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评估轮班工作对甲状腺疾病的影响:系统评价和荟萃分析。

Assessment of the impact of shift work on thyroid disorders: a systematic review and meta-analysis.

机构信息

Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Sleep Breath. 2023 May;27(2):703-708. doi: 10.1007/s11325-022-02652-9. Epub 2022 Jun 9.

Abstract

PURPOSE

Shift work including night work is a common work pattern worldwide and researchers have no consensus on the impact of shift work on thyroid disorders. We aimed to conduct a meta-analysis to summarize the evidence from published studies to ascertain the impact of shift work on thyroid disorders.

METHODS

Studies on the link between shift work and thyroid disorders published in Pubmed, Embase, Medline, and Cochrane databases by September 2021 were searched. Newcastle-Ottawa scale was used to assess the quality of included studies. The Mantel-Haenszel statistical method and the inverse-variance statistical method were used to evaluate the pooled results of dichotomous and continuous variables, respectively. Study heterogeneity analysis was performed using I statistics. Sensitivity analysis was conducted by omitting one study each time and re-calculating the pooled results of the remaining studies.

RESULTS

Seven eligible studies were included in the systematic review and meta-analysis. The results showed that shift work would lead to an increase in TSH (SMD: 0.30; 95%CI: 0.05-0.55; P = 0.02; I = 64%) and FT4 (SMD: 0.21; 95%CI: 0.02-0.40; P = 0.03; I = 0%). However, shift work had no clear effect on the risk of positive thyroid autoantibodies (OR: 1.26; 95%CI: 0.62-2.55; P = 0.52; I = 63%).

CONCLUSION

Shift work may be associated with abnormal TSH and FT4 levels. Thyroid health is affected in shift workers and it is advisable to remind patients to get good sleep the night before testing thyroid function.

摘要

目的

轮班工作包括夜班是一种全球范围内常见的工作模式,研究人员对于轮班工作对甲状腺疾病的影响尚未达成共识。我们旨在进行一项荟萃分析,以总结已发表研究的证据,确定轮班工作对甲状腺疾病的影响。

方法

检索了 2021 年 9 月前在 Pubmed、Embase、Medline 和 Cochrane 数据库中发表的关于轮班工作与甲状腺疾病之间关联的研究。使用纽卡斯尔-渥太华量表评估纳入研究的质量。采用 Mantel-Haenszel 统计方法和Inverse-variance 统计方法分别评估二分类变量和连续变量的汇总结果。采用 I ² 统计量进行研究异质性分析。通过每次剔除一项研究并重新计算其余研究的汇总结果来进行敏感性分析。

结果

系统评价和荟萃分析共纳入 7 项合格研究。结果表明,轮班工作会导致 TSH(SMD:0.30;95%CI:0.05-0.55;P=0.02;I²=64%)和 FT4(SMD:0.21;95%CI:0.02-0.40;P=0.03;I²=0%)水平升高。然而,轮班工作对甲状腺自身抗体阳性的风险没有明显影响(OR:1.26;95%CI:0.62-2.55;P=0.52;I²=63%)。

结论

轮班工作可能与异常 TSH 和 FT4 水平有关。轮班工作会影响到甲状腺健康,因此建议在检测甲状腺功能前一天晚上提醒患者保证良好的睡眠。

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