Shift Work and Metabolic Syndrome: Respective Impacts of Job Strain, Physical Activity, and Dietary Rhythms
Shift Work and Metabolic Syndrome: Respective Impacts of Job Strain, Physical Activity, and Dietary Rhythms
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DOI：
10.1080/07420520902821176
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发表时间：
2009-01-01
影响因子：
2.8
通讯作者：
Perret, Bertrand
中科院分区：
文献类型：
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作者：
Esquirol, Yolande;Bongard, Vanina;Perret, Bertrand
轮班工作对心血管疾病（CVD）危险因素和代谢综合征的影响尚不完全清楚。本研究的目的是根据两种不同的定义来评估轮班工作对代谢综合征的影响，在严格轮班工人（38小时）的人群中，与只工作一天的配对人群相比，在考虑了大量令人困惑的因素后，研究轮班工作本身是否是代谢综合征的决定因素。我们进行了一项横断面研究，比较了同一石化工厂内98名严格轮班工人和100名常规日工（所有受试者都有长期的工作节奏经验）。收集了临床、行为、职业和生物学数据，并进行了详细的营养调查。倒班工人和日工在主要心血管疾病因素方面具有可比性，10年Framingham风险评分均为11%。轮班工人报告说，他们的工作压力增加了，总的体力活动和工作时的体力活动也增加了。代谢参数的改变明显表现为甘油三酯、游离脂肪酸和谷氨酰转肽酶的升高和高密度脂蛋白胆固醇的降低。多元逻辑回归分析表明，轮班工作与代谢综合征的发生有关，根据国家胆固醇教育计划- atpiii标准的定义，OR: 2.38(1.13-4.98)，但没有使用国际糖尿病联合会最近的评分，该评分主要强调腹部肥胖。总能量摄入和主要营养素的贡献在两组之间没有差异，但饱和脂质的显著例外（轮班工人+10%）。膳食分布明显不同：白天的能量摄入更分散，早餐和午餐的贡献较小，但在中间的清淡餐，特别是下午和晚上的摄入量增加。进行多变量分析以检验饮食节律对NCEP-ATPIII代谢综合征发展的影响。早餐和中间清淡餐的饮食摄入似乎对代谢综合征有保护作用，而晚餐的高负荷更容易发生代谢综合征。午餐时高摄入量对轮班工人尤其有害。然而，在所有测试的模型中，在考虑了工作压力、体力活动、定量饮食参数和膳食分布等潜在协变量后，轮班工作仍然与代谢综合征显著相关。应向职业医生推荐轮班工人的具体随访。
The impact of shift work on cardiovascular disease (CVD) risk factors and metabolic syndrome are not yet completely understood. The objectives of this study were to evaluate the impact of shift work on metabolic syndrome according to two different definitions in a population of strictly rotating shift workers (38h) compared to paired counterparts working only day hours, and to study whether shift work itself is a determinant of metabolic syndrome after taking into account a large panel of confusing factors. We conducted a cross-sectional study comparing 98 strictly rotating shift workers to 100 regular day-workers (all subjects had a long experience of their working rhythms) within the same petrochemical plant. Clinical, behavioral, occupational, and biological data were collected, and a detailed nutritional investigation was done. Shift and day workers were comparable in terms of major CVD factors, and both had a 10yr Framingham risk scoring of 11%. Shift workers reported an increased job strain and higher total and at-work physical activity. Alterations in metabolic parameters were evident with a rise in triglycerides, free fatty acids, and gamma glutamyl transpeptidase and lower HDL-cholesterol. Multiple logistic regression analysis demonstrated that shift work was associated with occurrence of metabolic syndrome, as defined by the National Cholesterol Education Program-ATPIII criteria, OR: 2.38 (1.13-4.98), but not using the more recent score from the International Diabetes Federation, which gives a major emphasis on abdominal obesity. Total energy intake and contributions of the major nutrients did not differ between the two groups, with the notable exception of saturated lipids (+10% in shift workers). Meal distribution was clearly different: energy intake was more fractionated within the day, with a lesser contribution of breakfast and lunch but with increased intakes during intermediate light meals, particularly in the afternoon and night. Multivariate analyses were performed to test for the influence of dietary rhythms on the development of an NCEP-ATPIII metabolic syndrome. Dietary intakes at breakfast and during intermediate light meals appear to be protective against metabolic syndrome, while a high load at dinner favors its occurrence. A high intake at lunch is particularly deleterious to shift workers. However, in all tested models, shift work remained significantly associated with metabolic syndrome, after taking into account potential covariates like job strain, physical activity, quantitative dietary parameters, and meal distribution. A specific follow-up of shift workers should be recommended to occupational physicians.