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ShiftWork and Impaired Glucose Metabolism: A 14-Year Cohort Study on 7104 Male Workers
Abstract
The aim of this study was to assess the effect of shiftwork on hemoglobin A1c (HbA1c) level, as an index of glucose metabolism. A 14 yr prospective cohort study was conducted on day (n = 4219) and alternating shiftworkers (n = 2885) who received annual health checkups between 1991 and 2005 at a Japanese steel company. The endpoints were either a 10%, 15%, 20%, 25%, or 30% increase in HbA1c during the period of observation, compared to HbA1c at entry to the study. The association between the type of job schedule and increase in HbA1c was investigated after adjusting for age, body mass index, mean arterial pressure, total serum cholesterol, creatinine, alanine aminotransferase, gamma-glutamyl transpeptidase, uric acid, drinking habit, smoking habit, and habitual exercise using multivariate pooled logistic regression analyses. Shiftwork was significantly associated with the various HbA1c endpoints (> or =10% HbA1c increase, odds ratio 1.35 [95% confidence interval 1.26-1.44]; > or =15% HbA1c increase, odds ratio 1.29 [95% confidence interval, 1.19-1.40]; > or =20% HbA1c increase, odds ratio 1.23 [95% confidence interval 1.11-1.37]; and > or =25% HbA1c increase, odds ratio 1.19 [95% confidence interval 1.03-1.36]). Age, body mass index, alanine aminotransferase, and gamma-glutamyl transpeptidase were associated positively with all five HbA1c endpoints. Uric acid was associated negatively with all five HbA1c endpoints. Our study on male Japanese workers revealed alternating shiftwork (in addition to other established factors, such as age and body mass index) was a consistent risk factor for impaired glucose metabolism.
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“Different forms of shift work are reported to induce multiple forms of circadian misalignment, which are believed to underlie the observed raised postprandial glucose (120) and insulin concentrations in shift workers (121), as well as the increased risk of impaired glucose tolerance (122) and type 2 diabetes observed in epidemiologic studies (81).”
From Chronotype: Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health (2019) · cites this paper as [122]
In the citing paper
“the strongest evidence linking circadian disruption and type 2 diabetes, comes from epidemiological studies consistently showing an increased risk for type 2 diabetes in shift workers [138–140].”
From Circadian control of glucose metabolism (2014) · cites this paper as [139]
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Cited by
Sorted by citations
Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women
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“Several cohort studies reported an increased risk of impaired glucose metabolism [3],[6], and two prospective studies in male Japanese workers have revealed that alternation/shift worker had an increased risk of impaired glucose metabolism and diabetes compared with day workers [7],[8].”
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Costa, G. (2010) · Safety and Health at Work · doi:10.5491/shaw.2010.1.2.112 · Cited by 443
“With regards to the risk of diabetes, some studies reported an impairment of glucose tolerance in shift workers, with increased insulin resistance at night [52,53] and a higher (almost double) prevalence of type 2 diabetes in relation to rotating shift work [54], which appears to increase with years spent doing shift…”
BackgroundCircadian system, sleep and endocrinology
Morris, C. J., Aeschbach, D., & Scheer, F. A. J. L. (2012) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2011.09.003 · Cited by 403
“This high prevalence of night-work is of considerable significance for public health considering that shift-work (relative to day-work) has been shown to be a risk factor for health problems such as cardiovascular disease, impaired glucose metabolism and obesity (Tenkanen et al., 1997; Morikawa et al., 2005; Suwazono…”
BackgroundCircadian System and Glucose Metabolism: Implications for Physiology and Disease
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“[11, 12], late meal timing [6], late chronotype [13, 14], social jet lag [15], and sleep loss [16] are associated with increased risks of T2D.”
BackgroundCircadian control of glucose metabolism
Kalsbeek, A., la Fleur, S., & Fliers, E. (2014) · Molecular Metabolism · doi:10.1016/j.molmet.2014.03.002 · Cited by 338
Metadata
- Authors
- Suwazono, Y., Dochi, M., Oishi, M., Tanaka, K., Kobayashi, E., & Sakata, K.
- Affiliations
- Chiba University (JP)
- Corresponding author
- Suwazono, Yasushi
- Venue
- Chronobiology International
- Publisher
- Informa UK Limited
- Published
- 2009-01
- Volume
- 26
- Issue
- 5
- Pages
- 926-941
- ISSN
- 0742-0528 (ISSN-L)
- 1525-6073
- OpenAlex
- W2124194978
- Cited by
- 104
- References
- 44
- Citations by year
- 2025: 5 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 1 · 2020: 7 · 2019: 3 · 2018: 10 · 2017: 7 · 2016: 11 · 2015: 13 · 2014: 4 · 2013: 2 · 2012: 8
- FWCI
- 11.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Chronobiology International (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fondation pour la Recherche Médicale
- Japan Diabetes Society
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Keywords
- shift work, impaired glucose metabolism, HbA1c, diabetes risk, male workers, steelworkers, uric acid, alanine aminotransferase, gamma-glutamyl transferase, body mass index, occupational health
- MeSH terms
- Adult, Diabetes Mellitus, Glucose, Glycated Hemoglobin, Humans, Male, Prospective Studies, Regression Analysis, Risk, Risk Factors, Time Factors, Work Schedule Tolerance, Models, Statistical, Cohort Studies, Odds Ratio
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