Department of Integrative Physiology, University of Colorado, Boulder, CO
Broad Institute of MIT and Harvard, Cambridge, MA.
Diabetes Care. 2018 Apr;41(4):762-769. doi: 10.2337/dc17-1933. Epub 2018 Feb 12.
To examine the effects of past and current night shift work and genetic type 2 diabetes vulnerability on type 2 diabetes odds.
In the UK Biobank, we examined associations of current ( = 272,214) and lifetime ( = 70,480) night shift work exposure with type 2 diabetes risk (6,770 and 1,191 prevalent cases, respectively). For 180,704 and 44,141 unrelated participants of European ancestry (4,002 and 726 cases, respectively) with genetic data, we assessed whether shift work exposure modified the relationship between a genetic risk score (comprising 110 single-nucleotide polymorphisms) for type 2 diabetes and prevalent diabetes.
Compared with day workers, all current night shift workers were at higher multivariable-adjusted odds for type 2 diabetes (none or rare night shifts: odds ratio [OR] 1.15 [95% CI 1.05-1.26]; some nights: OR 1.18 [95% CI 1.05-1.32]; and usual nights: OR 1.44 [95% CI 1.19-1.73]), except current permanent night shift workers (OR 1.09 [95% CI 0.93-1.27]). Considering a person's lifetime work schedule and compared with never shift workers, working more night shifts per month was associated with higher type 2 diabetes odds (<3/month: OR 1.24 [95% CI 0.90-1.68]; 3-8/month: OR 1.11 [95% CI 0.90-1.37]; and >8/month: OR 1.36 [95% CI 1.14-1.62]; = 0.001). The association between genetic type 2 diabetes predisposition and type 2 diabetes odds was not modified by shift work exposure.
Our findings show that night shift work, especially rotating shift work including night shifts, is associated with higher type 2 diabetes odds and that the number of night shifts worked per month appears most relevant for type 2 diabetes odds. Also, shift work exposure does not modify genetic risk for type 2 diabetes, a novel finding that warrants replication.
研究既往和当前夜班工作以及 2 型糖尿病易感性遗传类型对 2 型糖尿病发病风险的影响。
在英国生物库中，我们研究了当前（=272214 人）和终生（=70480 人）夜班工作暴露与 2 型糖尿病风险之间的关联（分别有 6770 例和 1191 例现患病例）。对于 180704 名和 44141 名无关联的欧洲血统参与者（分别有 4002 例和 726 例），我们评估了夜班工作暴露是否改变了 2 型糖尿病遗传风险评分（包括 110 个单核苷酸多态性）与现患糖尿病之间的关系。
与白班工作者相比，所有当前夜班工作者的 2 型糖尿病发病风险均经多变量校正后升高（无或罕见夜班：比值比 [OR]1.15[95%CI1.05-1.26]；有些夜班：OR1.18[95%CI1.05-1.32]；通常夜班：OR1.44[95%CI1.19-1.73]），但当前永久夜班工作者除外（OR1.09[95%CI0.93-1.27]）。考虑到一个人的终生工作时间表，与从不轮班工作者相比，每月夜班工作次数越多，2 型糖尿病发病风险越高（<3 次/月：OR1.24[95%CI0.90-1.68]；3-8 次/月：OR1.11[95%CI0.90-1.37]；>8 次/月：OR1.36[95%CI1.14-1.62]；=0.001）。遗传 2 型糖尿病易感性与 2 型糖尿病发病风险之间的关联不受夜班工作暴露的影响。
我们的研究结果表明，夜班工作，尤其是包括夜班的轮班工作，与 2 型糖尿病发病风险增加有关，而且每月夜班工作的次数与 2 型糖尿病发病风险最相关。此外，夜班工作暴露不会改变 2 型糖尿病的遗传风险，这是一个需要进一步证实的新发现。
