Manodpitipong Areesa, Saetung Sunee, Nimitphong Hataikarn, Siwasaranond Nantaporn, Wongphan Thanawat, Sornsiriwong Chotima, Luckanajantachote Pranee, Mangjit Prasitchai, Keesukphan Prasit, Crowley Stephanie J, Hood Megan M, Reutrakul Sirimon
Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
International Health Policy Progeam (IHPP), Ministry of Public Health, Nonthaburi, Thailand.
J Sleep Res. 2017 Dec;26(6):764-772. doi: 10.1111/jsr.12554. Epub 2017 May 26.
The circadian system plays a role in regulating metabolism. Night-shift work, a form of circadian misalignment, is associated with increased type 2 diabetes risk. This study aimed to determine if night-shift workers with type 2 diabetes experience poorer glycaemic control than non-shift workers. Patients with type 2 diabetes (104 unemployed, 85 day workers and 60 night-shift workers) participated. Sleep duration, sleep quality, morningness-eveningness preference, depressive symptoms and dietary intake were assessed using standardized questionnaires. Haemoglobin A1c levels were measured. Night-shift workers had significantly higher haemoglobin A1c levels compared with others, while there were no differences between day workers and unemployed participants (median 7.86% versus 7.24% versus 7.09%, respectively). Additionally, night-shift workers were younger, had a higher body mass index, and consumed more daily calories than others. Among night-shift workers, there were no significant differences in haemoglobin A1c levels between those performing rotating versus non-rotating shifts (P = 0.856), or those with clockwise versus counterclockwise shift rotation (P = 0.833). After adjusting for age, body mass index, insulin use, sleep duration, morningness-eveningness preference and percentage of daily intake from carbohydrates, night-shift work, compared with day work, was associated with significantly higher haemoglobin A1c (B = 0.059, P = 0.044), while there were no differences between unemployed participants and day workers (B = 0.016, P = 0.572). In summary, night-shift work is associated with poorer glycaemic control in patients with type 2 diabetes.
昼夜节律系统在调节新陈代谢中发挥作用。夜班工作是昼夜节律失调的一种形式，与2型糖尿病风险增加有关。本研究旨在确定2型糖尿病夜班工作者的血糖控制是否比非夜班工作者更差。2型糖尿病患者（104名失业者、85名日班工作者和60名夜班工作者）参与了研究。使用标准化问卷评估睡眠时长、睡眠质量、晨型-夜型偏好、抑郁症状和饮食摄入量。测量糖化血红蛋白水平。与其他组相比，夜班工作者的糖化血红蛋白水平显著更高，而日班工作者和失业参与者之间没有差异（中位数分别为7.86%、7.24%和7.09%）。此外，夜班工作者比其他人更年轻，体重指数更高，每日热量摄入更多。在夜班工作者中，进行轮班与非轮班的人员之间（P = 0.856），或顺时针与逆时针轮班的人员之间（P = 0.833），糖化血红蛋白水平没有显著差异。在调整年龄、体重指数、胰岛素使用情况、睡眠时长、晨型-夜型偏好和碳水化合物每日摄入量百分比后，与日班工作相比，夜班工作与显著更高的糖化血红蛋白相关（B = 0.059，P = 0.044），而失业参与者和日班工作者之间没有差异（B = 0.016，P = 0.572）。总之，夜班工作与2型糖尿病患者较差的血糖控制有关。
