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Huang X, Tao Q, Ren C. A Comprehensive Overview of the Neural Mechanisms of Light Therapy. Neurosci Bull 2024; 40:350-362. [PMID: 37555919 PMCID: PMC10912407 DOI: 10.1007/s12264-023-01089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/22/2023] [Indexed: 08/10/2023] Open
Abstract
Light is a powerful environmental factor influencing diverse brain functions. Clinical evidence supports the beneficial effect of light therapy on several diseases, including depression, cognitive dysfunction, chronic pain, and sleep disorders. However, the precise mechanisms underlying the effects of light therapy are still not well understood. In this review, we critically evaluate current clinical evidence showing the beneficial effects of light therapy on diseases. In addition, we introduce the research progress regarding the neural circuit mechanisms underlying the modulatory effects of light on brain functions, including mood, memory, pain perception, sleep, circadian rhythm, brain development, and metabolism.
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Affiliation(s)
- Xiaodan Huang
- Guangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, 510632, China
| | - Qian Tao
- Psychology Department, School of Medicine, Jinan University, Guangzhou, 510632, China.
| | - Chaoran Ren
- Guangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, 510632, China.
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2
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Abstract
Shift work can cause circadian cycles disturbances and misaligns the endogenous rhythms. The physiological variables are driven by the circadian system and, its misalignment, can impair the metabolic functions. Thus, the main objective of this study was to evaluate the metabolic alterations as a result of shift work and night work reported in articles published in the last 5 years, using the eligibility criteria both gender and indexed articles in English language. In order to execute this work, we perform a systematic review according to PRISMA guidelines and searched about Chronobiology Disorders and Night Work, both related to metabolism, in Medline, Lilacs, ScienceDirect and Cochrane. Cross-sectional, cohort and experimental studies with low risk of bias were included. We found a total of 132 articles, and, after the selection process, 16 articles remained to be analyzed. It was observed that shift work can cause circadian misalignment and, consequently, some metabolic parameters alterations such as an impaired glycemic control and insulin functioning, cortisol phase release, cholesterol fractions imbalance, changes in morphological indexes and melatonin secretion. There are some limitations, such as heterogenicity in used databases and the 5 years restriction period, because the effects of sleep disturbance may have been reported earlier. In conclusion, we suggest that shift work interferes with the sleep-wake cycle and eating patterns, which cause crucial physiological alterations that, together, can lead to metabolic syndrome.
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Affiliation(s)
| | | | - Bruna Del Vechio Koike
- Department of Medicine, Medical School, Federal University of São Francisco Valley, Petrolina, PE, Brazil
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3
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Hohor S, Mandanach C, Maftei A, Zugravu CA, Oțelea MR. Impaired Melatonin Secretion, Oxidative Stress and Metabolic Syndrome in Night Shift Work. Antioxidants (Basel) 2023; 12:antiox12040959. [PMID: 37107334 PMCID: PMC10135726 DOI: 10.3390/antiox12040959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/08/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Metabolic syndrome has been associated in many studies with working in shifts. Even if the mechanistic details are not fully understood, forced sleep deprivation and exposure to light, as happens during night shifts, or irregular schedules with late or very early onset of the working program, lead to a sleep-wake rhythm misalignment, metabolic dysregulation and oxidative stress. The cyclic melatonin secretion is regulated by the hypothalamic suprachiasmatic nuclei and light exposure. At a central level, melatonin promotes sleep and inhibits wake-signals. Beside this role, melatonin acts as an antioxidant and influences the functionality of the cardiovascular system and of different metabolic processes. This review presents data about the influence of night shifts on melatonin secretion and oxidative stress. Assembling data from epidemiological, experimental and clinical studies contributes to a better understanding of the pathological links between chronodisruption and the metabolic syndrome related to working in shifts.
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Affiliation(s)
- Sorina Hohor
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania
| | - Cristina Mandanach
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania
| | - Andreea Maftei
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania
- "Dr. Carol Davila" Central Military Emergency University Hospital, 134 Calea Plevnei, Sector 1, 010242 Bucharest, Romania
| | - Corina Aurelia Zugravu
- Department of Hygiene and Ecology, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania
| | - Marina Ruxandra Oțelea
- Clinical Department 5, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania
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4
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Ishihara A, Courville AB, Chen KY. The Complex Effects of Light on Metabolism in Humans. Nutrients 2023; 15:nu15061391. [PMID: 36986120 PMCID: PMC10056135 DOI: 10.3390/nu15061391] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/15/2023] Open
Abstract
Light is an essential part of many life forms. The natural light–dark cycle has been the dominant stimulus for circadian rhythms throughout human evolution. Artificial light has restructured human activity and provided opportunities to extend the day without reliance on natural day–night cycles. The increase in light exposure at unwanted times or a reduced dynamic range of light between the daytime and nighttime has introduced negative consequences for human health. Light exposure is closely linked to sleep–wake regulation, activity and eating patterns, body temperature, and energy metabolism. Disruptions to these areas due to light are linked to metabolic abnormalities such as an increased risk of obesity and diabetes. Research has revealed that various properties of light influence metabolism. This review will highlight the complex role of light in human physiology, with a specific emphasis on metabolic regulation from the perspective of four main properties of light (intensity, duration, timing of exposure, and wavelength). We also discuss the potential influence of the key circadian hormone melatonin on sleep and metabolic physiology. We explore the relationship between light and metabolism through circadian physiology in various populations to understand the optimal use of light to mitigate short and long-term health consequences.
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5
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Galinde AAS, Al-Mughales F, Oster H, Heyde I. Different levels of circadian (de)synchrony -- where does it hurt? F1000Res 2022; 11:1323. [PMID: 37125019 PMCID: PMC10130703 DOI: 10.12688/f1000research.127234.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
A network of cellular timers ensures the maintenance of homeostasis by temporal modulation of physiological processes across the day. These so-called circadian clocks are synchronized to geophysical time by external time cues (or zeitgebers). In modern societies, natural environmental cycles are disrupted by artificial lighting, around-the-clock availability of food or shiftwork. Such contradictory zeitgeber input promotes chronodisruption, i.e., the perturbation of internal circadian rhythms, resulting in adverse health outcomes. While this phenomenon is well described, it is still poorly understood at which level of organization perturbed rhythms impact on health and wellbeing. In this review, we discuss different levels of chronodisruption and what is known about their health effects. We summarize the results of disrupted phase coherence between external and internal time vs. misalignment of tissue clocks amongst each other, i.e., internal desynchrony. Last, phase incoherence can also occur at the tissue level itself. Here, alterations in phase coordination can emerge between cellular clocks of the same tissue or between different clock genes within the single cell. A better understanding of the mechanisms of circadian misalignment and its effects on physiology will help to find effective tools to prevent or treat disorders arising from modern-day chronodisruptive environments.
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Affiliation(s)
- Ankita AS. Galinde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Faheem Al-Mughales
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
- Biochemistry Department, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Henrik Oster
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Isabel Heyde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
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6
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Galinde AAS, Al-Mughales F, Oster H, Heyde I. Different levels of circadian (de)synchrony -- where does it hurt? F1000Res 2022; 11:1323. [PMID: 37125019 PMCID: PMC10130703 DOI: 10.12688/f1000research.127234.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
A network of cellular timers ensures the maintenance of homeostasis by temporal modulation of physiological processes across the day. These so-called circadian clocks are synchronized to geophysical time by external time cues (or zeitgebers). In modern societies, natural environmental cycles are disrupted by artificial lighting, around-the-clock availability of food or shift work. Such contradictory zeitgeber input promotes chronodisruption, i.e., the perturbation of internal circadian rhythms, resulting in adverse health outcomes. While this phenomenon is well described, it is still poorly understood at which level of organization perturbed rhythms impact on health and wellbeing. In this review, we discuss different levels of chronodisruption and what is known about their health effects. We summarize the results of disrupted phase coherence between external and internal time vs. misalignment of tissue clocks amongst each other, i.e., internal desynchrony. Last, phase incoherence can also occur at the tissue level itself. Here, alterations in phase coordination can emerge between cellular clocks of the same tissue or between different clock genes within the single cell. A better understanding of the mechanisms of circadian misalignment and its effects on physiology will help to find effective tools to prevent or treat disorders arising from modern-day chronodisruptive environments.
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Affiliation(s)
- Ankita AS. Galinde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Faheem Al-Mughales
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
- Biochemistry Department, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Henrik Oster
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Isabel Heyde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
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7
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Gusmão WDP, Pureza IROM, Moreno CRC. Shift Work and Early Arterial Stiffness: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14569. [PMID: 36361448 PMCID: PMC9654495 DOI: 10.3390/ijerph192114569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Shift work is a way of organizing rotating schedules throughout the day. This can include 1-3 shifts for the same person on a rotational basis with other workers. Schedules that include night work have been associated with cardiovascular risk, mainly due to circadian misalignment. This systematic review sought to determine whether shift work is a risk factor for increased arterial stiffness. A systematic review of different databases was performed, using the following keywords: work shift, night work, arteriosclerosis, vascular stiffness, arterial stiffness, pulse wave velocity, and their Medical Subject Headings. We selected and analyzed 11 articles regarding pulse wave velocity as an indicator of arterial stiffness. Two studies identified higher levels of arterial stiffness in shift workers compared to day workers, while two studies found the opposite. In addition, four studies found no differences in arterial stiffness between shifts, two studies associated shorter sleep duration with arterial stiffness, and one study observed that physical activity could prevent adverse cardiovascular outcomes in shift workers. The findings are heterogeneous and preclude any robust conclusions. However, the present review points to the need for further studies to investigate arterial stiffness in shift workers, with greater control for confounding factors and longitudinal design.
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Affiliation(s)
- Waléria D. P. Gusmão
- Department of Health, Life Cycles and Society, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil
| | - Isabele R. O. M. Pureza
- Department of Nutrition, Campus I—Prof. Eduardo Almeida, Centro Universitário Cesmac, Maceió 57051-160, Brazil
| | - Claudia R. C. Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil
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8
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Sooriyaarachchi P, Jayawardena R, Pavey T, King NA. Shift work and the risk for metabolic syndrome among healthcare workers: A systematic review and meta-analysis. Obes Rev 2022; 23:e13489. [PMID: 35734805 PMCID: PMC9539605 DOI: 10.1111/obr.13489] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 11/27/2022]
Abstract
Shift work, defined as work occurring outside typical daytime working hours, is associated with an increased risk for metabolic syndrome (MetS) due to several biological and environmental changes. The MetS refers to the clustering of several known cardiovascular risk factors, including insulin resistance, obesity, dyslipidemia, and hypertension. This systematic review aims to evaluate the literature on the association between shift work and the risk of MetS in employees of the health sector. A systematic search was conducted in PubMed, Web of Science, and Scopus databases using appropriate keywords for studies published before September 1, 2021. Eligible studies were those that compared the prevalence of MetS between day and shift healthcare workers; had a cross-sectional, case-control, or cohort study design; provided sufficient data for calculating odds ratios or relative risks with 95% confidence intervals; and articles in English. The Joanna Briggs Institute prevalence critical appraisal tool was used for quality analysis. Risk for MetS and related measures of effect size were retrieved from studies for meta-analysis. Twelve studies met the criteria for inclusion in the review and meta-analysis. Sample sizes ranged from 42 to 738, and the age range of subjects was between 18 and 65 years. Ten studies demonstrated high methodological quality, while two studies were of average quality. Ten out of 12 studies in the review demonstrated a higher risk in shift workers for developing MetS than day workers. The pooled OR of MetS in shift workers based on 12 studies was 2.17 (95% CI = 1.31-3.60, P = 0.003; I2 = 82%, P < 0.001). Shift workers exhibited more than a twofold increase in the chance of developing MetS in comparison with day workers.
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Affiliation(s)
- Piumika Sooriyaarachchi
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranil Jayawardena
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Toby Pavey
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Neil A King
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
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9
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Frazier K, Kambal A, Zale EA, Pierre JF, Hubert N, Miyoshi S, Miyoshi J, Ringus DL, Harris D, Yang K, Carroll K, Hermanson JB, Chlystek JS, Overmyer KA, Cham CM, Musch MW, Coon JJ, Chang EB, Leone VA. High-fat diet disrupts REG3γ and gut microbial rhythms promoting metabolic dysfunction. Cell Host Microbe 2022; 30:809-823.e6. [PMID: 35439436 PMCID: PMC9281554 DOI: 10.1016/j.chom.2022.03.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/22/2021] [Accepted: 03/23/2022] [Indexed: 11/24/2022]
Abstract
Gut microbial diurnal oscillations are important diet-dependent drivers of host circadian rhythms and metabolism ensuring optimal energy balance. However, the interplay between diet, microbes, and host factors sustaining intestinal oscillations is complex and poorly understood. Here, using a mouse model, we report the host C-type lectin antimicrobial peptide Reg3γ works with key ileal microbes to orchestrate these interactions in a bidirectional manner and does not correlate with the intestinal core circadian clock. High-fat diet is the primary driver of microbial oscillators that impair host metabolic homeostasis, resulting in arrhythmic host Reg3γ expression that secondarily drives abundance and oscillation of key gut microbes. This illustrates transkingdom coordination of biological rhythms primarily influenced by diet and reciprocal sensor-effector signals between host and microbial components, ultimately driving metabolism. Restoring the gut microbiota's capacity to sense dietary signals mediated by specific host factors such as Reg3γ could be harnessed to improve metabolic dysfunction.
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Affiliation(s)
- Katya Frazier
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Amal Kambal
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Elizabeth A Zale
- Infectious Diseases Division, Weill Cornell Medicine, New York, NY 10065, USA
| | - Joseph F Pierre
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Nathaniel Hubert
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Sawako Miyoshi
- Department of General Medicine, Kyorin University School of Medicine, Tokyo 1818611, Japan
| | - Jun Miyoshi
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo 1818611, Japan
| | - Daina L Ringus
- Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Dylan Harris
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Karen Yang
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Katherine Carroll
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Jake B Hermanson
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - John S Chlystek
- Department of Biomolecular Chemistry, University of Wisconsin-Madison, Madison, WI 53506, USA
| | - Katherine A Overmyer
- Department of Biomolecular Chemistry, University of Wisconsin-Madison, Madison, WI 53506, USA; National Center for Quantitative Biology of Complex Systems, Madison, WI 53706, USA; Morgridge Institute for Research, Madison, WI 53715, USA
| | - Candace M Cham
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Mark W Musch
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Joshua J Coon
- Department of Biomolecular Chemistry, University of Wisconsin-Madison, Madison, WI 53506, USA; National Center for Quantitative Biology of Complex Systems, Madison, WI 53706, USA; Morgridge Institute for Research, Madison, WI 53715, USA; Department of Chemistry, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Eugene B Chang
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Vanessa A Leone
- Department of Animal & Dairy Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA.
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10
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Abstract
Shift work does not synchronize with the 24-hour human circadian rhythm, so shift workers experience various problems related to this disruption. This study investigated the relationship between suicidal risk and emotional difficulties such as depression and anxiety in shift workers according to gender. We analyzed data collected from 79,009 health checkup recipients. We checked psychosocial factors for different genders using the Chi-square test and t-tests. To examine the relationship between shift work and suicidal ideation, we estimated an odds ratio after adjustment for age, depression, and insomnia. There was no difference in terms of the risk of suicidal ideation between shift workers and day workers among women (adjusted odds ratio [AOR], 0.957; 95% confidence interval [CI], 0.826-1.109), whereas the risk of suicidal ideation was significantly higher for shift workers than for day workers among men (AOR, 1.157; 95% CI, 1.021-1.310). This study confirmed that associated factors of shift work-related suicidal ideation could act differently by gender. Shift work for women is generally associated with emotional difficulties such as depression and anxiety, whereas maladaptation to shift work may be related to suicidal ideation among men. A gender-specific suicide prevention approaches will be needed for shift workers.
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11
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Izadi N, Najafi A, Saraei M. Metabolic syndrome and its determinants among professional drivers: a systematic review and meta-analysis. J Diabetes Metab Disord 2021; 20:2015-2023. [PMID: 34900837 DOI: 10.1007/s40200-021-00928-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022]
Abstract
Background Drivers are one of the trade unions that are most exposed to various health-related risks, especially metabolic diseases. The present study aimed to systematically assess the overall prevalence of metabolic syndrome and its determinants among drivers in the world. Methods All retrospective, cross-sectional, or prospective studies evaluating the prevalence and risk for metabolic syndrome and its main components among male professional drivers were eligible for the initial assessment. PRISMA guideline was used. Two blinded reviewers independently screened the titles and abstracts of the manuscripts followed by a deep assessment of the full texts for determining the inclusion appropriateness. Results In the final, 12 articles were eligible for the final analysis. Overall, 19,350 professional male drivers with a total average age of 43.06 years (ranged from 35.5 to 51.1 years) were included in the study. The prevalence of metabolic syndrome was estimated to be 32.8% (95%CI: 32.1% to 33.5%), and the major determinants of appearing this syndrome among professional drivers were advanced age, years of driving experience, higher body mass index, smoking, high cholesterol dietary regimen, high Framingham risk score, low regular exercising, history of diabetes mellitus, history of gout, and shift work pattern. Conclusion According to the 32.8% prevalence rate of metabolic syndrome among drivers, managerial measures are needed to prevent and control metabolic disturbances among professional drivers are recommended.
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Affiliation(s)
- Nazanin Izadi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saraei
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
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12
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Grant LK, Czeisler CA, Lockley SW, Rahman SA. Time-of-day and Meal Size Effects on Clinical Lipid Markers. J Clin Endocrinol Metab 2021; 106:e1373-e1379. [PMID: 33051649 PMCID: PMC8502473 DOI: 10.1210/clinem/dgaa739] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT Dyslipidemia and cardiovascular disease are common in shift workers and eating at night may contribute to this pathophysiology. OBJECTIVE To examine the effects of eating at different times of day on lipid profiles. DESIGN Two 24-hour baseline days with 8 hours of sleep, 3 meals (breakfast, lunch, dinner) and a snack, followed by a 40-hour constant routine (CR) with hourly isocaloric meals. SETTING Intensive Physiological Monitoring Unit, Brigham and Women's Hospital. PARTICIPANTS Twenty-one healthy adults [23.4 ± 2.7 years, 5F]. INTERVENTION Forty-hour CR. MAIN OUTCOME MEASURES A standard clinical lipid panel, consisting of total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), was assayed in blood samples collected 4-hourly across ~4 days. RESULTS When participants ate at night, levels of TG were similar to eating during the day, however, these levels at night were reached with consuming approximately half the calories. Additionally, 24-hour levels of TG were 10% higher when meals were consumed hourly across 24 hours compared to consuming a typical 3-meal schedule while awake during the day and sleeping at night. The endogenous circadian rhythms of TG, which peaked at night, were shifted earlier by ~10 hours under baseline conditions, whereas the rhythms in total cholesterol, HDL-C, and LDL-C remained unchanged and peaked in the afternoon. CONCLUSIONS The time-of-day dependency on postprandial lipid metabolism, which leads to hypersensitivity in TG responses when eating at night, may underlie the dyslipidemia and elevated cardiovascular disease risk observed in shift workers.
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Affiliation(s)
- Leilah K Grant
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Steven W Lockley
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
- Correspondence and Reprint Requests: Shadab A. Rahman, Ph.D., M.P.H., Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA 02115. E-mail:
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13
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Lahtinen A, Häkkinen A, Puttonen S, Vanttola P, Viitasalo K, Porkka-Heiskanen T, Härmä M, Paunio T. Differential DNA methylation in recovery from shift work disorder. Sci Rep 2021; 11:2895. [PMID: 33536559 PMCID: PMC7858604 DOI: 10.1038/s41598-021-82627-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/22/2021] [Indexed: 01/07/2023] Open
Abstract
The human DNA methylome is responsive to our environment, but its dynamics remain underexplored. We investigated the temporal changes to DNA methylation (DNAme) in relation to recovery from a shift work disorder (SWD) by performing a paired epigenome-wide analysis in an occupational cohort of 32 shift workers (25 men, age = 43.8 ± 8.8 years, 21 SWD cases). We found that the effect of vacation on DNAme was more prominent in the SWD-group as compared to controls, with respect to the amount of significantly differentially methylated positions (DMPs; Punadj < 0.05) 6.5 vs 3.7%, respectively. The vast majority (78%) of these DMPs were hypomethylated in SWD but not in controls (27%) during the work period. The Gene Ontology Cellular component "NMDA glutamate receptor" (PFDR < 0.05) was identified in a pathway analysis of the top 30 genes in SWD. In-depth pathway analyses revealed that the Reactome pathway "CREB phosphorylation through the activation of CaMKII" might underlie the recovery. Furthermore, three DMPs from this pathway, corresponding to GRIN2C, CREB1, and CAMK2B, correlated with the degree of recovery (Punadj < 0.05). Our findings provide evidence for the dynamic nature of DNAme in relation to the recovery process from a circadian disorder, with biological relevance of the emerging pathways.
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Affiliation(s)
- Alexandra Lahtinen
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Biomedicum 1, Haartmaninkatu 8, 00290, Helsinki, Finland. .,Genomics and Biobank UnitDepartment of Public Health Solutions, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271, Helsinki, Finland.
| | - Antti Häkkinen
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sampsa Puttonen
- Work Ability and Working Careersareers, Finnish Institute of Occupational Health, PO Box 40, 00032, Helsinki, Finland
| | - Päivi Vanttola
- Work Ability and Working Careersareers, Finnish Institute of Occupational Health, PO Box 40, 00032, Helsinki, Finland
| | | | - Tarja Porkka-Heiskanen
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Biomedicum 1, Haartmaninkatu 8, 00290, Helsinki, Finland
| | - Mikko Härmä
- Work Ability and Working Careersareers, Finnish Institute of Occupational Health, PO Box 40, 00032, Helsinki, Finland
| | - Tiina Paunio
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Biomedicum 1, Haartmaninkatu 8, 00290, Helsinki, Finland. .,Genomics and Biobank UnitDepartment of Public Health Solutions, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271, Helsinki, Finland.
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Bottalico LN, Weljie AM. Cross-species physiological interactions of endocrine disrupting chemicals with the circadian clock. Gen Comp Endocrinol 2021; 301:113650. [PMID: 33166531 PMCID: PMC7993548 DOI: 10.1016/j.ygcen.2020.113650] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 10/09/2020] [Accepted: 10/17/2020] [Indexed: 02/06/2023]
Abstract
Endocrine disrupting chemicals (EDCs) are endocrine-active chemical pollutants that disrupt reproductive, neuroendocrine, cardiovascular and metabolic health across species. The circadian clock is a transcriptional oscillator responsible for entraining 24-hour rhythms of physiology, behavior and metabolism. Extensive bidirectional cross talk exists between circadian and endocrine systems and circadian rhythmicity is present at all levels of endocrine control, from synthesis and release of hormones, to sensitivity of target tissues to hormone action. In mammals, a range of hormones directly alter clock gene expression and circadian physiology via nuclear receptor (NR) binding and subsequent genomic action, modulating physiological processes such as nutrient and energy metabolism, stress response, reproductive physiology and circadian behavioral rhythms. The potential for EDCs to perturb circadian clocks or circadian-driven physiology is not well characterized. For this reason, we explore evidence for parallel endocrine and circadian disruption following EDC exposure across species. In the reviewed studies, EDCs dysregulated core clock and circadian rhythm network gene expression in brain and peripheral organs, and altered circadian reproductive, behavioral and metabolic rhythms. Circadian impacts occurred in parallel to endocrine and metabolic alterations such as impaired fertility and dysregulated metabolic and energetic homeostasis. Further research is warranted to understand the nature of interaction between circadian and endocrine systems in mediating physiological effects of EDC exposure at environmental levels.
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Affiliation(s)
- Lisa N Bottalico
- Department of Systems Pharmacology and Translational Therapeutics, Institute for Translational Medicine and Therapeutics, Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Aalim M Weljie
- Department of Systems Pharmacology and Translational Therapeutics, Institute for Translational Medicine and Therapeutics, Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Dutheil F, Baker JS, Mermillod M, De Cesare M, Vidal A, Moustafa F, Pereira B, Navel V. Shift work, and particularly permanent night shifts, promote dyslipidaemia: A systematic review and meta-analysis. Atherosclerosis 2020; 313:156-169. [PMID: 33069952 DOI: 10.1016/j.atherosclerosis.2020.08.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/15/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Shift work is common worldwide and linked to deleterious cardiovascular effects that might be underlined by dyslipidemia. The aim of this systematic review and meta-analysis is to determine the impact of shiftwork on dyslipidemia. METHODS Searching in PubMed, Cochrane Library, Science Direct and Embase databases without language restriction on 15 February 2020, included studies that describe blood lipids levels or a risk measure in shift workers compared with fixed-day workers (controls). Differences by study-level characteristics were estimated using stratified meta-analysis by type of shift work, and meta-regression to examine relations between dyslipidemia and demographic, lifestyle and work characteristics. Estimates were pooled using random-effect meta-analysis. RESULTS We included a total of 66 articles, representing 197,063 workers. Shift work globally increased the levels of triglycerides (overall SMD = 0.09; 95CI 0.05 to 0.13; p < 0.001), and globally decreased the levels of c-HDL (-0.08; 95CI -0.12 to -0.03; p = 0.001). Permanent night shift workers were an at-risk type of shift for dyslipidemia with significantly higher blood levels of total cholesterol (0.22; 95CI 0.01 to 0.42; p = 0.043) and triglycerides (0.18; 0.03 to 0.33; p = 0.017), and significantly lower blood levels of c-HDL (-0.16; 95CI -0.32 to 0.00; p = 0.05). Permanent night shift workers were more at-risk for total cholesterol than rotating 3 × 8 shift workers (Coefficient 0.22; 95CI 0.01 to 0.42; p = 0.038) and rotating 2 × 12 shift workers (0.24; 0.02 to 0.46; p = 0.037), and more at-risk for triglycerides than rotating day shift workers (0.21; 95CI 0.03 to 0.38; p = 0.023). Results were non-significant for c-LDL, nor depending on type of shifts. CONCLUSIONS Shift work, and particularly permanent night shift, is associated with dyslipidaemia via elevated total cholesterol and triglycerides, and reduced HDL-cholesterol. Our current study provides a practical and valuable strengthening of the evidence-base required for preventive health initiatives and workplace reform.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000, Clermont-Ferrand, France.
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France; Institut Universitaire de France, Paris, France
| | - Mélanie De Cesare
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Alexia Vidal
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Fares Moustafa
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Emergency Unit, F-63000, Clermont-Ferrand, France
| | - Bruno Pereira
- University Hospital of Clermont-Ferrand (CHU), Clinical Research and Innovation Direction, Clermont-Ferrand, France
| | - Valentin Navel
- Université Clermont Auvergne, CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France
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High-Intensity Training Reduces CVD Risk Factors among Rotating Shift Workers: An Eight-Week Intervention in Industry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113943. [PMID: 32498373 PMCID: PMC7312909 DOI: 10.3390/ijerph17113943] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 01/23/2023]
Abstract
Rotating shift work is associated with risk factors for cardiovascular disease (CVD). We have studied the effect of 17 min high-intensity training three times a week over eight weeks on CVD risk factors among shift workers. Sixty-five shift workers from two plants were recruited. They were all deemed healthy at the initial health screening and in 100% work. From plant A, 42 workers, and plant B, 23 workers participated. After the intervention, 56 workers were retested. The intervention group consisted of 19 participants from plant A who had participated in at least 10 sessions. Twenty workers from plant B and 17 workers from plant A that not had taken part in the training were included in the control group. All workers reported physical activity (PA) by questionnaires before and after the training intervention. We measured blood pressure, heart rate, lipids, glycated hemoglobin (HbA1c), and C-reactive protein (CRP) and arterial stiffness. Maximal oxygen uptake (V.O2max) was assessed by bicycle ergometry. The intervention group favorably differed significantly from the control group in improvement of systolic and diastolic blood pressure and glycated hemoglobin (HbA1c). Short training sessions with 4 min of high-intensity PA, three times a week, for eight weeks among rotating shift workers reduced some CVD risk factors. PA interventions in occupational settings may thus decrease coronary heart disease and stroke incidences in this vulnerable group of workers.
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Barca‐Mayo O, Boender AJ, Armirotti A, De Pietri Tonelli D. Deletion of astrocytic BMAL1 results in metabolic imbalance and shorter lifespan in mice. Glia 2020; 68:1131-1147. [PMID: 31833591 PMCID: PMC7496695 DOI: 10.1002/glia.23764] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/26/2019] [Accepted: 12/03/2019] [Indexed: 12/19/2022]
Abstract
Disruption of the circadian cycle is strongly associated with metabolic imbalance and reduced longevity in humans. Also, rodent models of circadian arrhythmia, such as the constitutive knockout of the clock gene Bmal1, leads to metabolic disturbances and early death. Although astrocyte clock regulates molecular and behavioral circadian rhythms, its involvement in the regulation of energy balance and lifespan is unknown. Here, we show that astrocyte-specific deletion of Bmal1 is sufficient to alter energy balance, glucose homeostasis, and reduce lifespan. Mutant animals displayed impaired hypothalamic molecular clock, age-dependent astrogliosis, apoptosis of hypothalamic astrocytes, and increased glutamate and GABA levels. Importantly, modulation of GABAA-receptor signaling completely restored glutamate levels, delayed the reactive gliosis as well as the metabolic phenotypes and expanded the lifespan of the mutants. Our results demonstrate that the astrocytic clock can influence many aspects of brain function and neurological disease and suggest astrocytes and GABAA receptor as pharmacological targets to prevent the metabolic dysfunctions and shortened lifespan associated with alterations of circadian rhythms.
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Affiliation(s)
- Olga Barca‐Mayo
- Neurobiology of miRNA labFondazione Istituto Italiano di TecnologiaGenoaItaly
| | - Arjen J. Boender
- Neuromodulation of Cortical and Subcortical Circuits LabFondazione Istituto Italiano di TecnologiaGenoaItaly
| | - Andrea Armirotti
- D3 PharmaChemistryFondazione Istituto Italiano di TecnologiaGenoaItaly
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Amini M, Zayeri F. Application of multiple-group latent growth model to determine the effect of shift work on body mass index among petrochemical industries staff. Med J Islam Repub Iran 2020; 33:109. [PMID: 31934569 PMCID: PMC6946924 DOI: 10.34171/mjiri.33.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Indexed: 11/18/2022] Open
Abstract
Background: Shift work can be defined as work activity scheduled in which employees work outside standard daytime hours. Some reports have shown that shift work is associated with several health problems. The main objective of this research was to explore the effect of shift work on body mass index (BMI) over time among Iranian petroleum industry staff. Methods: This longitudinal study sample was consisted of 3,686 (1,872 day workers and 1,814 shift workers) petrochemical industries staff in Mahshahr, southwest of Iran, from 2012 to 2015. The weight and height of these staff were measured using standard techniques and equipment. Multiple-group latent growth curve modeling was used to determine the effect of shift working on BMI trajectories over this period of time via Mplus software, version 6.0. Results: The mean (±SD) age of the shift workers and day workers were 38.96 (±8.36) and 43.33 (±8.35) years, respectively. Findings from the modeling approach showed that the slope of BMI in shift workers on average was 0.14 kg/m2 greater than the day workers in years under study (p<0.001). Conclusion: The findings of the current study suggest that shift work can be considered as a potential risk indicator for higher weight gain in petrochemical staff. Hence, health policy-makers should organize health screening programs and periodical checkups to find high-risk staff and control unhealthy lifestyle factors in these industries.
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Affiliation(s)
- Maedeh Amini
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farid Zayeri
- Proteomics Research Center and Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ferri GM, Cavone D, Intranuovo G, Macinagrossa L. Healthy Diet and Reduction of Chronic Disease Risks of Night Shift Workers. Curr Med Chem 2019; 26:3521-3541. [PMID: 28730970 DOI: 10.2174/0929867324666170720160632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 05/05/2017] [Accepted: 05/05/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The large increase in epidemiological studies on night shift work is due to the important effects of night shift work on workers' health and psychophysical wellbeing. The short-term effects-insomnia, difficulties in managing work and private life, lower work performance, and more work and extra-work accidents-are easily studied. However, there are several long-term effects that are difficult to study because of the need for detailed exposure assessment and the long latency periods of these diseases. OBJECTIVE The aim was to collect epidemiologic evidence of diseases in night shift workers, describing their biological pathways and a set of dietary guidelines. METHODS This is a review on diet and health effects in night shift workers. RESULTS Significant increases in the rate ratios and hazard ratios of different diseases were associated with modified eating behaviours and poor eating habits among night shift workers. Night shift work is a risk factor for disruption of the circadian rhythms and for some genetic deregulation because it produces the inversion of the sleep/wake cycle and modifies the alternation between activity and rest. CONCLUSION A healthy diet and improved dietary practices, together with other factors, can reduce shift workers' chronic disease risk. The literature showed the importance of eating behaviour in order to prevent diseases in these workers; therefore, educational programmes are necessary to encourage several important lifestyle changes. The target of our future research will be the role of food components in some dietetic habits for the prevention of disease in night shift workers.
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Affiliation(s)
- G M Ferri
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
| | - D Cavone
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
| | - G Intranuovo
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
| | - L Macinagrossa
- Interdisciplinary Department of Medicine (DIM), Section "B. Ramazzini", Unit of Occupational Medicine, University Regional Hospital "Policlinico - Giovanni XXIIIth", Bari, Italy
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Gao Y, Gan T, Jiang L, Yu L, Tang D, Wang Y, Li X, Ding G. Association between shift work and risk of type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies. Chronobiol Int 2019; 37:29-46. [DOI: 10.1080/07420528.2019.1683570] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yinyan Gao
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Ting Gan
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Gansu, China
| | - Lili Jiang
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Li Yu
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Daimao Tang
- Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Gansu, China
| | - Yihui Wang
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Xiuxia Li
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Gansu, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Gansu, China
| | - Guowu Ding
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
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Reid KJ, Weng J, Ramos AR, Zee PC, Daviglus M, Mossavar-Rahmani Y, Sotres-Alvarez D, Gallo LC, Chirinos DA, Patel SR. Impact of shift work schedules on actigraphy-based measures of sleep in Hispanic workers: results from the Hispanic Community Health Study/Study of Latinos ancillary Sueño study. Sleep 2019; 41:5053098. [PMID: 30010969 DOI: 10.1093/sleep/zsy131] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Indexed: 12/15/2022] Open
Abstract
Study Objectives To describe sleep characteristics of shift workers compared with day workers from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sueño ancillary study and test the hypothesis that shift work is associated with shorter sleep duration, worse sleep quality, greater sleep variability, and other sleep/health-related factors. Methods Employed adults (N = 1253, mean age 46.3 years, 36.3% male) from the Sueño study were included. Measures of sleep duration, timing, regularity, and continuity were calculated from 7 days of wrist-activity monitoring. Participants provided information on demographics, employment, work schedule (day, afternoon, night, split, irregular, and rotating), sleepiness, depressive symptoms, medications, caffeine, and alcohol use. Survey linear regression adjusting for age, sex, background, site, number of jobs, and work hours was used. Results In age and sex-adjusted models, all shift work schedules were associated with delayed sleep timing. Night and irregular schedules were associated with shorter sleep duration, greater napping, and greater variability of sleep. Afternoon and rotating shifts were associated with lower sleep regularity. In fully adjusted models, night and irregular schedules remained associated with shorter sleep duration, later sleep midpoint, and greater variability in sleep measures compared with day schedules. Split schedules were associated with, less time in bed, less sleep fragmentation, and less wake during the sleep period than day schedules. Conclusions Work schedule significantly affects sleep-wake with substantial differences between day work and other types of schedule. Detailed assessment of work schedule type not just night shift should be considered as an important covariate when examining the association between sleep and health outcomes.
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Affiliation(s)
- Kathryn J Reid
- Department of Neurology, Northwestern University, Chicago, IL
| | - Jia Weng
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Alberto R Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
| | - Phyllis C Zee
- Department of Neurology, Northwestern University, Chicago, IL
| | | | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | | | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
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Dietary Interventions for Night Shift Workers: A Literature Review. Nutrients 2019; 11:nu11102276. [PMID: 31547547 PMCID: PMC6836085 DOI: 10.3390/nu11102276] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 09/09/2019] [Accepted: 09/15/2019] [Indexed: 12/21/2022] Open
Abstract
(1) Background: Night shift workers have greater risks of developing cardiometabolic diseases compared to day workers due to poor sleep quality and dietary habits, exacerbated by circadian misalignment. Assessing effects of dietary interventions on health outcomes among this group will highlight gaps for future research. (2) Methods: A search of studies was conducted on PubMed, Cochrane Library, Embase, Embase Classic, Ovid Emcare, and Google Scholar, from earliest to June 2019. The population-intervention-comparator-outcomes-study design format determined inclusion criteria. (3) Results: 756 articles were retrieved; five met inclusion and exclusion criteria. Six-hundred-and-seventy night shift workers were from healthcare, industrial, and public safety industries. Dietary interventions included two longer-term nutrition programs and three shorter-term adjustments of meal composition, type, and timing. Outcome measures were varied but included weight and cardiometabolic health measures. Nutrition programs found no weight improvement at both six and 12 months; low-density lipoprotein (LDL)-cholesterol levels decreased at six months. Triglycerides peaked after meals at 7:30 pm; glucose and insulin area under the curve peaked after meals at 11:30 pm. (4) Conclusions: Weight loss was not achieved in the studies reviewed but LDL-cholesterol improved. Future studies should investigate the effects of energy reduction and altering meal timing on cardiometabolic risk factors of night shift workers in randomised controlled trials, while assessing hunger, sleepiness, and performance.
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Association between shift work and obesity in a large sample of Iranian steel industry workers. Arh Hig Rada Toksikol 2019; 70:194-200. [PMID: 32597131 DOI: 10.2478/aiht-2019-70-3266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 09/01/2019] [Indexed: 12/23/2022] Open
Abstract
Obesity is associated with several chronic diseases, and previous research suggests that shift work could be associated with the risk of overweight and obesity, but the results remain inconclusive. Furthermore, only a few studies report related findings for industrial workforce with high job-related stress. The aim of this cross-sectional study was to see if such association exists in a large sample of 3063 industrial workers in a developing country. The sample was selected among 16,000 steel company workers through multistage cluster sampling. We took anthropometric measurements, including body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR). Information about potential confounders was collected with a self-administered questionnaire. The association between shift work and both general and abdominal obesity was established with multinomial and binary logistic regression analysis. The study sample consisted of 1683 (54.9 %) rotational shift workers and 1380 (45.1 %) day workers. Shift work was significantly associated with higher risk of overweight after adjusting for the impacts of potential confounders (OR=1.2; 95 % CI:1.04-1.4) but not with abdominal obesity. This study established that shift work was an independent risk factor for overweight in industrial shift workers. Modification of working schedules is recommended, particularly for prolonged, continuous shift work.
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Ryu JC, Zimmer ER, Rosa-Neto P, Yoon SO. Consequences of Metabolic Disruption in Alzheimer's Disease Pathology. Neurotherapeutics 2019; 16:600-610. [PMID: 31270743 PMCID: PMC6694332 DOI: 10.1007/s13311-019-00755-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's disease (AD) is an irreversible, progressive disease that slowly destroys cognitive function, such as thinking, remembering, and reasoning, to a level that one cannot carry out a daily living. As people live longer, the risk of developing AD has increased to 1 in 10 among people who are older than 65 and to almost 1 in 2 among those who are older than 85 according to a 2019 Alzheimer's Association report. As a most common cause of dementia, AD accounts for 60-80% of all dementia cases. AD is characterized by amyloid plaques and neurofibrillary tangles, composed of extracellular aggregates of amyloid-β peptides and intracellular aggregates of hyperphosphorylated tau, respectively. Besides plaques and tangles, AD pathology includes synaptic dysfunction including loss of synapses, inflammation, brain atrophy, and brain hypometabolism, all of which contribute to progressive cognitive decline. Recent genetic studies of sporadic cases of AD have identified a score of risk factors, as reported by Hollingworth et al. (Nat Genet 43:429-435, 2001) and Lambert et al. (Nat Genet 45:1452-1458, 2013). Of all these genes, apolipoprotein E4 (APOE4) still presents the biggest risk factor for sporadic cases of AD, as stated in Saunders et al. (Neurology 43:1467-1472, 1993): depending on whether you have 1 or 2 copies of APOE4 allele, the risk increases from 3- to 12-fold, respectively, in line with Genin et al. (Mol Psychiatry 16:903-907, 2011). Besides these genetic risk factors, having type 2 diabetes (T2D), a chronic metabolic disease, is known to increase the AD risk by at least 2-fold when these individuals age, conforming to Sims-Robinson et al. (Nat Rev Neurol 6:551-559, 2010). Diabetes is reaching a pandemic scale with over 422 million people diagnosed worldwide in 2014 according to World Health Organization. Although what proportion of these diabetic patients develop AD is not known, even if 10% of diabetic patients develop AD later in their life, it would double the number of AD patients in the world. Better understanding between T2D and AD is of paramount of importance for the future. The goal of this review is to examine our current understanding on metabolic dysfunction in AD, so that a potential target can be identified in the near future.
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Affiliation(s)
- J C Ryu
- Department of Biological Chemistry & Pharmacology, Ohio State University, Columbus, OH, USA
| | - E R Zimmer
- Department of Pharmacology, UFRGS, Porto Alegre, Brazil
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Biological Sciences: Pharmacology and Therapeutics, UFRGS, Porto Alegre, Brazil
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - P Rosa-Neto
- Montreal Neurological Institute, Montreal, Canada
| | - S O Yoon
- Department of Biological Chemistry & Pharmacology, Ohio State University, Columbus, OH, USA.
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Tomizawa A, Nogawa K, Watanabe Y, Oishi M, Tanaka K, Sakata K, Suwazono Y. Effect of circadian rhythm type on serum lipid levels in shift workers: A 5-year cohort study. Chronobiol Int 2019; 36:751-757. [PMID: 31014131 DOI: 10.1080/07420528.2018.1549563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We investigated how differences in circadian rhythm type affect the health of workers engaged in shift work. Employees, who were newly hired in a steel company between 2007 and 2011, received the Morningness-Eveningness Questionnaire (MEQ) survey. The target participants were 153 male shift workers who were not being treated with any antihyperlipidemic drugs and underwent periodic physical examinations including blood tests at least twice. According to the score of the MEQ at the time of joining the company, we classified the subjects into five types. Longitudinal changes in serum lipid level were estimated among the circadian rhythm types adjusted for age, BMI, and other covariates using a linear mixed model. The regression coefficient of total cholesterol level in the "definitely and moderately morning" group was -17.83 (95% confidence interval (CI): -33.42 to -2.23), and in the "intermediate 'group' was -16.84 [95% CI: -30.40 to -3.28], compared to the moderate evening type." The total cholesterol level was higher in the moderately evening type than in any of the other groups. Between the Morningness-Eveningness (ME) type and Low-density lipoprotein (LDL) cholesterol levels, compared with the "moderately evening type" group, the regression coefficient in the "intermediate type" group was -16.08 (95% CI: -28.79 to -3.37), and in the "definitely and moderately morning type" group was -17.50 [95% CI: -32.11 to -2.88]. The "moderately evening type" group had a higher LDL cholesterol level than any of the other groups. Evening-type circadian rhythm type shift workers are more prone to elevated serum lipid levels.
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Affiliation(s)
- Aki Tomizawa
- a Department of Occupational and Environmental Medicine, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Kazuhiro Nogawa
- a Department of Occupational and Environmental Medicine, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Yuuka Watanabe
- a Department of Occupational and Environmental Medicine, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Mitsuhiro Oishi
- a Department of Occupational and Environmental Medicine, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Kumihiko Tanaka
- a Department of Occupational and Environmental Medicine, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Kouichi Sakata
- a Department of Occupational and Environmental Medicine, Graduate School of Medicine , Chiba University , Chiba , Japan
| | - Yasushi Suwazono
- a Department of Occupational and Environmental Medicine, Graduate School of Medicine , Chiba University , Chiba , Japan
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Nikpour M, Tirgar A, Hajiahmadi M, Hosseini A, Heidari B, Ghaffari F, Ebadi A, Nasiri F, Firouzbakht M. Shift work and metabolic syndrome: A multi-center cross-sectional study on females of reproductive age. Biomed Rep 2019; 10:311-317. [PMID: 31086665 DOI: 10.3892/br.2019.1205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/01/2019] [Indexed: 12/26/2022] Open
Abstract
Shift work during reproductive age can be a risk factor for metabolic syndrome. The present study evaluated the association between shift work and metabolic syndrome during reproductive age. This multi-center cross-sectional correlational study was performed between September 2017 and May 2018. A total of 419 female shift and day workers were purposively recruited to the study from three central cities in Mazandaran, Iran. To diagnose metabolic syndrome based on the National Cholesterol Education Program Adult Treatment Panel III guidelines, the anthropometric measures, blood pressure, and levels of serum triglyceride, high-density lipoprotein and fasting blood sugar were taken. Data were analyzed using the independent-sample t, Chi-square and the Fisher's exact tests as well as the logistic regression analysis. Among the 419 participants, 28 were excluded during the study. The total prevalence of metabolic syndrome was 16.3%, and its prevalence among shift workers and day workers was 17.3 and 14.9%, respectively. The most prevalent components of metabolic syndrome were low serum level of high-density lipoprotein and abdominal obesity. Following adjustments for the effects of potential cofounders, the logistic regression analysis revealed that the odds of metabolic syndrome among shift workers was ~2 times greater than day workers (odds ratio, 1.83; 95% confidence interval, 0.088-3.79), although this association was statistically insignificant (P=0.10). The results of the current study suggest that shift work is associated with a greater risk of metabolic syndrome for women. The most important components of metabolic syndrome are low serum level of high-density lipoprotein and abdominal obesity, which are attributable to limited physical activity and high occupational stress. The risk of metabolic syndrome among female shift workers of reproductive age may be reduced through strategies, including awareness raising, dietary educations and provision of physical activity facilities in the workplace.
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Affiliation(s)
- Maryam Nikpour
- Student Research Committee, Health Research Institute, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Aram Tirgar
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Mahmod Hajiahmadi
- Department of Biostatistics, Non Communicable Pediatric Disease Research Center, Health Research Institute, Babol 47745-47176, Iran
| | - Akram Hosseini
- Clinical Research Development Center, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Behzad Heidari
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Fatemeh Ghaffari
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran 14359-16471, Iran
| | - Fatemh Nasiri
- Midwifery Department, Fateme Zahra Fertility and Infertility Research Health Center, Health Research Institute, Babol University of Medical Sciences, Babol 47745-47176, Iran
| | - Mojgan Firouzbakht
- Student Research Committee, Health Research Institute, Babol University of Medical Sciences, Babol 47745-47176, Iran
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Dalbram E, Basse AL, Zierath JR, Treebak JT. Voluntary wheel running in the late dark phase ameliorates diet-induced obesity in mice without altering insulin action. J Appl Physiol (1985) 2019; 126:993-1005. [DOI: 10.1152/japplphysiol.00737.2018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Metabolic dysfunction and Type 2 diabetes are associated with perturbed circadian rhythms. However, exercise appears to ameliorate circadian disturbances, as it can phase-shift or reset the internal clock system. Evidence is emerging that exercise at a distinct time of day can correct misalignments of the circadian clock and influence energy metabolism. This suggests that timing of exercise training can be important for the prevention and management of metabolic dysfunction. In this study, obese, high-fat diet-fed mice were subjected to voluntary wheel running (VWR) at two different periods of the day to determine the effects of time-of-day-restricted VWR on basal and insulin-stimulated glucose disposal. VWR in the late dark phase reduced body weight gain compared with VWR in the beginning of the dark phase. Conversely, time-of-day-restricted VWR did not influence insulin action and glucose disposal, since skeletal muscle and adipose tissue glucose uptake and insulin signaling remained unaffected. Protein abundance of the core clock proteins, brain-muscle arnt-like 1 (BMAL1), and circadian locomotor output control kaput (CLOCK), were increased in skeletal muscle after VWR, independent of whether mice had access to running wheels in the early or late dark phase. Collectively, we provide evidence that VWR in the late dark phase ameliorates diet-induced obesity without altering insulin action or glucose homeostasis. NEW & NOTEWORTHY Exercise appears to ameliorate circadian disturbances as it can entrain the internal clock system. We provide evidence that voluntary wheel running increases core clock protein abundance and influences diet-induced obesity in mice in a time-of-day-dependent manner. However, the effect of time-of-day-restricted voluntary wheel running on body weight gain is not associated with enhanced basal- and insulin-stimulated glucose disposal, suggesting that time-of-day-restricted voluntary wheel running affects energy homeostasis rather than glucose homeostasis.
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Affiliation(s)
- Emilie Dalbram
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Astrid L. Basse
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Juleen R. Zierath
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Integrative Physiology, Department of Molecular Medicine and Surgery and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jonas T. Treebak
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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Rácz B, Dušková M, Stárka L, Hainer V, Kunešová M. Links between the circadian rhythm, obesity and the microbiome. Physiol Res 2018; 67:S409-S420. [PMID: 30484668 DOI: 10.33549/physiolres.934020] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Obesity is linked to a wide range of serious illnesses. In addition to the important impact on the health of the individual, obesity also has a substantial impact on the economy. Disruption of physiological day-night cycles could contribute to the increased incidence of obesity. According to the American National Sleep Federation, the percentage of the people who reported a sleep duration of six hours or less increased from 12 to 37 % over ten years. Insufficient sleep leads not only to an increase of the total calorie intake but changes the meal preference in favor of palatable foods and meals with high carbohydrate content. A decrease of leptin and increase of ghrelin levels caused by sleep deficiency can also play a role. In addition to the higher caloric intake, the timing of food consumption should be taken into account. The same meal eaten during the night versus the day is associated with increased postprandial glucose and triglyceride levels. The gut microbiome has also been recently understood as an endocrine system, with links between the gut microbiome and circadian rhythm changes possibly influencing increased obesity.
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Affiliation(s)
- B Rácz
- Institute of Endocrinology, Prague, Czech Republic.
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30
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Melatonin, leptin, and ghrelin levels in nurses working night shifts. JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.443902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Basse AL, Dalbram E, Larsson L, Gerhart-Hines Z, Zierath JR, Treebak JT. Skeletal Muscle Insulin Sensitivity Show Circadian Rhythmicity Which Is Independent of Exercise Training Status. Front Physiol 2018; 9:1198. [PMID: 30210362 PMCID: PMC6121032 DOI: 10.3389/fphys.2018.01198] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/08/2018] [Indexed: 11/13/2022] Open
Abstract
Circadian rhythms can be perturbed by shift work, travel across time zones, many occupational tasks, or genetic mutations. Perturbed circadian rhythms are associated with the increasing problem of obesity, metabolic dysfunction, and insulin resistance. We hypothesized that insulin sensitivity in skeletal muscle follows a circadian pattern and that this pattern is important for overall metabolic function. This hypothesis was verified using mice as a model system. We observed circadian rhythmicity in whole body insulin tolerance, as well as in signaling pathways regulating insulin- and exercise-induced glucose uptake in skeletal muscle, including AKT, 5'-adenosine monophosphate-activated protein kinase (AMPK) and TBC1 domain family member 4 (TBC1D4) phosphorylation. Basal and insulin-stimulated glucose uptake in skeletal muscle and adipose tissues in vivo also differed between day- and nighttime. However, the rhythmicity of glucose uptake differed from the rhythm of whole-body insulin tolerance. These results indicate that neither skeletal muscle nor adipose tissue play a major role for the circadian rhythmicity in whole-body insulin tolerance. To study the circadian pattern of insulin sensitivity directly in skeletal muscle, we determined glucose uptake under basal and submaximal insulin-stimulated conditions ex vivo every sixth hour. Both insulin sensitivity and signaling of isolated skeletal muscle peaked during the dark period. We next examined the effect of exercise training on the circadian rhythmicity of insulin sensitivity. As expected, voluntary exercise training enhanced glucose uptake in skeletal muscle. Nevertheless, exercise training did not affect the circadian rhythmicity of skeletal muscle insulin sensitivity. Taken together, our results provide evidence that skeletal muscle insulin sensitivity exhibits circadian rhythmicity.
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Affiliation(s)
- Astrid L Basse
- Section of Integrative Physiology, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Emilie Dalbram
- Section of Integrative Physiology, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Louise Larsson
- Section of Integrative Physiology, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Zach Gerhart-Hines
- Section for Metabolic Receptology, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Juleen R Zierath
- Section of Integrative Physiology, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.,Section of Integrative Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jonas T Treebak
- Section of Integrative Physiology, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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Onaolapo AY, Onaolapo OJ. Circadian dysrhythmia-linked diabetes mellitus: Examining melatonin’s roles in prophylaxis and management. World J Diabetes 2018; 9:99-114. [PMID: 30079146 PMCID: PMC6068738 DOI: 10.4239/wjd.v9.i7.99] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/01/2018] [Accepted: 06/08/2018] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus is a chronic, life-threatening metabolic disorder that occurs worldwide. Despite an increase in the knowledge of the risk factors that are associated with diabetes mellitus, its worldwide prevalence has continued to rise; thus, necessitating more research into its aetiology. Recent researches are beginning to link a dysregulation of the circadian rhythm to impairment of intermediary metabolism; with evidences that circadian rhythm dysfunction might play an important role in the aetiology, course or prognosis of some cases of diabetes mellitus. These evidences thereby suggest possible relationships between the circadian rhythm regulator melatonin, and diabetes mellitus. In this review, we discuss the roles of the circadian rhythm in the regulation of the metabolism of carbohydrates and other macronutrients; with emphasis on the importance of melatonin and the impacts of its deficiency on carbohydrate homeostasis. Also, the possibility of using melatonin and its analogs for the “prophylaxis” or management of diabetes mellitus is also considered.
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Affiliation(s)
- Adejoke Y Onaolapo
- Behavioural Neuroscience/Neurobiology Unit, Department of Anatomy, Ladoke Akintola University of Technology, Ogbomosho 210211, Oyo State, Nigeria
| | - Olakunle J Onaolapo
- Behavioural Neuroscience/Neuropharmacology Unit, Department of Pharmacology, Ladoke Akintola University of Technology, Osogbo 230263, Osun State, Nigeria
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Abu Farha R, Alefishat E. Shift Work and the Risk of Cardiovascular Diseases and Metabolic Syndrome Among Jordanian Employees. Oman Med J 2018; 33:235-242. [PMID: 29896332 DOI: 10.5001/omj.2018.43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objectives We sought to evaluate the effect of night shift working on increasing the risk of developing cardiovascular disease (CVD) using three different predictors. Methods One hundred and forty adult Jordanian employees were recruited in this cross-sectional study. Demographic data, anthropometric parameters, and working patterns information were documented. Metabolic syndrome (MetS) was diagnosed, and atherogenic index of the plasma (AIP) and Framingham risk score were calculated. Results Night shift workers had a significantly higher AIP ratio compared to daytime workers (p = 0.024). No significant association was observed between the two groups in term of 30-year Framingham risk score (p = 0.115). However, the duration of night shifts and the number of night shifts per months were found to significantly increase the 30-year Framingham risk (p = 0.000 and 0.012, respectively). Furthermore, the incidence of MetS among night shift workers was 15.9% (13/82) compared to 10.3% (6/58) among daytime workers (p = 0.484). Conclusions This is the first study to assess the association between night shift work and AIP as well as the 30-year Framingham risk score as predictors of CVDs. Night shift work was associated with an increase in AIP score compared to daytime work. Also, the duration of night shifts and the number of night shifts per month significantly increased the 30-year Framingham risk among night shift workers. These findings suggest an association between night shift work and the risk of CVD and atherosclerosis. Our results highlight the need for interventional strategies to diminish the risk of CVD in night shift workers.
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Affiliation(s)
- Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Eman Alefishat
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
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Sun M, Feng W, Wang F, Zhang L, Wu Z, Li Z, Zhang B, He Y, Xie S, Li M, Fok JPC, Tse G, Wong MCS, Tang JL, Wong SYS, Vlaanderen J, Evans G, Vermeulen R, Tse LA. Night shift work exposure profile and obesity: Baseline results from a Chinese night shift worker cohort. PLoS One 2018; 13:e0196989. [PMID: 29763461 PMCID: PMC5953447 DOI: 10.1371/journal.pone.0196989] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/24/2018] [Indexed: 12/14/2022] Open
Abstract
AIMS This study aimed to evaluate the associations between types of night shift work and different indices of obesity using the baseline information from a prospective cohort study of night shift workers in China. METHODS A total of 3,871 workers from five companies were recruited from the baseline survey. A structured self-administered questionnaire was employed to collect the participants' demographic information, lifetime working history, and lifestyle habits. Participants were grouped into rotating, permanent and irregular night shift work groups. Anthropometric parameters were assessed by healthcare professionals. Multiple logistic regression models were used to evaluate the associations between night shift work and different indices of obesity. RESULTS Night shift workers had increased risk of overweight and obesity, and odds ratios (ORs) were 1.17 (95% CI, 0.97-1.41) and 1.27 (95% CI, 0.74-2.18), respectively. Abdominal obesity had a significant but marginal association with night shift work (OR = 1.20, 95% CI, 1.01-1.43). A positive gradient between the number of years of night shift work and overweight or abdominal obesity was observed. Permanent night shift work showed the highest odds of being overweight (OR = 3.94, 95% CI, 1.40-11.03) and having increased abdominal obesity (OR = 3.34, 95% CI, 1.19-9.37). Irregular night shift work was also significantly associated with overweight (OR = 1.56, 95% CI, 1.13-2.14), but its association with abdominal obesity was borderline (OR = 1.26, 95% CI, 0.94-1.69). By contrast, the association between rotating night shift work and these parameters was not significant. CONCLUSION Permanent and irregular night shift work were more likely to be associated with overweight or abdominal obesity than rotating night shift work. These associations need to be verified in prospective cohort studies.
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Affiliation(s)
- Miaomiao Sun
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wenting Feng
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Feng Wang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
- * E-mail: (LAT); (FW)
| | - Liuzhuo Zhang
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Zijun Wu
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Zhimin Li
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Bo Zhang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yonghua He
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shaohua Xie
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Mengjie Li
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joan P. C. Fok
- Occupational Medicine Care Service, New Territories East Cluster, Hospital Authority, Hong Kong SAR, China
| | - Gary Tse
- Department of Medicine and Therapeutics, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Martin C. S. Wong
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jin-ling Tang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
| | - Samuel Y. S. Wong
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jelle Vlaanderen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherland
| | - Greg Evans
- Occupational and Environmental Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherland
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
- * E-mail: (LAT); (FW)
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Lee J, Ma K, Moulik M, Yechoor V. Untimely oxidative stress in β-cells leads to diabetes - Role of circadian clock in β-cell function. Free Radic Biol Med 2018; 119:69-74. [PMID: 29458148 PMCID: PMC5910243 DOI: 10.1016/j.freeradbiomed.2018.02.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/12/2018] [Accepted: 02/14/2018] [Indexed: 12/31/2022]
Abstract
Diabetes results from a loss of β-cell function. With the number of people with diabetes reaching epidemic proportions globally, understanding mechanisms that are contributing to this increasing prevalence is critical. One such factor has been circadian disruption, with shift-work, light pollution, jet-lag, increased screen time, all acting as potential contributory factors. Though circadian disruption has been epidemiologically associated with diabetes and other metabolic disorders for many decades, it is only recently that there has been a better understanding of the underlying molecular mechanisms. Experimental circadian disruption, via manipulation of environmental or genetic factors using gene-deletion mouse models, has demonstrated the importance of circadian rhythms in whole body metabolism. Genetic disruption of core clock genes, specifically in the β-cells in mice, have, now demonstrated the importance of the intrinsic β-cell clock in regulating function. Recent work has also shown the interaction of the circadian clock and enhancers in β-cells, indicating a highly integrated regulation of transcription and cellular function by the circadian clock. Disruption of either the whole body or only the β-cell clock leads to significant impairment of mitochondrial function, uncoupling, impaired vesicular transport, oxidative stress in β-cells and finally impaired glucose-stimulated insulin secretion and diabetes. In this review, we explore the role of the circadian clock in mitigating oxidative stress and preserving β-cell function.
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Affiliation(s)
- J Lee
- Diabetes and Beta Cell Biology Center, Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Pittsburgh, 200 Lothrop, BST-1058W, Pittsburgh, PA 15261, United States
| | - K Ma
- Diabetes and Metabolism Research Institute, City of Hope, Duarte, CA, United States
| | - M Moulik
- Division of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh and University of Pittsburgh, Pittsburgh, PA, United States
| | - V Yechoor
- Diabetes and Beta Cell Biology Center, Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Pittsburgh, 200 Lothrop, BST-1058W, Pittsburgh, PA 15261, United States.
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Tam G, Yeung MPS. A systematic review of the long-term effectiveness of work-based lifestyle interventions to tackle overweight and obesity. Prev Med 2018; 107:54-60. [PMID: 29155225 DOI: 10.1016/j.ypmed.2017.11.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 11/03/2017] [Accepted: 11/09/2017] [Indexed: 11/26/2022]
Abstract
Obesity is one of the five leading global risks for mortality, accounting for 5% of deaths worldwide. Workplace health promotion programs have the potential to deliver population-level interventions combining physical activity and exercise. However, there is no recent critical review of trials on long-term effectiveness of multicomponent lifestyle interventions in the workplace targeting obesity. Good quality evidence is needed to develop optimal strategies to tackle adult obesity. 1035 studies were retrieved by literature search in MEDLINE, Embase, PSYCH INFO and Cochrane library from 2005 to September 2016. 11 studies were identified, which were critiqued using 2010 CONSORT guideline. Most of the studies were not high quality. Five studies reported positive findings. Many studies included environmental interventions, but only two showed significant Body Mass Index (BMI) reduction. Studies showing significant BMI reduction were of high intensity or included a specific motivational component. Although there is some evidence demonstrating long-term effectiveness of multicomponent lifestyle interventions in the workplace targeting obesity, more research is needed into the best methods of conducting these interventions. This study provides evidence that could be used as the basis for implementing similar programs.
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Affiliation(s)
- Greta Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
| | - May P S Yeung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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37
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The role of the circadian clock system in physiology. Pflugers Arch 2018; 470:227-239. [PMID: 29302752 DOI: 10.1007/s00424-017-2103-y] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/20/2017] [Indexed: 12/28/2022]
Abstract
Life on earth is shaped by the 24-h rotation of our planet around its axes. To adapt behavior and physiology to the concurring profound but highly predictable changes, endogenous circadian clocks have evolved that drive 24-h rhythms in invertebrate and vertebrate species. At the molecular level, circadian clocks comprised a set of clock genes organized in a system of interlocked transcriptional-translational feedback loops. A ubiquitous network of cellular central and peripheral tissue clocks coordinates physiological functions along the day through activation of tissue-specific transcriptional programs. Circadian rhythms impact on diverse physiological processes including the cardiovascular system, energy metabolism, immunity, hormone secretion, and reproduction. This review summarizes our current understanding of the mechanisms of circadian timekeeping in different species, its adaptation by external timing signals and the pathophysiological consequences of circadian disruption.
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Sun M, Feng W, Wang F, Li P, Li Z, Li M, Tse G, Vlaanderen J, Vermeulen R, Tse LA. Meta-analysis on shift work and risks of specific obesity types. Obes Rev 2018; 19:28-40. [PMID: 28975706 DOI: 10.1111/obr.12621] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/27/2017] [Accepted: 08/28/2017] [Indexed: 12/17/2022]
Abstract
AIMS This systematic review and meta-analysis evaluated the associations between shift work patterns and risks of specific types of obesity. METHODS PubMed was searched until March 2017 for observational studies that examined the relationships between shift work patterns and obesity. Odds ratio for obesity was extracted using a fixed-effects or random-effects model. Subgroup meta-analyses were carried out for study design, specific obesity types and characteristics of shift work pattern. RESULTS A total of 28 studies were included in this meta-analysis. The overall odds ratio of night shift work was 1.23 (95% confidence interval = 1.17-1.29) for risk of obesity/overweight. Cross-sectional studies showed a higher risk of 1.26 than those with the cohort design (risk ratio = 1.10). Shift workers had a higher frequency of developing abdominal obesity (odds ratio = 1.35) than other obesity types. Permanent night workers demonstrated a 29% higher risk than rotating shift workers (odds ratio 1.43 vs. 1.14). CONCLUSION This meta-analysis confirmed the risks of night shift work for the development of overweight and obesity with a potential gradient association suggested, especially for abdominal obesity. Modification of working schedules is recommended, particularly for prolonged permanent night work. More accurate and detailed measurements on shift work patterns should be conducted in future research.
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Affiliation(s)
- M Sun
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - W Feng
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - F Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - P Li
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Z Li
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - M Li
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - G Tse
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - J Vlaanderen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - R Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,Shenzhen Municipal Key Laboratory for health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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Khalyfa A, Poroyko VA, Qiao Z, Gileles-Hillel A, Khalyfa AA, Akbarpour M, Almendros I, Farré R, Gozal D. Exosomes and Metabolic Function in Mice Exposed to Alternating Dark-Light Cycles Mimicking Night Shift Work Schedules. Front Physiol 2017; 8:882. [PMID: 29163218 PMCID: PMC5673652 DOI: 10.3389/fphys.2017.00882] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/18/2017] [Indexed: 12/30/2022] Open
Abstract
Sleep is an important modulator of metabolic function. Disruptions of sleep in circadian rhythm are common in modern societies and are associated with increased risk of developing cardiometabolic disorders. Exosomes are ubiquitous extracellular vesicles that may play a mechanistic role in metabolic derangements. We hypothesized that alternating dark-light cycles mimicking shift work in mice would alter fecal microbiota and colonic epithelium permeability and alter plasma exosome cargo and metabolic function. C57BL/6 mice were randomly assigned to (i) control day light (CL), or (ii) inverted dark-light every 2 weeks for 8 weeks (IN). Body weight, fat mass and HOMA-IR were measured, along with Tregs, metabolic, and resident macrophages in visceral white adipose tissue (vWAT). Fecal water samples were incubated with confluent colonic epithelium cell cultures in electric cell-substrate impedance sensing (ECIS) arrays, and plasma exosomes were added to differentiated adipocytes and insulin-induced pAKT/AKT expression changes were assessed by western blots. Mice exposed to IN showed elevated HOMA-IR, and their fecal samples showed altered microbiota which promote increased permeability of the colonic epithelial cell barrier. Plasma exosomes decreased pAKT/AKT responses to exogenous insulin compared to CL, and altered expression of circadian clock genes. Inflammatory macrophages (Ly-6chigh) were increased in IN-exposed vWAT, while Tregs were decreased. Thus, gut microbiota and the cargo of plasma exosomes are altered by periodic shifts in environmental lighting, and effectively alter metabolic function, possibly via induction of systemic inflammation and altered clock expression in target tissues. Further exploration of exosomal miRNA signatures in shift workers and their putative metabolic organ cell targets appears warranted.
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Affiliation(s)
- Abdelnaby Khalyfa
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Valeriy A Poroyko
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Zhuanhong Qiao
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Alex Gileles-Hillel
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Ahamed A Khalyfa
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Mahzad Akbarpour
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - David Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, United States
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Manodpitipong A, Saetung S, Nimitphong H, Siwasaranond N, Wongphan T, Sornsiriwong C, Luckanajantachote P, Mangjit P, Keesukphan P, Crowley SJ, Hood MM, Reutrakul S. Night-shift work is associated with poorer glycaemic control in patients with type 2 diabetes. J Sleep Res 2017; 26:764-772. [PMID: 28548389 DOI: 10.1111/jsr.12554] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/01/2017] [Indexed: 01/21/2023]
Abstract
The circadian system plays a role in regulating metabolism. Night-shift work, a form of circadian misalignment, is associated with increased type 2 diabetes risk. This study aimed to determine if night-shift workers with type 2 diabetes experience poorer glycaemic control than non-shift workers. Patients with type 2 diabetes (104 unemployed, 85 day workers and 60 night-shift workers) participated. Sleep duration, sleep quality, morningness-eveningness preference, depressive symptoms and dietary intake were assessed using standardized questionnaires. Haemoglobin A1c levels were measured. Night-shift workers had significantly higher haemoglobin A1c levels compared with others, while there were no differences between day workers and unemployed participants (median 7.86% versus 7.24% versus 7.09%, respectively). Additionally, night-shift workers were younger, had a higher body mass index, and consumed more daily calories than others. Among night-shift workers, there were no significant differences in haemoglobin A1c levels between those performing rotating versus non-rotating shifts (P = 0.856), or those with clockwise versus counterclockwise shift rotation (P = 0.833). After adjusting for age, body mass index, insulin use, sleep duration, morningness-eveningness preference and percentage of daily intake from carbohydrates, night-shift work, compared with day work, was associated with significantly higher haemoglobin A1c (B = 0.059, P = 0.044), while there were no differences between unemployed participants and day workers (B = 0.016, P = 0.572). In summary, night-shift work is associated with poorer glycaemic control in patients with type 2 diabetes.
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Affiliation(s)
| | - Sunee Saetung
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Thanawat Wongphan
- International Health Policy Progeam (IHPP), Ministry of Public Health, Nonthaburi, Thailand
| | | | | | | | - Prasit Keesukphan
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Stephanie J Crowley
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Megan M Hood
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sirimon Reutrakul
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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41
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Loef B, Hulsegge G, Wendel-Vos GCW, Verschuren WMM, Vermeulen RCH, Bakker MF, van der Beek AJ, Proper KI. Non-occupational physical activity levels of shift workers compared with non-shift workers. Occup Environ Med 2017; 74:328-335. [PMID: 27872151 PMCID: PMC5520260 DOI: 10.1136/oemed-2016-103878] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/24/2016] [Accepted: 09/06/2016] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Lack of physical activity (PA) has been hypothesised as an underlying mechanism in the adverse health effects of shift work. Therefore, our aim was to compare non-occupational PA levels between shift workers and non-shift workers. Furthermore, exposure-response relationships for frequency of night shifts and years of shift work regarding non-occupational PA levels were studied. METHODS Data of 5980 non-shift workers and 532 shift workers from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) were used in these cross-sectional analyses. Time spent (hours/week) in different PA types (walking/cycling/exercise/chores) and intensities (moderate/vigorous) were calculated based on self-reported PA. Furthermore, sports were operationalised as: playing sports (no/yes), individual versus non-individual sports, and non-vigorous-intensity versus vigorous-intensity sports. PA levels were compared between shift workers and non-shift workers using Generalized Estimating Equations and logistic regression. RESULTS Shift workers reported spending more time walking than non-shift workers (B=2.3 (95% CI 1.2 to 3.4)), but shift work was not associated with other PA types and any of the sports activities. Shift workers who worked 1-4 night shifts/month (B=2.4 (95% CI 0.6 to 4.3)) and ≥5 night shifts/month (B=3.7 (95% CI 1.8 to 5.6)) spent more time walking than non-shift workers. No exposure-response relationships were found between years of shift work and PA levels. CONCLUSIONS Shift workers spent more time walking than non-shift workers, but we observed no differences in other non-occupational PA levels. To better understand if and how PA plays a role in the negative health consequences of shift work, our findings need to be confirmed in future studies.
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Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Gerben Hulsegge
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - G C Wanda Wendel-Vos
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - W M Monique Verschuren
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marije F Bakker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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Kiehn JT, Tsang AH, Heyde I, Leinweber B, Kolbe I, Leliavski A, Oster H. Circadian Rhythms in Adipose Tissue Physiology. Compr Physiol 2017; 7:383-427. [PMID: 28333377 DOI: 10.1002/cphy.c160017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The different types of adipose tissues fulfill a wide range of biological functions-from energy storage to hormone secretion and thermogenesis-many of which show pronounced variations over the course of the day. Such 24-h rhythms in physiology and behavior are coordinated by endogenous circadian clocks found in all tissues and cells, including adipocytes. At the molecular level, these clocks are based on interlocked transcriptional-translational feedback loops comprised of a set of clock genes/proteins. Tissue-specific clock-controlled transcriptional programs translate time-of-day information into physiologically relevant signals. In adipose tissues, clock gene control has been documented for adipocyte proliferation and differentiation, lipid metabolism as well as endocrine function and other adipose oscillations are under control of systemic signals tied to endocrine, neuronal, or behavioral rhythms. Circadian rhythm disruption, for example, by night shift work or through genetic alterations, is associated with changes in adipocyte metabolism and hormone secretion. At the same time, adipose metabolic state feeds back to central and peripheral clocks, adjusting behavioral and physiological rhythms. In this overview article, we summarize our current knowledge about the crosstalk between circadian clocks and energy metabolism with a focus on adipose physiology. © 2017 American Physiological Society. Compr Physiol 7:383-427, 2017.
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Affiliation(s)
- Jana-Thabea Kiehn
- Chronophysiology Group, Medical Department I, University of Lübeck, Lübeck, Germany
| | - Anthony H Tsang
- Chronophysiology Group, Medical Department I, University of Lübeck, Lübeck, Germany
| | - Isabel Heyde
- Chronophysiology Group, Medical Department I, University of Lübeck, Lübeck, Germany
| | - Brinja Leinweber
- Chronophysiology Group, Medical Department I, University of Lübeck, Lübeck, Germany
| | - Isa Kolbe
- Chronophysiology Group, Medical Department I, University of Lübeck, Lübeck, Germany
| | - Alexei Leliavski
- Institute of Systemic Inflammation Research, University of Lübeck, Lübeck, Germany
| | - Henrik Oster
- Chronophysiology Group, Medical Department I, University of Lübeck, Lübeck, Germany
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Anothaisintawee T, Lertrattananon D, Thamakaison S, Knutson KL, Thakkinstian A, Reutrakul S. Later chronotype is associated with higher hemoglobin A1c in prediabetes patients. Chronobiol Int 2017; 34:393-402. [DOI: 10.1080/07420528.2017.1279624] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Thunyarat Anothaisintawee
- Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Dumrongrat Lertrattananon
- Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sangsulee Thamakaison
- Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kristen L. Knutson
- Section of Pulmonary and Critical Care, Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sirimon Reutrakul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Lu YC, Wang CP, Yu TH, Tsai IT, Hung WC, Lu IC, Hsu CC, Tang WH, Houng JY, Chung FM, Yen Jean MC. Shift work is associated with metabolic syndrome in male steel workers-the role of resistin and WBC count-related metabolic derangements. Diabetol Metab Syndr 2017; 9:83. [PMID: 29075331 PMCID: PMC5644151 DOI: 10.1186/s13098-017-0283-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 10/08/2017] [Indexed: 01/02/2023] Open
Abstract
AIMS There is increasing evidence linking a shift work schedule with various adverse health effects. The present study aimed to examine the relationship between shift work and the metabolic syndrome (MetS) in male steel workers, and also the possible mechanism of shift work-related metabolic derangements. METHODS A total of 1732 men aged 42 ± 8 years were enrolled in this cross-sectional study, including 862 day workers and 870 shift workers. Circulating levels of resistin were measured by ELISA using monoclonal specific antibodies. RESULTS The shift workers had higher rates of MetS and its components (central obesity, hypertension, and hypertriglyceridemia) than the day workers. In multiple logistic regression analysis, shift work was independently associated with MetS. In further analysis, the shift workers had elevated circulating levels of resistin (13 ± 10 vs. 10 ± 7 ng/mL) and total white blood cell (WBC) count (6.865 ± 1.819 vs. 6.304 ± 1.547 109/L) than the day workers. In addition, both resistin level and total WBC count were significantly associated with shift work, MetS, and its components (body mass index, fasting glucose, triglyceride, and high-density lipoprotein-cholesterol levels), and plasma resistin levels were significantly associated with total WBC count (β = 0.34, p < 0.0001). CONCLUSION Shift work was independently associated with MetS in male steel workers. Resistin and WBC count were associated with shift work-related metabolic derangements.
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Affiliation(s)
- Yung-Chuan Lu
- Division of Endocrinologic, E-Da Hospital, I-Shou University, Kaohsiung, 82445 Taiwan
- School of Medicine for International Students, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Chao-Ping Wang
- Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445 Taiwan
- School of Medicine for International Students, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Teng-Hung Yu
- Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445 Taiwan
| | - I-Ting Tsai
- Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung, 82445 Taiwan
- Department of Nursing, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Wei-Chin Hung
- Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445 Taiwan
| | - I-Cheng Lu
- Department of Occupational Medicine, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445 Taiwan
| | - Chia-Chang Hsu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Wei-Hua Tang
- Division of Cardiology, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Jer-Yiing Houng
- Department of Nutrition, Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Fu-Mei Chung
- Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Mei-Chu Yen Jean
- Department of Occupational Medicine, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445 Taiwan
- Department of Nursing, I-Shou University, Kaohsiung, 82445 Taiwan
- School of Medicine for International Students, I-Shou University, Kaohsiung, 82445 Taiwan
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Fujishiro K, Lividoti Hibert E, Schernhammer E, Rich-Edwards JW. Shift work, job strain and changes in the body mass index among women: a prospective study. Occup Environ Med 2016; 74:410-416. [DOI: 10.1136/oemed-2016-103747] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 10/05/2016] [Accepted: 10/19/2016] [Indexed: 11/03/2022]
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Johnson MO, Siska PJ, Contreras DC, Rathmell JC. Nutrients and the microenvironment to feed a T cell army. Semin Immunol 2016; 28:505-513. [PMID: 27712958 PMCID: PMC5154770 DOI: 10.1016/j.smim.2016.09.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/28/2016] [Accepted: 09/30/2016] [Indexed: 02/04/2023]
Abstract
T cells have dramatic functional and proliferative shifts in the course of maintaining immune protection from pathogens and cancer. To support these changes, T cells undergo metabolic reprogramming upon stimulation and again after antigen clearance. Depending on the extrinsic cell signals, T cells can differentiate into functionally distinct subsets that utilize and require diverse metabolic programs. Effector T cells (Teff) enhance glucose and glutamine uptake, whereas regulatory T cells (Treg) do not rely on significant rates of glycolysis. The dependence of these subsets on specific metabolic programs makes T cells reliant on these signaling pathways and nutrients. Metabolic pathways, such as those regulated by mTOR and Myc, augment T cell glycolysis and glutaminolysis programs to promote T cell activity. These pathways respond to signals and control metabolism through both transcriptional or post-transcriptional mechanisms. Epigenetic modifications also play an important role by stabilizing the transcription factors that define subset specific reprogramming. In addition, circadian rhythm cycling may also influence energy use, immune surveillance, and function of T cells. In this review, we focus on the metabolic and nutrient requirements of T cells, and how canonical pathways of growth and metabolism regulate nutrients that are essential for T cell function.
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Affiliation(s)
- Marc O Johnson
- Department of Pathology, Microbiology, and Immunology, and Cancer Biology, Vanderbilt Center for Immunobiology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Peter J Siska
- Department of Pathology, Microbiology, and Immunology, and Cancer Biology, Vanderbilt Center for Immunobiology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Diana C Contreras
- Department of Pathology, Microbiology, and Immunology, and Cancer Biology, Vanderbilt Center for Immunobiology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Jeffrey C Rathmell
- Department of Pathology, Microbiology, and Immunology, and Cancer Biology, Vanderbilt Center for Immunobiology, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
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Koch CE, Leinweber B, Drengberg BC, Blaum C, Oster H. Interaction between circadian rhythms and stress. Neurobiol Stress 2016; 6:57-67. [PMID: 28229109 PMCID: PMC5314421 DOI: 10.1016/j.ynstr.2016.09.001] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/26/2016] [Accepted: 09/05/2016] [Indexed: 01/24/2023] Open
Abstract
Life on earth has adapted to the day-night cycle by evolution of internal, so-called circadian clocks that adjust behavior and physiology to the recurring changes in environmental conditions. In mammals, a master pacemaker located in the suprachiasmatic nucleus (SCN) of the hypothalamus receives environmental light information and synchronizes peripheral tissues and central non-SCN clocks to geophysical time. Regulatory systems such as the hypothalamus-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), both being important for the regulation of stress responses, receive strong circadian input. In this review, we summarize the interaction of circadian and stress systems and the resulting physiological and pathophysiological consequences. Finally, we critically discuss the relevance of rodent stress studies for humans, addressing complications of translational approaches and offering strategies to optimize animal studies from a chronobiological perspective.
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Affiliation(s)
- C E Koch
- University of Lübeck, Chronophysiology Group, Medical Department 1, Lübeck, Germany
| | - B Leinweber
- University of Lübeck, Chronophysiology Group, Medical Department 1, Lübeck, Germany
| | - B C Drengberg
- University of Lübeck, Chronophysiology Group, Medical Department 1, Lübeck, Germany
| | - C Blaum
- University of Lübeck, Chronophysiology Group, Medical Department 1, Lübeck, Germany
| | - H Oster
- University of Lübeck, Chronophysiology Group, Medical Department 1, Lübeck, Germany
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Jaeger C, Tischkau SA. Role of Aryl Hydrocarbon Receptor in Circadian Clock Disruption and Metabolic Dysfunction. ENVIRONMENTAL HEALTH INSIGHTS 2016; 10:133-141. [PMID: 27559298 PMCID: PMC4990151 DOI: 10.4137/ehi.s38343] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 06/01/2023]
Abstract
The prevalence of metabolic syndrome, a clustering of three or more risk factors that include abdominal obesity, increased blood pressure, and high levels of glucose, triglycerides, and high-density lipoproteins, has reached dangerous and costly levels worldwide. Increases in morbidity and mortality result from a combination of factors that promote altered glucose metabolism, insulin resistance, and metabolic dysfunction. Although diet and exercise are commonly touted as important determinants in the development of metabolic dysfunction, other environmental factors, including circadian clock disruption and activation of the aryl hydrocarbon receptor (AhR) by dietary or other environmental sources, must also be considered. AhR binds a range of ligands, which prompts protein-protein interactions with other Per-Arnt-Sim (PAS)-domain-containing proteins and subsequent transcriptional activity. This review focuses on the reciprocal crosstalk between the activated AhR and the molecular circadian clock. AhR exhibits a rhythmic expression and time-dependent sensitivity to activation by AhR agonists. Conversely, AhR activation influences the amplitude and phase of expression of circadian clock genes, hormones, and the behavioral responses of the clock system to changes in environmental illumination. Both the clock and AhR status and activation play significant and underappreciated roles in metabolic homeostasis. This review highlights the state of knowledge regarding how AhR may act together with the circadian clock to influence energy metabolism. Understanding the variety of AhR-dependent mechanisms, including its interactions with the circadian timing system that promote metabolic dysfunction, reveals new targets of interest for maintenance of healthy metabolism.
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Loef B, van Baarle D, van der Beek AJ, van Kerkhof LW, van de Langenberg D, Proper KI. Klokwerk + study protocol: An observational study to the effects of night-shift work on body weight and infection susceptibility and the mechanisms underlying these health effects. BMC Public Health 2016; 16:692. [PMID: 27484676 PMCID: PMC4969645 DOI: 10.1186/s12889-016-3317-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Night-shift work may cause severe disturbances in the worker's circadian rhythm, which has been associated with the onset of health problems and diseases. As a substantial part of the workforce is exposed to night-shift work, harmful aspects of night-shift work should not be overlooked. The aim of the Klokwerk + study is to study the effects of night-shift work on body weight and infection susceptibility and the mechanisms underlying these health effects. First, we will study the relation between night-shift work exposure and body weight and between night-shift work exposure and infection susceptibility. Second, we will examine the mechanisms linking night-shift work exposure to body weight and infection susceptibility, with a specific focus on sleep, physical activity, diet, light exposure, vitamin D level, and immunological factors. Lastly, we will focus on the identification of biomarkers for chronic circadian disturbance associated with night-shift work. METHODS/DESIGN The design of this study is a prospective observational cohort study consisting of 1,960 health care workers aged 18-65 years. The study population will consist of a group of night-shift workers and an equally sized group of non-night-shift workers. During the study, there will be two measurement periods. As one of the main outcomes of this study is infection susceptibility, the measurement periods will take place at approximately the first (September/October) (T0) and the last month (April/May) (T1, after 6 months) of the flu season. The measurements will consist of questionnaires, anthropometric measurements, a smartphone application to determine infection susceptibility, food diaries, actigraphy, light sensors, and blood sample analyses. DISCUSSION The Klokwerk + study will contribute to the current need for high-quality data on the health effects of night-shift work and its underlying behavioral and physiological mechanisms. The findings can be the starting point for the development of interventions that prevent negative health effects caused by night-shift work. In addition, the identification of biomarkers indicative of loss of homeostasis due to circadian disturbance may be an important asset in monitoring the effects of such interventions.
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Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.,Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Debbie van Baarle
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Linda W van Kerkhof
- Center for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. .,Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
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Copin N, Gusto G, Vol S, Rollier S, Lantieri O, Lasfargues G, Tichet J. Perturbation du métabolisme lipidique chez des travailleurs postés consultants de centres d’examens de santé. Presse Med 2016; 45:e145-56. [DOI: 10.1016/j.lpm.2015.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 10/19/2015] [Accepted: 12/17/2015] [Indexed: 12/29/2022] Open
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