Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000, Clermont-Ferrand, France.
Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
Atherosclerosis. 2020 Nov;313:156-169. doi: 10.1016/j.atherosclerosis.2020.08.015. Epub 2020 Sep 3.
Shift work is common worldwide and linked to deleterious cardiovascular effects that might be underlined by dyslipidemia. The aim of this systematic review and meta-analysis is to determine the impact of shiftwork on dyslipidemia.
Searching in PubMed, Cochrane Library, Science Direct and Embase databases without language restriction on 15 February 2020, included studies that describe blood lipids levels or a risk measure in shift workers compared with fixed-day workers (controls). Differences by study-level characteristics were estimated using stratified meta-analysis by type of shift work, and meta-regression to examine relations between dyslipidemia and demographic, lifestyle and work characteristics. Estimates were pooled using random-effect meta-analysis.
We included a total of 66 articles, representing 197,063 workers. Shift work globally increased the levels of triglycerides (overall SMD = 0.09; 95CI 0.05 to 0.13; p < 0.001), and globally decreased the levels of c-HDL (-0.08; 95CI -0.12 to -0.03; p = 0.001). Permanent night shift workers were an at-risk type of shift for dyslipidemia with significantly higher blood levels of total cholesterol (0.22; 95CI 0.01 to 0.42; p = 0.043) and triglycerides (0.18; 0.03 to 0.33; p = 0.017), and significantly lower blood levels of c-HDL (-0.16; 95CI -0.32 to 0.00; p = 0.05). Permanent night shift workers were more at-risk for total cholesterol than rotating 3 × 8 shift workers (Coefficient 0.22; 95CI 0.01 to 0.42; p = 0.038) and rotating 2 × 12 shift workers (0.24; 0.02 to 0.46; p = 0.037), and more at-risk for triglycerides than rotating day shift workers (0.21; 95CI 0.03 to 0.38; p = 0.023). Results were non-significant for c-LDL, nor depending on type of shifts.
Shift work, and particularly permanent night shift, is associated with dyslipidaemia via elevated total cholesterol and triglycerides, and reduced HDL-cholesterol. Our current study provides a practical and valuable strengthening of the evidence-base required for preventive health initiatives and workplace reform.
倒班工作在全球范围内很常见，与可能由血脂异常引起的有害心血管影响有关。本系统评价和荟萃分析的目的是确定倒班工作对血脂异常的影响。
于 2020 年 2 月 15 日在 PubMed、Cochrane 图书馆、Science Direct 和 Embase 数据库中进行无语言限制的检索，纳入描述轮班工作与固定日班工人（对照组）相比血液脂质水平或风险指标的研究。通过按轮班类型进行分层荟萃分析和荟萃回归来估计研究水平特征的差异，以检查血脂异常与人口统计学、生活方式和工作特征之间的关系。使用随机效应荟萃分析汇总估计值。
我们共纳入了 66 篇文章，代表了 197063 名工人。轮班工作总体上增加了甘油三酯水平（总体 SMD=0.09；95%CI 0.05 至 0.13；p<0.001），总体上降低了 c-HDL 水平（-0.08；95%CI -0.12 至 -0.03；p=0.001）。永久性夜班工人是血脂异常的高危类型，总胆固醇（0.22；95%CI 0.01 至 0.42；p=0.043）和甘油三酯（0.18；0.03 至 0.33；p=0.017）血液水平显著升高，c-HDL 水平显著降低（-0.16；95%CI -0.32 至 0.00；p=0.05）。永久性夜班工人比轮班 3×8 小时的工人（系数 0.22；95%CI 0.01 至 0.42；p=0.038）和轮班 2×12 小时的工人（0.24；0.02 至 0.46；p=0.037）的总胆固醇风险更高，比轮班日班工人的甘油三酯风险更高（0.21；95%CI 0.03 至 0.38；p=0.023）。c-LDL 无显著相关性，也与轮班类型无关。
倒班工作，特别是永久性夜班工作，通过升高总胆固醇和甘油三酯以及降低高密度脂蛋白胆固醇，与血脂异常有关。我们目前的研究为预防健康倡议和工作场所改革提供了实用且有价值的证据基础强化。
