The role of night shift work in metabolic disorders during and after pregnancy

晚班工作在孕期和孕后代谢紊乱中的作用 (I.Agarwal，项目负责人) 妊娠期糖尿病(GDM)是一种大规模且不断增长的流行病，导致严重的发病率和死亡率 无论是母亲还是婴儿。妊娠期糖尿病是II型糖尿病(T2 DM)的主要风险因素，使风险增加7倍。 有妊娠期糖尿病病史的女性患T2 DM风险的影响因素不佳 明白了。一种新的假设是，昼夜节律失调，或不适当的睡眠时间，可能 影响妊娠期糖尿病及随后的T2 DM的风险。夜班工作，一种极端的昼夜节律失调， 在横断面和前瞻性队列研究中一直与T2 DM的高风险相关。 关于夜班工作与妊娠期糖尿病的关系，存在有限且相互矛盾的数据。我的中心假设是 夜班工作增加了患妊娠期糖尿病的风险，以及从妊娠期糖尿病发展到T2 DM的风险。我要测试一下这个 使用从国家护士健康研究(NHS)2和3连续收集的纵向数据的假设 一群人。NHS包含有关社会人口、临床、生殖、职业和 生活方式变量，事件临床结果的前瞻性测量，包括中位数超过25%的T2 DM 多年的随访(NHS2)，以及来自孕妇亚队列的头发和血浆生物检疫(NHS3)。 总体而言，NHS是同类研究中最全面、最具前瞻性的纵向研究之一，并提供了 解决重要研究问题的独特机会。该项目的目标是： 具体目标1.调查夜班工作是妊娠期糖尿病的可改变的危险因素，并测试夜班工作是否 工作与早期测量的压力相关和炎性生物标记物有关 怀孕了。如果夜班工作与早孕生物标记物相关，这些可能是 用于风险分层，或在未来的干预试验中作为亚临床生物学终点。 明确目标2.确定孕后夜班工作与疾病进展风险的关系 从GDM到T2 DM。这一目标将调查高危女性中是否有夜班工作 有妊娠期糖尿病病史的患者增加了进展为T2 DM的风险。 建议的研究是我职业发展不可或缺的一部分，是为了补充我的 培训活动。这将使我能够作为一名具有专业知识的独立研究员开始成功的职业生涯 在倒班工作和新陈代谢中。此外，它还解决了一个重要的公共卫生问题，并将向未来 研究包括潜在的干预研究，以降低妊娠期糖尿病和随后的T2 DM的发生率。

The role of night shift work in metabolic disorders during and after pregnancy (I. Agarwal, Project Lead) Gestational diabetes (GDM) is a large and growing epidemic resulting in significant morbidity and mortality to both mothers and babies. GDM is a major risk factor for type II diabetes (T2DM), increasing the risk by 7-fold. Factors that influence the risk of developing T2DM among women with a history of GDM are not well understood. One emerging hypothesis is that circadian misalignment, or inappropriately timed sleep, may influence the risk of GDM and subsequent T2DM. Night shift work, an extreme form of circadian misalignment, has been consistently associated with a higher risk of T2DM in cross-sectional and prospective cohort studies. Limited and conflicting data exist on the relationship of night shift work with GDM. My central hypothesis is that night shift work increases the risk of GDM, and risk of progression from GDM to T2DM. I will test this hypothesis using serially-collected longitudinal data from the national Nurses’ Health Study (NHS) 2 and 3 cohorts. The NHS contains detailed information on sociodemographic, clinical, reproductive, occupational, and lifestyle variables, prospective measurement of incident clinical outcomes including T2DM over a median of 25 years of follow-up (NHS2), and hair and plasma biospecimens from a sub-cohort of pregnant women (NHS3). Overall, the NHS is one of the most comprehensive, prospective longitudinal studies of its kind, and provides unique opportunities to address important research questions. The aims of this project are to: Specific Aim 1. Investigate night shift work as a modifiable risk factor for GDM, and test whether night shift work is associated with stress-related and inflammatory biomarkers measured in early pregnancy. If night shift work is associated with early pregnancy biomarkers, these could be used for risk-stratification, or as sub-clinical biological endpoints in future interventional trials. Specific Aim 2. Determine the relationship between post-pregnancy night shift work and risk of progression from GDM to T2DM. This aim will investigate whether night shift work among high-risk women with a history of GDM increases the risk of progression to T2DM. The proposed research is an integral component of my career development and is tailored to complement my training activities. It will enable me to launch a successful career as an independent researcher with expertise in shift work and metabolism. Furthermore, it addresses an important public health issue and will inform future research including potential interventional studies to lower rates of GDM and subsequent T2DM.