL cholesterol and obesity, especially abdominal obesity, have a greater chance of developing diabetes. The aim of this study was to analyze glycemic levels, total cholesterol, HDL-C, LDL-C, triglycerides and the anthropometric alterations that precede diabetes, considering their possible association with nigh work among a non-diabetic population. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) comprises of 15,105 civil servants (35-74 years old) at baseline (2008-2010). The following parameters were analyzed: serum cholesterol (total cholesterol, HDL-C, LDL-C), triglycerides and glucose drawn from 12-hour fasting blood sample, glycated hemoglobin and 2-hour plasma glucose obtained after a 75 g oral glucose tolerance test, BMI, hip and waist measurements using standard equipment and techniques. Participants with diabetes, retired workers and day workers with previous experience of night work were excluded. Generalized linear models, a gamma regression model with an identity link function, were performed to test the association of night work with metabolic and anthropometric variables. The study sample consisted of 3918 men and 4935 women; 305 (7.8%) and 379 (7.7%) of the participants were men and women who worked at night, respectively. Among the men, the exposure to night work was associated with an increase in BMI (b-value = 0.542; p = 0.032) and waist circumference (b-value = 1.66; p = 0.014). For women, increased fasting plasma glucose (b-value = 2.278; p < 0.001), glycated hemoglobin (b-value = 0.099, p < 0.001) and 2 hour plasma glucose (b-value = 5.479, p = 0.001) were associated with night work after adjustments. No significant associations between night work and triglycerides, LDL-C, HDL-C, total cholesterol levels or waist-hip ratio were found. The influences of night work on metabolic and anthropometric factors suggest night work as a potential risk factor for type 2 diabetes. Further studies are needed to investigate the inconclusive data on gender differences in the associations.
夜班工作被认为是糖尿病的一个风险因素。甘油三酯水平高、低密度脂蛋白胆固醇高、高密度脂蛋白胆固醇低以及肥胖,尤其是腹部肥胖的个体,患糖尿病的几率更大。本研究的目的是分析血糖水平、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯以及糖尿病前期的人体测量学改变,并考虑它们与非糖尿病人群夜班工作的可能关联。巴西成人健康纵向研究(ELSA - Brasil)在基线期(2008 - 2010年)纳入了15105名公务员(35 - 74岁)。分析了以下参数:从12小时空腹血样中测得的血清胆固醇(总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)、甘油三酯和葡萄糖、糖化血红蛋白以及75克口服葡萄糖耐量试验后测得的2小时血浆葡萄糖、使用标准设备和技术测量的体重指数、臀围和腰围。患有糖尿病的参与者、退休工人以及有夜班工作经历的日班工人被排除。采用广义线性模型,即具有恒等连接函数的伽马回归模型,来检验夜班工作与代谢和人体测量学变量之间的关联。研究样本包括3918名男性和4935名女性;分别有305名(7.8%)男性和379名(7.7%)女性从事夜班工作。在男性中,从事夜班工作与体重指数增加(b值 = 0.542;p = 0.032)和腰围增加(b值 = 1.66;p = 0.014)相关。对于女性,调整后空腹血糖升高(b值 = 2.278;p < 0.001)、糖化血红蛋白升高(b值 = 0.099,p < 0.001)和2小时血浆葡萄糖升高(b值 = 5.479,p = 0.001)与夜班工作相关。未发现夜班工作与甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇水平或腰臀比之间存在显著关联。夜班工作对代谢和人体测量学因素的影响表明夜班工作是2型糖尿病的一个潜在风险因素。需要进一步研究来调查这些关联中关于性别差异的不确定数据。