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

夜班工作在怀孕期间和怀孕后代谢紊乱中的作用

• 批准号: 10711699
• 负责人: Isha Agarwal
• 金额: $ 30.23万
• 依托单位: MAINEHEALTH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10711699
• 关键词: Address; Affect; Age; American; Biochemical Pathway; Biological; Biological Markers; Biometry; Centers of Research Excellence; Cesarean section; Chronic Disease; Circadian Dysregulation; Circadian Rhythms; Circadian desynchrony; Clinical; Cohort Studies; Complement; Complex; Data; Development; Diabetes Mellitus; Eating; Epidemic; Epidemiology; Fasting; Fetal Macrosomia; Funding; Future; Gestational Age; Gestational Diabetes; Hair; Health; High Risk Woman; Homeostasis; Hydrocortisone; Hyperglycemia; Hypothalamic structure; IL8 gene; Industry; Inflammation; Inflammatory; Insulin Resistance; Interferon Type II; Interleukin-6; Intervention Studies; Intervention Trial; Lead; Life Style; Measurement; Measures; Mediation; Mentors; Mesenchymal; Metabolic; Metabolic Diseases; Metabolic syndrome; Metabolism; Morbidity - disease rate; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Nurses' Health Study; Obesity; Occupational; Outcome; Phase; Physicians; Pituitary Gland; Plasma; Play; Pregnancy; Pregnant Women; Prevalence; Prospective Studies; Prospective, cohort study; Public Health; Questionnaires; Recording of previous events; Research; Research Methodology; Research Personnel; Risk; Risk Factors; Role; Scientist; Sleep; Sleep disturbances; Statistical Methods; Stress; TNF gene; Testing; Training; Training Activity; Woman; Work; awake; biological adaptation to stress; career; career development; cohort; early pregnancy; epidemiology study; experience; experimental study; follow-up; high risk; longitudinal, prospective study; metabolomics; middle age; modifiable risk; mortality; neuroregulation; post pregnancy; pregnant; prevent; progression risk; prospective; reproductive; reproductive epidemiology; risk stratification; secondary analysis; shift work; sociodemographics

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.

夜班工作在妊娠期和妊娠后代谢紊乱中的作用 （一）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，导致显著的发病率和死亡率， 包括母亲和婴儿。GDM是II型糖尿病（T2DM）的主要危险因素，使风险增加7倍。 影响有GDM病史的女性发生T2DM风险的因素并不充分 明白一个新出现的假说是，昼夜节律失调，或不适当的睡眠时间， 影响GDM和随后的T2DM的风险。夜班工作，一种极端的昼夜失调， 在横断面和前瞻性队列研究中，与T2DM的高风险始终相关。 关于夜班工作与GDM的关系，存在有限和相互矛盾的数据。我的核心假设是 夜班工作增加了GDM的风险，以及从GDM进展为T2DM的风险。我来测试一下 假设使用连续收集的纵向数据，从国家护士健康研究（NHS）2和3 同伙国民保健制度包含关于社会人口、临床、生殖、职业和 生活方式变量，包括T2DM在内的事件临床结局的前瞻性测量，中位数为25 年的随访（NHS 2），以及来自子队列的孕妇的毛发和血浆生物样本（NHS 3）。 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 独特的机会来解决重要的研究问题。该项目的目标是： 具体目标1。调查夜班工作作为GDM的一个可改变的危险因素， 工作与早期测量的压力相关和炎症生物标志物有关。 怀孕如果夜班工作与早孕生物标志物有关， 用于风险分层，或作为未来干预性试验的亚临床生物学终点。 具体目标2。确定妊娠后夜班工作与疾病进展风险之间的关系 从GDM到T2DM这一目标将调查夜班工作是否在高危妇女中 有GDM病史的患者进展为T2DM的风险增加。 拟议的研究是我职业发展的一个组成部分，是专门为补充我的 培训活动。这将使我能够作为一名独立的研究人员， 在轮班工作和新陈代谢方面。此外，它解决了一个重要的公共卫生问题，并将告知未来 研究，包括潜在的干预性研究，以降低GDM和随后的T2DM的发生率。