Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.
Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
Int Arch Occup Environ Health. 2022 Sep;95(7):1501-1510. doi: 10.1007/s00420-022-01854-8. Epub 2022 Mar 31.
Present shift work has been associated with chronic disease. But influence of past shift work has not been established. This study is designed to investigate whether shift work in the past is associated with chronic kidney disease (CKD) in retired workers, and whether cardiometabolic traits affect the relationship.
Overall, 15,775 retired workers (aged 62.3 ± 7.2 years) without CKD at baseline in the Dongfeng-Tongji cohort were included. Duration of past shift work was obtained through questionnaires, and divided into < 10.0, 10.0-20.0, and ≥ 20.0 years. CKD was diagnosed if individual's estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m. Logistic regression model was used to estimate the association between past shift work and CKD. Mediation analysis was conducted to analyze the mediating effects of cardiometabolic traits.
During the median follow-up of 4.7 years, 1072 (6.8%) incident CKD cases were recorded. Retired workers with past shift work had elevated CKD risk [ORs and 95% CIs for those with < 10.0, 10.0-20.0, and ≥ 20.0 years of past shift work were 1.61 (1.30, 2.00), 0.90 (0.72, 1.12), and 1.33 (1.11, 1.61)]. The associations were more evident among participants with poor or terrible sleep quality (P for interaction, 0.022). Mediation analysis showed that cardiometabolic traits including diastolic blood pressure and high density lipoprotein cholesterol mediated 7.02% and 10.05% of the relationship from past shift work to higher CKD risk.
Past shift work was related with increased risk of incident CKD among retired workers, and this relationship was partly mediated by cardiometabolic traits.
目前的轮班工作与慢性疾病有关。但是，过去轮班工作的影响尚未确定。本研究旨在调查过去的轮班工作是否与退休工人的慢性肾脏病（CKD）有关，以及代谢特征是否会影响这种关系。
共有 15775 名在东风-同济队列中基线时无 CKD 的退休工人（年龄 62.3±7.2 岁）纳入本研究。通过问卷调查获得过去轮班工作的时间，并分为<10.0、10.0-20.0 和≥20.0 年。如果个体的估计肾小球滤过率（eGFR）<60ml/min/1.73m，则诊断为 CKD。使用逻辑回归模型来估计过去轮班工作与 CKD 之间的关联。进行中介分析以分析代谢特征的中介作用。
在中位随访 4.7 年期间，记录了 1072 例（6.8%）新发 CKD 病例。过去有轮班工作的退休工人发生 CKD 的风险增加[过去轮班工作<10.0、10.0-20.0 和≥20.0 年的 OR 值和 95%CI 分别为 1.61（1.30，2.00）、0.90（0.72，1.12）和 1.33（1.11，1.61）]。在睡眠质量差或极差的参与者中，这种关联更为明显（交互作用 P 值，0.022）。中介分析表明，包括舒张压和高密度脂蛋白胆固醇在内的代谢特征部分解释了过去轮班工作与更高 CKD 风险之间的关系，分别占 7.02%和 10.05%。
过去的轮班工作与退休工人发生 CKD 的风险增加有关，这种关系部分是由代谢特征介导的。
