Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Clin Exp Med. 2024 Nov 14;25(1):6. doi: 10.1007/s10238-024-01514-w.
Shift work, particularly night shifts, disrupts circadian rhythms and increases stroke risk. This manuscript explores the mechanisms connecting shift work with stroke, focusing on circadian rhythms, hypertension, and diabetes. The circadian system, controlled by different mechanisms including central and peripheral clock genes, suprachiasmatic nuclei (SCN), and pineal gland (through melatonin production), regulates body functions and responds to environmental signals. Disruptions in this system affect endothelial cells, leading to blood pressure issues. Type 2 diabetes mellitus (T2DM) is significantly associated with night shifts, with circadian disturbances affecting glucose metabolism, insulin sensitivity, and hormone regulation. The manuscript examines the relationship between melatonin, insulin, and glucose balance, highlighting pathways that link T2DM to stroke risk. Additionally, dyslipidemia, particularly reduced HDL-c levels, results from shift work and contributes to stroke development. High lipid levels cause oxidative stress, inflammation, and endothelial dysfunction, increasing cerebrovascular risks. The manuscript details the effects of dyslipidemia on brain functions, including disruptions in blood flow, blood-brain barrier integrity, and neural cell death. This comprehensive analysis emphasizes the complex interplay of circadian disruption, hypertension, diabetes, and dyslipidemia in increasing stroke risk among shift workers. Understanding these mechanisms is essential for developing targeted interventions to reduce stroke susceptibility and improve cerebrovascular health in this vulnerable population.
轮班工作，特别是夜班，会打乱生物钟并增加中风风险。本文探讨了轮班工作与中风之间的联系机制，重点关注生物钟、高血压和糖尿病。生物钟受不同机制控制，包括中央和外周时钟基因、视交叉上核（SCN）和松果腺（通过褪黑素产生），调节身体功能并对环境信号做出反应。该系统的紊乱会影响内皮细胞，导致血压问题。2 型糖尿病（T2DM）与夜班有显著关联，生物钟紊乱会影响葡萄糖代谢、胰岛素敏感性和激素调节。本文研究了褪黑素、胰岛素和葡萄糖平衡之间的关系，强调了将 T2DM 与中风风险联系起来的途径。此外，血脂异常，特别是 HDL-c 水平降低，是轮班工作的结果，并导致中风的发生。高脂质水平会导致氧化应激、炎症和内皮功能障碍，增加脑血管风险。本文详细说明了血脂异常对大脑功能的影响，包括血流紊乱、血脑屏障完整性和神经细胞死亡。这一综合分析强调了生物钟紊乱、高血压、糖尿病和血脂异常在增加轮班工人中风风险方面的复杂相互作用。了解这些机制对于制定针对轮班工人的干预措施以降低中风易感性和改善脑血管健康至关重要。
