Association between shift work or long working hours with metabolic syndrome: a systematic review and dose–response meta-analysis of observational studies

Wang, Yihui; Li, Yu; Gao, Yinyan; Jiang, Lili; Yuan, Lin; Wang, Pengju; Cao, Yanwen; Song, Xuping; Ge, Long; Ding, Guowu

doi:10.1080/07420528.2020.1797763

Cited by 20 publications

(22 citation statements)

References 72 publications

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“…Recently, another meta-analysis of 38 studies confirmed an increased risk of MetS among rotating shift workers (odds ratio [OR] 1.29, 95%CI 1.11-1.46) [39]. Similar results across 36 studies were reported by Wang et al (OR 1.42, 95%CI 1.18-1.71) [40]. However, the studies included in these meta-analyses relied on heterogeneous study designs, outcome definitions, various exposure to shift work, and unmeasured confounding factors.…”

Section: Cardio-metabolic Effectssupporting

confidence: 59%

The Effects of Shift Work on Cardio-Metabolic Diseases and Eating Patterns

Hemmer¹,

Mareschal²,

Dibner

et al. 2021

Nutrients

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Energy metabolism is tightly linked with circadian rhythms, exposure to ambient light, sleep/wake, fasting/eating, and rest/activity cycles. External factors, such as shift work, lead to a disruption of these rhythms, often called circadian misalignment. Circadian misalignment has an impact on some physiological markers. However, these proxy measurements do not immediately translate into major clinical health outcomes, as shown by later detrimental health effects of shift work and cardio-metabolic disorders. This review focuses on the effects of shift work on circadian rhythms and its implications in cardio-metabolic disorders and eating patterns. Shift work appears to be a risk factor of overweight, obesity, type 2 diabetes, elevated blood pressure, and the metabolic syndrome. However, past studies showed discordant findings regarding the changes of lipid profile and eating patterns. Most studies were either small and short lab studies, or bigger and longer cohort studies, which could not measure health outcomes in a detailed manner. These two designs explain the heterogeneity of shift schedules, occupations, sample size, and methods across studies. Given the burden of non-communicable diseases and the growing concerns about shift workers’ health, novel approaches to study shift work in real contexts are needed and would allow a better understanding of the interlocked risk factors and potential mechanisms involved in the onset of metabolic disorders.

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Section: Cardio-metabolic Effectssupporting

confidence: 59%

The Effects of Shift Work on Cardio-Metabolic Diseases and Eating Patterns

Hemmer¹,

Mareschal²,

Dibner

et al. 2021

Nutrients

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“…A number of meta-analyses and systematic reviews have attempted to combine the various epidemiological studies that address the relationship between shift work and metabolic and cardiovascular health, providing evidence for an association between shift work and metabolic syndrome (Wang et al, 2021), diabetes mellitus (Gan et al, 2015; Gao et al, 2020), obesity (Sun et al, 2018), hypertension (Manohar et al, 2017), and cardiovascular disease (Torquati et al, 2018). Sex appears to moderate some of these relationships, as female shift workers were shown to have a higher risk of developing metabolic syndrome and diabetes mellitus compared with male shift workers (Gao et al, 2020; Wang et al, 2021), but a lower risk of hypertension (Manohar et al, 2017). However, Gan et al (2015) reported an increased risk of diabetes mellitus in female compared with male shift workers.…”

Section: Impact Of Shift Work On Physical and Mental Healthmentioning

confidence: 99%

“…In a large meta-analysis comprising 21 longitudinal and case-controls studies, Torquati et al (2018) recently demonstrated a heightened risk of coronary heart disease and ischemic heart disease associated with shift work. Several meta-analyses have revealed dose-response effects in the relationship between health and exposure to shift work, such that more years as a shift worker is linked to poorer cardiometabolic health (Sun et al, 2018; Torquati et al, 2018; Gao et al, 2020; Wang et al, 2021). Nonetheless, there is no consensus on the definition of exposure, and more research is required to differentiate the effect of years of work and intensity of shift schedules on health outcomes (Kecklund and Axelsson, 2016).…”

Section: Impact Of Shift Work On Physical and Mental Healthmentioning

confidence: 99%

Disturbance of the Circadian System in Shift Work and Its Health Impact

2021

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The various non-standard schedules required of shift workers force abrupt changes in the timing of sleep and light-dark exposure. These changes result in disturbances of the endogenous circadian system and its misalignment with the environment. Simulated night-shift experiments and field-based studies with shift workers both indicate that the circadian system is resistant to adaptation from a day- to a night-oriented schedule, as determined by a lack of substantial phase shifts over multiple days in centrally controlled rhythms, such as those of melatonin and cortisol. There is evidence that disruption of the circadian system caused by night-shift work results not only in a misalignment between the circadian system and the external light-dark cycle, but also in a state of internal desynchronization between various levels of the circadian system. This is the case between rhythms controlled by the central circadian pacemaker and clock genes expression in tissues such as peripheral blood mononuclear cells, hair follicle cells, and oral mucosa cells. The disruptive effects of atypical work schedules extend beyond the expression profile of canonical circadian clock genes and affects other transcripts of the human genome. In general, after several days of living at night, most rhythmic transcripts in the human genome remain adjusted to a day-oriented schedule, with dampened group amplitudes. In contrast to circadian clock genes and rhythmic transcripts, metabolomics studies revealed that most metabolites shift by several hours when working nights, thus leading to their misalignment with the circadian system. Altogether, these circadian and sleep-wake disturbances emphasize the all-encompassing impact of night-shift work, and can contribute to the increased risk of various medical conditions. Here, we review the latest scientific evidence regarding the effects of atypical work schedules on the circadian system, sleep and alertness of shift-working populations, and discuss their potential clinical impacts.

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“…Biological as well as social and environmental factors may interact as underlying mechanisms behind an association between shift work and mental health. Sleep disturbances, circadian misalignment (6), and abnormal stress responses (7) may affect mood, and vigilance (8) and in turn the regulation of emotions (7). Working in shifts may impact the work-life balance (8), marital satisfaction (10), and social life (11) negatively.…”

mentioning

confidence: 99%

Night-shift work and psychiatric treatment. A follow-up study among employees in Denmark

Albertsen¹,

Hannerz²,

Nielsen³

et al. 2022

Scand J Work Environ Health

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Night-shift work and psychiatric treatment. A follow-up study among employees in Denmark by Albertsen K, Hannerz H, Nielsen ML, Garde AHThis study found a small but statistically significant increased risk for mental ill health issues among night-shift workers, and yielded support for a dose-response association. To our knowledge, this is the largest study ever conducted on this issue, and indications of a dose-response relationship has not previously been shown.

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Association between shift work or long working hours with metabolic syndrome: a systematic review and dose–response meta-analysis of observational studies

Cited by 20 publications

References 72 publications

The Effects of Shift Work on Cardio-Metabolic Diseases and Eating Patterns

The Effects of Shift Work on Cardio-Metabolic Diseases and Eating Patterns

Disturbance of the Circadian System in Shift Work and Its Health Impact

Night-shift work and psychiatric treatment. A follow-up study among employees in Denmark

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