PLoS Medicine: Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women
Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women
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1 Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America, 2 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America, 3 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Abstract Top
Background
Rotating night shift work disrupts circadian rhythms and has been associated with obesity, metabolic syndrome, and glucose dysregulation. However, its association with type 2 diabetes remains unclear. Therefore, we aimed to evaluate this association in two cohorts of US women.Methods and Findings
We followed 69,269 women aged 42–67 in Nurses' Health Study I (NHS I, 1988–2008), and 107,915 women aged 25–42 in NHS II (1989–2007) without diabetes, cardiovascular disease, and cancer at baseline. Participants were asked how long they had worked rotating night shifts (defined as at least three nights/month in addition to days and evenings in that month) at baseline. This information was updated every 2–4 years in NHS II. Self-reported type 2 diabetes was confirmed by a validated supplementary questionnaire. We documented 6,165 (NHS I) and 3,961 (NHS II) incident type 2 diabetes cases during the 18–20 years of follow-up. In the Cox proportional models adjusted for diabetes risk factors, duration of shift work was monotonically associated with an increased risk of type 2 diabetes in both cohorts. Compared with women who reported no shift work, the pooled hazard ratios (95% confidence intervals) for participants with 1–2, 3–9, 10–19, and ≥20 years of shift work were 1.05 (1.00–1.11), 1.20 (1.14–1.26), 1.40 (1.30–1.51), and 1.58 (1.43–1.74, p-value for trend <0.001), respectively. Further adjustment for updated body mass index attenuated the association, and the pooled hazard ratios were 1.03 (0.98–1.08), 1.06 (1.01–1.11), 1.10 (1.02–1.18), and 1.24 (1.13–1.37, p-value for trend <0.001).Conclusions
Our results suggest that an extended period of rotating night shift work is associated with a modestly increased risk of type 2 diabetes in women, which appears to be partly mediated through body weight. Proper screening and intervention strategies in rotating night shift workers are needed for prevention of diabetes.Please see later in the article for the Editors' Summary
Citation: Pan A, Schernhammer ES, Sun Q, Hu FB (2011) Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women. PLoS Med 8(12): e1001141. doi:10.1371/journal.pmed.1001141
Academic Editor: Leif Groop, Lund University Diabetes Centre, Sweden
Received: June 21, 2011; Accepted: October 25, 2011; Published: December 6, 2011
Copyright: © 2011 Pan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The study was supported by the National Institutes of Health grant (DK58845, CA55075, CA87969, CA50385). Dr. Sun was supported by a career development award K99HL098459 from the National Heart, Lung, and Blood Institute. Dr. Schernhammer was supported by R01HL103607 grant from National Heart, Lung, and Blood Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: BMI, body mass index; NHS, Nurses' Health Study; SD, standard deviation
* E-mail: frank.hu@channing.harvard.edu
Academic Editor: Leif Groop, Lund University Diabetes Centre, Sweden
Received: June 21, 2011; Accepted: October 25, 2011; Published: December 6, 2011
Copyright: © 2011 Pan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The study was supported by the National Institutes of Health grant (DK58845, CA55075, CA87969, CA50385). Dr. Sun was supported by a career development award K99HL098459 from the National Heart, Lung, and Blood Institute. Dr. Schernhammer was supported by R01HL103607 grant from National Heart, Lung, and Blood Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: BMI, body mass index; NHS, Nurses' Health Study; SD, standard deviation
* E-mail: frank.hu@channing.harvard.edu
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