Hanprathet Nitt, Lertmaharit Somrat, Lohsoonthorn Vitool, Rattananupong Thanapoom, Ammaranond Palanee, Jiamjarasrangsi Wiroj
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
Diabetes Metab Syndr Obes. 2019 Nov 12;12:2341-2354. doi: 10.2147/DMSO.S219524. eCollection 2019.
The gender differential evidence of the association between shift work and type 2 diabetes risk remains scarce. This longitudinal study determines whether the association between shift-work exposure and type 2 diabetes risk and abnormal fasting plasma glucose (FPG) differs according to gender; the study aims to find the association between shift work and changes in physiological, behavioral, and psychosocial stress.
This retrospective cohort study was conducted among 5947 workers (4647 female and 1300 male) aged ≤60 years old in Bangkok, Thailand. Participants required a normal FPG level (<100 mg/dL) at baseline and at least two health check-up results from 2009 to 2016. Shift-work exposure history was assessed using a self-administered questionnaire; FPG levels were measured annually. Cox proportional hazard models were used to assess the aforementioned association.
During the follow-up period, 1470 new abnormal FPG and 154 new type 2 diabetes cases developed. Stratified analysis of male workers' data revealed an association was significant in the unadjusted model, which tended to be stronger after adjustment for demographic data and the baseline values of anthropometric and biochemical parameters. This was the case both for type 2 diabetes [Hazard Ratio (HR) (95% Confidence Interval (CI))=2.98 (1.58-5.62)] and abnormal FPG [HR (95% CI)=1.86 (1.43-2.41)]; this association was less obvious among women.
Shift work is a risk factor for type 2 diabetes and abnormal FPG; this risk is gender differential, being more pronounced in men. Preventive measures aiming at ameliorating shift work induced type 2 diabetes risk should pay more attention to men.
轮班工作与2型糖尿病风险之间关联的性别差异证据仍然匮乏。这项纵向研究旨在确定轮班工作暴露与2型糖尿病风险及空腹血糖（FPG）异常之间的关联是否因性别而异；该研究旨在找出轮班工作与生理、行为及心理社会压力变化之间的关联。
这项回顾性队列研究在泰国曼谷年龄≤60岁的5947名工人（4647名女性和1300名男性）中进行。参与者在基线时需有正常的FPG水平（<100mg/dL），且在2009年至2016年期间至少有两次健康检查结果。使用自行填写的问卷评估轮班工作暴露史；每年测量FPG水平。采用Cox比例风险模型评估上述关联。
在随访期间，出现了1470例新的FPG异常和154例新的2型糖尿病病例。对男性工人数据的分层分析显示，在未调整模型中关联显著，在调整人口统计学数据以及人体测量和生化参数的基线值后，这种关联往往更强。2型糖尿病[风险比（HR）（95%置信区间（CI））=2.98（1.58 - 5.62）]和FPG异常[HR（95%CI）=1.86（1.43 - 2.41）]均是如此；这种关联在女性中不太明显。
轮班工作是2型糖尿病和FPG异常的一个风险因素；这种风险存在性别差异，在男性中更为明显。旨在改善轮班工作诱发的2型糖尿病风险的预防措施应更多地关注男性。
