Retrospective cohort study of the risk of impaired glucose tolerance among shift workers

Abstract

OBJECTIVES: The aim of this study was to investigate the effect of shift working on the risk of developing impaired glucose tolerance (IGT). METHODS: This study comprised 6413 male employees (5608 daytime workers, 512 3-shift workers and 293 2-shift workers) whose work schedules remained constant during the follow-up period (mean follow-up period 9.9 years). IGT was defined as Hemoglobin A1c ≥5.9%. The Cox proportional hazards model was used to estimate the risk of developing IGT, after making adjustments for age, smoking, alcohol consumption, leisure-time physical activity, body mass index (BMI) and Hemoglobin A1c (HbA1c) at baseline. Analysis was additionally performed for a sub-cohort of 1625 workers with BMI of 20.0–25.0 kg/m^2 that did not change by >2.0 kg/m^2 during the follow up period. RESULTS: The risk of developing IGT was significantly elevated among both 3-shift workers [hazard ratio (HR) 1.78, 95% confidence interval (95% CI) 1.49– 2.14] and 2-shift workers (HR 2.62, 95% CI 2.17–3.17). Significant elevations of the risk were still observed at the additional analysis on the sub-cohort (3-shift work: HR 3.55, 95% CI 2.02–6.25; 2-shift work: HR 4.86, 95% CI 2.62–9.01). CONCLUSIONS: Both 2- and 3-shift workers were associated with a high risk factor of developing IGT compared to day workers. Moreover, 2-shift workers had a higher risk than 3-shift workers. The risk was observed even among workers whose body mass remained within the normal range.

Keywords

• retrospective cohort study
• impaired glucose tolerance
• glucose
• glucose metabolism disorder
• historical cohort study
• cohort study
• japan
• shift work
• shift worker
• retrospective study
• work schedule tolerance