Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea.
Scand J Work Environ Health. 2023 Mar 1;49(2):126-135. doi: 10.5271/sjweh.4072. Epub 2022 Nov 24.
This study aimed to investigate the effect of vitamin D deficiency on metabolic syndrome among shift workers.
This study included 207 756 workers who underwent a comprehensive health examination at a large South Korean university hospital between 2012 and 2018. We performed multivariate-adjusted logistic regression analysis and analyzed mediation and exposure-mediator interaction.
Overall, 5.5% of the participants had metabolic syndrome. Compared to day work, the odds ratios (OR) of metabolic syndrome and vitamin D deficiency (<12 ng/mL) for shift work were 1.14 [95% confidence interval (CI) 1.06-1.22] and 1.63 (95% CI 1.57-1.70), respectively. Among shift workers, the OR of metabolic syndrome for vitamin D levels of 12-20 and <12 ng/mL, compared with a level of ≥20 ng/mL, were 1.36 (95% CI 1.15-1.61) and 1.51 (95% CI 1.26-1.81), respectively. Shift work and vitamin D deficiency showed an additive interaction; the relative excess risks due to interaction, attributable proportion, and synergy index were 0.26 (95% CI 0.08-0.44), 0.17 (95% CI 0.07-0.28), and 2.09 (95% CI 1.23-3.55), respectively. When vitamin D deficiency was treated as a mediator, the direct and total effects of shift work on metabolic syndrome were 1.12 (95% CI 1.04-1.22) and 1.15 (95% CI 1.07-1.25), respectively. The indirect effect was 1.03 (95% CI 1.02-1.04) and accounted for 18% of the total effect.
Vitamin D is a potential mediator of the impact of shift work on metabolic risk factors.
本研究旨在探讨维生素 D 缺乏对轮班工人代谢综合征的影响。
本研究纳入了 207756 名于 2012 年至 2018 年期间在韩国某大型大学医院接受全面健康检查的工人。我们进行了多变量调整的 logistic 回归分析，并分析了中介和暴露-中介相互作用。
总体而言，有 5.5%的参与者患有代谢综合征。与白班相比，轮班工作的代谢综合征和维生素 D 缺乏（<12ng/ml）的比值比（OR）分别为 1.14（95%可信区间 [CI] 1.06-1.22）和 1.63（95% CI 1.57-1.70）。在轮班工人中，维生素 D 水平为 12-20ng/ml 和<12ng/ml 与≥20ng/ml 相比，患代谢综合征的 OR 分别为 1.36（95% CI 1.15-1.61）和 1.51（95% CI 1.26-1.81）。轮班工作和维生素 D 缺乏表现出相加交互作用；交互作用的相对超额风险、归因比例和协同指数分别为 0.26（95% CI 0.08-0.44）、0.17（95% CI 0.07-0.28）和 2.09（95% CI 1.23-3.55）。当维生素 D 缺乏被视为中介时，轮班工作对代谢综合征的直接和总效应分别为 1.12（95% CI 1.04-1.22）和 1.15（95% CI 1.07-1.25）。间接效应为 1.03（95% CI 1.02-1.04），占总效应的 18%。
维生素 D 可能是轮班工作对代谢风险因素影响的中介。
