The associations of chronotype and shift work with rheumatoid arthritis
The associations of chronotype and shift work with rheumatoid arthritis
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时间型和轮班工作与类风湿性关节炎的关系
DOI：
10.1101/2022.07.07.22277352
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Butler T
中科院分区：
文献类型：
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作者：
Butler T
生物钟调节人体生理的多个方面，包括免疫。人们有一种被称为“时型”的生理偏好。那些喜欢晚睡的人可能更适合轮班工作，但也有更高的健康风险。轮班工作会导致昼夜节律失调，并与哮喘和癌症等炎症性疾病的风险增加有关。在这里，我们调查了睡眠类型、轮班工作和类风湿关节炎（RA）之间的关系。在444,210名英国生物银行参与者中，研究了轮班工作和生物钟类型对类风湿关节炎风险的影响。对多变量logistic回归模型进行协变量调整：年龄、性别、种族、饮酒、吸烟史、汤森剥夺指数（TDI）、睡眠时间、每周工作时间和体重指数（BMI）。在调整协变量后，与中间时间型相比，晨起型个体患类风湿关节炎（RA；比值比[OR]: 0.93, 95%可信区间[CI]: 0.88-0.99）的几率较低。在更严格的RA病例定义中，早晨睡眠类型与RA之间的关联持续存在（协变量校正OR: 0.89, 95% CI: 0.81-0.97）。当根据年龄、性别、种族和TDI进行调整后，与日工相比，轮班工人患RA的几率更高（OR: 1.22, 95% CI: 1.1-1.36），在进一步的协变量调整后，日工的RA几率降低为零（OR: 1.1, 95% CI: 0.98-1.22）。与白班工人相比，长期上夜班的晨型工人患RA的几率明显更高（OR: 1.89, 95% CI: 1.19-2.99）。这些数据表明昼夜节律在类风湿关节炎发病机制中的作用。需要进一步的研究来确定这种关联的潜在机制，并了解轮班工作对慢性炎症疾病及其介导因素的潜在影响。
The circadian clock regulates multiple aspects of human physiology including immunity. People have a circadian preference termed chronotype. Those with an evening preference may be better suited to shift work, but also carry higher risk of adverse health. Shift work leads to misalignment of circadian rhythms and is associated with increased risk of inflammatory disease such as asthma and cancer. Here, we investigate the association between chronotype, shift work, and rheumatoid arthritis (RA). The associations between exposures of shift work and chronotype on risk of RA were studied in up to 444,210 U.K. Biobank participants. Multivariable logistic regression models were adjusted for covariates: age, sex, ethnicity, alcohol intake, smoking history, Townsend Deprivation Index (TDI), sleep duration, length of working week, and body mass index (BMI). After adjusting for covariates, individuals with a morning chronotype had lower odds of having rheumatoid arthritis (RA; odds ratio [OR]: 0.93, 95% confidence interval [CI]: 0.88-0.99) when compared to intermediate chronotypes. The association between morning chronotype and RA persisted with a more stringent RA case definition (covariate-adjusted OR: 0.89, 95% CI: 0.81-0.97). When adjusted for age, sex, ethnicity, and TDI, shift workers had higher odds of RA (OR: 1.22, 95% CI: 1.1-1.36) compared to day workers that attenuated to the null after further covariate adjustment (OR: 1.1, 95% CI: 0.98-1.22). Morning chronotypes working permanent night shifts had significantly higher odds of RA compared to day workers (OR: 1.89, 95% CI: 1.19-2.99). These data point to a role for circadian rhythms in RA pathogenesis. Further studies are required to determine the mechanisms underlying this association and understand the potential impact of shift work on chronic inflammatory disease and its mediating factors.