Park Juha, Shin Sang-Yeop, Kang Yangwon, Rhie Jeongbae
Department of Occupational and Environmental Medicine, Dankook University Hospital, Cheonan, Korea.
Korea Medical Institute, Seoul, Korea.
Ann Occup Environ Med. 2019 Oct 10;31:e27. doi: 10.35371/aoem.2019.31.e27. eCollection 2019.
Night shift work induces physiological and psychological stress by altering sleep and biological rhythms and is associated with hypertension, diabetes, obesity, and cardiovascular diseases. Few studies have been conducted on the control of hypertension and diabetes. This study aimed to examine the effect of night shift work on the control rate of hypertension and diabetes.
Subjects comprised workers aged 20-65 years who underwent specific health examination at a single facility in seven different affiliated examination centers from 1 January to 31 December 2016. Workers were categorised into day workers and night shift workers. Demographic and medical history were taken, and physical examination was done. Blood pressure (BP) and fasting glucose were measured. The control rate of each disease was evaluated based on treatment goals presented in the treatment guidelines of the Korean Society of Hypertension and the Korean Diabetes Association (systolic BP < 140 mmHg and diastolic BP < 90 mmHg; fasting glucose ≤ 130 mg/dL).
Among 631,418 subjects, 11.2% (70,450) were night shift workers. Of whom 6.1% (4,319) were taking antihypertensive medication and 2.5% (1,775) were taking diabetes medication. Among patients taking antihypertensive medications, the proportion of those whose BP was controlled to suit treatment goals was 81.7% (26,635) of day workers and 77.4% (3,343) of night shift workers, which was significantly different ( < 0.001). Among patients taking diabetes medications, the proportion of those whose blood glucose was controlled to suit treatment goals was 37.4% (4,489) of day workers and 36.5% (647) of night shift workers, but the difference was not significant. The control rates for patients taking antihypertensive medications (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.68-0.80) were lower among night shift workers than day workers with adjustment for age, sex, smoking history, alcohol consumption, exercise, and obesity. However, there were no differences in control rates for patients taking diabetes medications (OR: 0.99, 95% CI: 0.87-1.10) between day workers and night shift workers.
Night shift work can have an effect on the uncontrolled BP in workers taking antihypertensive medications. Therefore, additional efforts for disease control are necessary for night shift workers with hypertension.
夜班工作通过改变睡眠和生物节律诱发生理和心理压力，与高血压、糖尿病、肥胖症及心血管疾病相关。关于高血压和糖尿病控制方面的研究较少。本研究旨在探讨夜班工作对高血压和糖尿病控制率的影响。
研究对象为20 - 65岁的工人，于2016年1月1日至12月31日在七个不同附属检查中心的单一机构接受特定健康检查。工人分为日班工人和夜班工人。记录人口统计学和病史，并进行体格检查。测量血压（BP）和空腹血糖。根据韩国高血压学会和韩国糖尿病协会治疗指南中提出的治疗目标（收缩压<140 mmHg，舒张压<90 mmHg；空腹血糖≤130 mg/dL）评估每种疾病的控制率。
在631,418名研究对象中，11.2%（70,450名）为夜班工人。其中，6.1%（4,319名）服用抗高血压药物，2.5%（1,775名）服用糖尿病药物。在服用抗高血压药物的患者中，血压控制达到治疗目标的比例，日班工人为81.7%（26,635名），夜班工人为77.4%（3,343名），差异有统计学意义（<0.001）。在服用糖尿病药物的患者中，血糖控制达到治疗目标的比例，日班工人为37.4%（4,489名），夜班工人为36.5%（647名），但差异无统计学意义。在对年龄、性别、吸烟史、饮酒、运动和肥胖进行调整后，夜班工人中服用抗高血压药物患者的控制率（优势比[OR]：0.74，95%置信区间[CI]：0.68 - 0.80）低于日班工人。然而，日班工人和夜班工人中服用糖尿病药物患者的控制率无差异（OR：0.99，95% CI：0.87 - 1.10）。
夜班工作可能会影响服用抗高血压药物工人的血压控制不佳情况。因此，对于患有高血压的夜班工人，需要采取额外的疾病控制措施。
