目的:在各种职业中,12小时轮班工作的患病率正在增加。轮班工作与昼夜节律中断有关,这可能导致荷尔蒙变化和代谢紊乱,包括葡萄糖的改变,脂质,嘌呤代谢.尽管如此,关于轮班与异常血清尿酸(SUA)水平之间潜在联系的研究有限.此外,导致轮班工人SUA水平异常的因素还没有得到很好的理解。因此,这项研究旨在分析在飞机维修公司雇用的轮班工人的SUA水平,调查轮班工作与SUA水平之间的潜在关联,并探讨可能影响轮班工人SUA水平异常的因素。
方法:本研究采用整群抽样方法,共纳入了来自飞机维修公司的2263名男性工人。工人根据工作班次分为两组:夜班(N=1047,46.27%)和白天工作(N=1216,53.73%)。在4月1日至6月30日之间进行了一项调查,2022年收集工作信息,生活方式,体检结果,以及其他相关因素。调查包括自行设计的人口统计信息问卷,以收集有关工人特征的数据,病史,就业年限,吸烟和饮酒习惯,和主要的生活方式行为。使用尿酸酶比色法测量工人的SUA水平。采用单因素方差分析比较两组SUA异常检出率的差异,采用多因素logistic回归分析确定SUA异常水平的影响因素。
结果:研究表明,48.9%的夜班工人和43.8%的普通班工人SUA水平异常,两组比较差异有统计学意义(χ2=6.125,P=0.013)。昼夜节律类型等因素,轮班工作,年龄,饮食的味道,饮食类型,吸烟,基于体重指数(BMI)的超重或肥胖,尿肌酐浓度(CREA),总胆固醇,甘油三酯,低密度脂蛋白胆固醇与SUA异常相关(P<0.05)。发现间歇性(OR=1.34,95%CI:0.83-2.12,P<0.05)或夜间昼夜节律型(OR=1.45,95%CI:0.86-2.43,P>0.05)的个体发生SUA异常的风险高于早晨型。此外,夜班工作等因素,高钠饮食,吸烟,高肉低蔬菜的饮食,超重或肥胖,和更高水平的CREA也被发现增加发生SUA异常的风险。该研究还揭示了BMI与异常尿酸水平之间的显着剂量反应关系。在控制其他因素后,发现夜班工作组发生SUA异常的风险比白天工作组高1.18倍(OR=1.18,95%CI:1.02-1.34,P=0.01).
结论:轮班工作与发生SUA异常的高风险有关,有几个因素可能导致这种风险。为了预防疾病,建议企业对轮班工人实施更好的健康监测和管理措施。
OBJECTIVE: The prevalence of 12-hour shift work is increasing in various occupations. Shift work has been linked to circadian rhythm disruption, which may lead to hormonal changes and metabolic disorders, including alterations in glucose, lipid, and purine metabolism. Despite this, there is limited research on the potential connection between work shifts and abnormal serum uric acid (SUA) levels. Furthermore, the factors that contribute to abnormal SUA levels in shift workers are not well-understood. Therefore, this study aimed to analyze the SUA levels of shift workers employed in an aircraft maintenance company, investigate the potential association between shift work and SUA levels, and explore the factors that may influence abnormal SUA levels in shift workers.
METHODS: A total of 2263 male workers from an aircraft maintenance company were included in this study using the cluster sampling method. The workers were divided into two groups based on their working shifts: night shift (N = 1047, 46.27%) and day working (N = 1216, 53.73%). A survey was conducted between April 1st and June 30th, 2022 to gather information on work, lifestyle, physical examination results, and other relevant factors. The survey included a self-designed demographic information questionnaire to collect data on workers\' characteristics, medical history, years of employment, smoking and drinking habits, and main lifestyle behaviors. The workers\' SUA levels were measured using uricase colorimetry. One-way ANOVA was used to compare the difference in the abnormal detection rate of SUA between the two groups, and multi-factor logistic regression analysis was used to identify the factors that influence abnormal SUA levels.
RESULTS: The study indicated that 48.9% of night shift workers and 43.8% in the regular day workers had abnormal SUA levels, with a significant difference between the two groups (χ2 = 6.125, P = 0.013). Factors such as circadian rhythm type, shift work, age, the taste of diet, type of diet, smoking, overweight or obesity based on body mass index (BMI), concentration of urine creatinine (CREA), total cholesterol, triglyceride, and low-density lipoprotein cholesterol were found to be correlated with SUA abnormalities (P < 0.05). The risk of developing SUA abnormalities was found to be higher in individuals with an intermittent (OR = 1.34, 95% CI: 0.83-2.12, P < 0.05) or evening circadian rhythm type (OR = 1.45, 95% CI: 0.86-2.43, P > 0.05) compared to those with a morning type. Additionally, factors such as night shift work, a high-sodium diet, smoking, a diet high in meat and low in vegetables, being overweight or obese, and higher levels of CREA were also found to increase the risk of developing SUA abnormalities. The study also revealed a significant dose-response relationship between BMI and abnormal uric acid levels. After controlling for other factors, the risk of developing SUA abnormalities was found to be 1.18 times higher in the night shift work group than in the day work group (OR = 1.18, 95% CI:1.02-1.34, P = 0.01).
CONCLUSIONS: Shift work has been linked to a higher risk of developing SUA abnormalities, and there are several factors that may contribute to this risk. To prevent diseases, it is recommended that enterprises implement better health monitoring and management practices for shift workers.