Xu Jiahui, Ni Shu, Wang Yuming, Yan Mengfan, Yang Xueli, Ge Han, Jia Zizhuo, Yang Ze, Shan Anqi, Liu Huanyu, Tang Nai-Jun
Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China.
Int Arch Occup Environ Health. 2023 Jan;96(1):179-190. doi: 10.1007/s00420-022-01913-0. Epub 2022 Aug 21.
Occupational harmful factors, such as shift work, are attracting increasing attention as a potential cause of nonalcoholic fatty liver disease (NAFLD). In this study, we aimed to identify the association between shift work and NAFLD incidence in Chinese rail population.
A cohort study was conducted among 14,112 rail workers for 4-year follow-up. Shift work frequency and other potential variables were recorded by questionnaires, including demographic, lifestyle, and occupation information. Besides, body mass index, blood pressure, fasting blood glucose, total cholesterol, triglyceride, alanine aminotransferase, and aspartate aminotransferase were measured by anthropometric measurement and blood test. Diagnosis of new NAFLD case was based on abdominal ultrasonography. Cox proportional hazards regression model was used to determine whether shift work has effect on occurrence of NAFLD.
The incidence of NAFLD was 30.43% in total subjects. After adjustment for possible confounders, the RRs of NAFLD were 1.069 (95% CI 0.998-1.146) and 1.179 (95% CI 1.059-1.312) in occasionally shift work group and frequently shift work group respectively, compared to the seldom shift work group. In stratified analyses, the RRs of NAFLD incidence linked to shift work exposure seems increase among female and elder. The results of three sensitivity analyses were similar with main analysis.
This research provided further evidence of positive harmful effect of shift work on NAFLD incidence in Chinese rail workers, particularly in frequently shift work population. The risk estimate of shift work on NAFLD was higher in female and elder.
诸如轮班工作等职业有害因素，作为非酒精性脂肪性肝病（NAFLD）的潜在病因正受到越来越多的关注。在本研究中，我们旨在确定中国铁路职工人群中轮班工作与NAFLD发病率之间的关联。
对14112名铁路工人进行了一项队列研究，随访4年。通过问卷调查记录轮班工作频率和其他潜在变量，包括人口统计学、生活方式和职业信息。此外，通过人体测量和血液检测测量体重指数、血压、空腹血糖、总胆固醇、甘油三酯、丙氨酸氨基转移酶和天冬氨酸氨基转移酶。新的NAFLD病例诊断基于腹部超声检查。采用Cox比例风险回归模型来确定轮班工作是否对NAFLD的发生有影响。
全部受试者中NAFLD的发病率为30.43%。在对可能的混杂因素进行调整后，与很少轮班工作组相比，偶尔轮班工作组和经常轮班工作组的NAFLD风险比（RRs）分别为1.069（95%可信区间0.998 - 1.146）和1.179（95%可信区间1.059 - 1.312）。在分层分析中，与轮班工作暴露相关的NAFLD发病率的RRs在女性和年长者中似乎有所增加。三项敏感性分析的结果与主要分析相似。
本研究进一步证明了轮班工作对中国铁路工人NAFLD发病率有正向有害影响，特别是在经常轮班工作人群中。轮班工作对NAFLD的风险估计在女性和年长者中更高。
