Tosoratto Javier, Tárraga López Pedro Juan, López-González Ángel Arturo, Obrador de Hevia Joan, Busquets-Cortés Carla, Ramírez-Manent José Ignacio
Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Spain.
Faculty of Medicine, UCLM (University of Castilla La Mancha), 02008 Albacete, Spain.
J Clin Med. 2025 Aug 23;14(17):5969. doi: 10.3390/jcm14175969.
: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. : This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. : This cross-sectional study included 53,053 workers (59.8% men) aged 18-69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. : Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. : Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.
糖尿病肥胖症，即肥胖与2型糖尿病并存，是一个主要的公共卫生问题。轮班工作和不健康的生活方式行为可能会加剧其流行，尤其是在工作人群中。本研究旨在使用体重指数（BMI）和CUN - BAE估计值，评估西班牙一大群工人的社会人口学特征、健康行为、轮班工作与糖尿病肥胖症患病率之间的关联。这项横断面研究纳入了53053名年龄在18 - 69岁之间接受职业健康检查的工人（男性占59.8%）。糖尿病肥胖症的定义为肥胖（BMI≥30 kg/m²或高CUN - BAE）加上空腹血糖≥100 mg/dL或既往有糖尿病诊断。通过MEDAS问卷评估对地中海饮食的依从性，通过国际体力活动问卷（IPAQ）评估身体活动情况，通过标准饮酒单位（UBEs）评估酒精摄入量，通过CNAE - 11分类评估社会经济阶层。轮班工作根据国际劳工组织（ILO）标准定义。采用逻辑回归评估关联，并对潜在混杂因素进行调整。轮班工作在男性和女性中均与糖尿病肥胖症几率增加独立相关。与BMI相比，用CUN - BAE评估时糖尿病肥胖症患病率更高。年龄、男性、社会经济阶层较低、身体不活动、吸烟、饮食依从性差和酒精摄入均与较高风险显著相关。CUN - BAE指数在识别高危个体方面显示出更高的敏感性。轮班工作和不健康行为是西班牙工人糖尿病肥胖症的关键决定因素。在职业健康监测中应鼓励使用除BMI之外的肥胖估计指标，如CUN - BAE。迫切需要针对工作场所的干预措施来应对这一日益增加的代谢负担。
