Increased Risk Of Type 2 Diabetes And Abnormal FPG Due To Shift Work Differs According To Gender: A Retrospective Cohort Study Among Thai Workers In Bangkok, Thailand
Received 17 June 2019
Accepted for publication 26 September 2019
Published 12 November 2019 Volume 2019:12 Pages 2341—2354
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Konstantinos Tziomalos
Nitt Hanprathet,1 Somrat Lertmaharit,1 Vitool Lohsoonthorn,1,2 Thanapoom Rattananupong,1 Palanee Ammaranond,3 Wiroj Jiamjarasrangsi1,2
1Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; 2Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; 3Department of Transfusion Medicine, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand
Correspondence: Wiroj Jiamjarasrangsi
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, Thailand
Tel +66 2 256 4000 ext. 3700
Fax +662 256 4292
Purpose: The gender differential evidence of the association between shift work and type 2 diabetes risk remains scarce. This longitudinal study determines whether the association between shift-work exposure and type 2 diabetes risk and abnormal fasting plasma glucose (FPG) differs according to gender; the study aims to find the association between shift work and changes in physiological, behavioral, and psychosocial stress.
Patients and methods: This retrospective cohort study was conducted among 5947 workers (4647 female and 1300 male) aged ≤60 years old in Bangkok, Thailand. Participants required a normal FPG level (<100 mg/dL) at baseline and at least two health check-up results from 2009 to 2016. Shift-work exposure history was assessed using a self-administered questionnaire; FPG levels were measured annually. Cox proportional hazard models were used to assess the aforementioned association.
Results: During the follow-up period, 1470 new abnormal FPG and 154 new type 2 diabetes cases developed. Stratified analysis of male workers’ data revealed an association was significant in the unadjusted model, which tended to be stronger after adjustment for demographic data and the baseline values of anthropometric and biochemical parameters. This was the case both for type 2 diabetes [Hazard Ratio (HR) (95% Confidence Interval (CI))=2.98 (1.58–5.62)] and abnormal FPG [HR (95% CI)=1.86 (1.43–2.41)]; this association was less obvious among women.
Conclusion: Shift work is a risk factor for type 2 diabetes and abnormal FPG; this risk is gender differential, being more pronounced in men. Preventive measures aiming at ameliorating shift work induced type 2 diabetes risk should pay more attention to men.
Keywords: shift-work exposure, diabetes, abnormal fasting plasma glucose, gender difference, behavioral stress, retrospective cohort study, Cox proportional hazard models
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