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来自布法罗心血管代谢职业警察压力研究的警察中轮班工作与免疫细胞的关联。

Association of shiftwork and immune cells among police officers from the Buffalo Cardio-Metabolic Occupational Police Stress study.

作者信息

Wirth Michael D, Andrew Michael E, Burchfiel Cecil M, Burch James B, Fekedulegn Desta, Hartley Tara A, Charles Luenda E, Violanti John M

机构信息

a Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , USA.

b Department of Epidemiology and Biostatistics , University of South Carolina , Columbia , SC , USA.

出版信息

Chronobiol Int. 2017;34(6):721-731. doi: 10.1080/07420528.2017.1316732. Epub 2017 May 10.

Abstract

Shift workers suffer from a constellation of symptoms associated with disruption of circadian rhythms including sleep abnormalities, and abnormal hormone secretion (e.g. melatonin, cortisol). Recent, but limited, evidence suggests that shift workers have elevated levels of circulating white blood cells (WBCs) compared to their day working counterparts. Interestingly, recent reviews highlight the strong linkage between the immune system and circadian rhythms which includes, but is not limited to, circulating cell populations and functions. The elevated levels of these WBCs may be associated with the increased chronic disease risk observed among this group. The purpose of this analysis was to examine the cross-sectional association between long- and short-term (3, 5, 7, and 14 days) shiftwork (SW) and counts of WBCs among officers in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) cohort. Data collection for this analysis took place among 464 police officers working in Buffalo, New York, USA between 2004 and 2009. Precise SW histories were obtained using electronic payroll records. Officers were assigned a shift type based on the shift (i.e. day, evening, night) that they spent a majority (i.e. ≥50%) of their time from 1994 to the data collection date for long-term SW. The same process was applied to SW over 3, 5, 7, and 14 days prior to data collection. A fasted blood sample collected in the morning of a non-work day was used for characterization of WBCs (total), neutrophils, monocytes, lymphocytes, eosinophils, and basophils. Potential confounding factors included demographic characteristics (e.g. age, sex, race), occupational characteristics (e.g. rank), health behaviors (e.g. smoking, alcohol consumption, diet), anthropometrics, and other biomarkers (e.g. lipids, hemoglobin A1C, leptin). Generalized linear models were used to estimate least square means of the immune cells according to SW categorization for long- and short-term SW histories. Compared to the day shift group, those working long-term night shifts had greater absolute numbers of total WBCs, neutrophils, lymphocytes, and monocytes (all p < 0.05). Those working mainly on the night shift over 7-days had elevated counts of WBCs, lymphocytes, and monocytes (p < 0.05) compared to those mainly working day shifts. Results based on 3-, 5-, and 14-day SW were similar to the 7-day results. This study corroborates other studies with similar findings. However, this analysis provided insights into the effect of both long- and short-term SW on the number of circulating WBCs. SW may lead to disruption of circadian-influenced components of the immune system, which in term, may result in various chronic diseases. These findings, plus previous findings, may provide evidence that SW may lead to immune system dysregulation. Future research is needed to understand whether increases in immune cells among shift workers may be associated with the increased disease risk among this group.

摘要

轮班工作者会出现一系列与昼夜节律紊乱相关的症状,包括睡眠异常和激素分泌异常(如褪黑素、皮质醇)。近期虽有但有限的证据表明,与日班工作的同行相比,轮班工作者的循环白细胞(WBC)水平有所升高。有趣的是,近期的综述强调了免疫系统与昼夜节律之间的紧密联系,这包括但不限于循环细胞群体及其功能。这些白细胞水平的升高可能与该群体中观察到的慢性病风险增加有关。本分析的目的是研究在布法罗心脏代谢职业警察压力(BCOPS)队列中,长期和短期(3天、5天、7天和14天)轮班工作(SW)与警察白细胞计数之间的横断面关联。本分析的数据收集工作于2004年至2009年在美国纽约州布法罗市工作的464名警察中进行。使用电子工资记录获取精确的轮班工作历史。根据1994年至数据收集日期期间轮班工作者大部分时间(即≥50%)所从事的班次(即日班、晚班、夜班)为其分配班次类型,以此确定长期轮班工作情况。在数据收集前3天、5天、7天和14天的轮班工作情况也采用同样的方法确定。在非工作日的早晨采集空腹血样,用于白细胞(总数)、中性粒细胞、单核细胞、淋巴细胞、嗜酸性粒细胞和嗜碱性粒细胞的特征分析。潜在的混杂因素包括人口统计学特征(如年龄、性别、种族)、职业特征(如职级)、健康行为(如吸烟、饮酒、饮食)、人体测量学指标以及其他生物标志物(如血脂、糖化血红蛋白A1C、瘦素)。采用广义线性模型根据长期和短期轮班工作历史的轮班分类来估计免疫细胞的最小二乘均值。与日班组相比,长期上夜班的人员白细胞总数、中性粒细胞、淋巴细胞和单核细胞的绝对数量更多(所有p<0.05)。与主要上日班的人员相比,在7天内主要上夜班的人员白细胞、淋巴细胞和单核细胞计数升高(p<0.05)。基于3天、5天和14天轮班工作情况的结果与7天的结果相似。本研究证实了其他有类似发现的研究。然而,本分析深入探讨了长期和短期轮班工作对循环白细胞数量的影响。轮班工作可能导致免疫系统中受昼夜节律影响的成分紊乱,进而可能引发各种慢性疾病。这些发现以及之前的发现可能为轮班工作可能导致免疫系统失调提供证据。未来需要开展研究,以了解轮班工作者免疫细胞数量的增加是否与该群体疾病风险的增加有关。

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