Ruidavets J B, Cambou J P, Esquirol Y, Soulat J M, Ferrières J
Service d'épidémiologie et de santé publique, CJF-INSERM 94-06, Faculté de médecine, Toulouse.
Arch Mal Coeur Vaiss. 1998 Aug;91(8):957-62.
The goal of this study was to examine the relationship between shift work and cardiovascular risk factors in a cross sectional survey.
2 610 men of the PRIME study, aged 50-60 years, residing in Haute-Garonne (France) and selected from health centers and various firms were screened. White-collar workers, retired and disabled men at the time of the study were excluded so the analysis was performed on a sample of 1,341 subjects. Work was categorized as day work (n = 1,161) and three types of shift work: 2 x 8 (n = 108), 3 x 8 (n = 41) and night (n = 31). A comparison of cardiovascular risk factors was performed in the different types of work.
Univariate analysis showed that systolic blood pressure was significantly higher among 2 x 8 workers (132.7 +/- 17.4 mmHg) than in other shift workers and day workers (126.9 +/- 15.1 mmHg). The same difference was observed for diastolic blood pressure. Plasma triglycerides were significantly higher among night workers (1.60 +/- 0.76 g/l) than among day workers (1.29 +/- 0.81 g/L). Logistic regression analysis showed that the risk of hypertension, defined as systolic (> or = 140 mmHg) and diastolic (> or = 90 mmHg) blood pressure and/or antihypertensive drug, was 2 times higher among 2 x 8 shift workers (OR: 2.14, 95% CI [1.42-3.23]) than among day workers after adjustment for BMI, alcohol and tobacco consumption and plasma triglyceride levels. The same result (OR: 1.99, 95% CI [1.28-3.12] was obtained with a different definition of hypertension (systolic > or = 160 mmHg and/or diastolic > or = 95 mmHg blood pressure and/or antihypertensive drug). Among night workers the risk of triglycerides > 2 g/L was higher (OR: 2.52, 95% CI [1.06-6.01] than among day workers. The risk of both hypertension (140/90 mmHg) and hypertriglyceridemia in comparison to day workers was (OR: 2.01, 95% CI [1.33-3.03]) and (OR: 2.44, 95% CI [1.14-5.21]) for 2 x 8 shift workers and night shift workers respectively.
The results of this study, putting into evidence a relationship between shift work, hypertension and high level of triglycerides, justify a careful screening by occupational physicians of cardiovascular risk factors among shift workers.
本研究旨在通过横断面调查，探究轮班工作与心血管危险因素之间的关系。
对PRIME研究中2610名年龄在50至60岁之间、居住在法国上加龙省、从健康中心和各类公司选取的男性进行筛查。研究时的白领、退休男性和残疾男性被排除在外，因此对1341名受试者的样本进行了分析。工作类型分为日班（n = 1161）和三种轮班类型：两班倒（n = 108）、三班倒（n = 41）和夜班（n = 31）。对不同工作类型的心血管危险因素进行了比较。
单因素分析显示，两班倒工人的收缩压（132.7±17.4 mmHg）显著高于其他轮班工人和日班工人（126.9±15.1 mmHg）。舒张压也观察到同样的差异。夜班工人的血浆甘油三酯水平（1.60±0.76 g/l）显著高于日班工人（1.29±0.81 g/L）。逻辑回归分析表明，在调整了体重指数、酒精和烟草消费以及血浆甘油三酯水平后，两班倒工人中高血压（定义为收缩压（≥140 mmHg）和舒张压（≥90 mmHg）以及/或者使用降压药）的风险是日班工人的2倍（比值比：2.14，95%置信区间[1.42 - 3.23]）。采用不同的高血压定义（收缩压≥160 mmHg和/或舒张压≥95 mmHg以及/或者使用降压药）也得到了相同的结果（比值比：1.99，95%置信区间[1.28 - 3.12]）。夜班工人中甘油三酯>2 g/L的风险高于日班工人（比值比：2.52，95%置信区间[1.06 - 6.01]）。与日班工人相比，两班倒工人和夜班工人患高血压（140/90 mmHg）和高甘油三酯血症的风险分别为（比值比：2.01，95%置信区间[1.33 - 3.03]）和（比值比：2.44，95%置信区间[1.14 - 5.21]）。
本研究结果表明轮班工作、高血压和高甘油三酯水平之间存在关联，这证明职业医生应对轮班工人的心血管危险因素进行仔细筛查。
