Rotating Night Shift Work, Exposure to Light at Night, and Glomerular Filtration Rate: Baseline Results from a Chinese Occupational Cohort
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Assessment of GFR
2.3. Assessment of Shift Work
2.4. Assessment of Bedroom Light Environment
2.5. Assessment of Covariates
2.6. Statistical Analysis
3. Results
3.1. General Characteristics of the Participants
3.2. Night Shift Work, LAN and eGFR
3.3. Sensitivity Analyses
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Overall | Non-Decreased eGFR | Decreased eGFR | |
---|---|---|---|---|
(n = 6869) | (n = 5860) | (n = 1009) | p Value | |
Age (year), mean ± SD | 44.2 ± 8.0 | 43.6 ± 8.1 | 47.9 ± 6.3 | <0.001 |
Sex, n (%) | ||||
Male | 6283 (91.5) | 5370 (91.6) | 913 (90.5) | 0.226 |
Female | 586 (8.5) | 490 (8.4) | 96 (9.5) | |
Ethnicity, n (%) | 0.494 | |||
Han | 6727 (97.9) | 5736 (97.9) | 991 (98.2) | |
Others | 142 (2.1) | 124 (2.1) | 18 (1.8) | |
BMI (kg/m2), mean ± SD | 25.2 ± 3.4 | 25.1 ± 3.4 | 25.7 ± 3.3 | <0.001 |
Smoking status, n (%) | 0.196 | |||
Never | 2817 (41.0) | 2409 (41.1) | 408 (40.4) | |
Ever | 549 (8.0) | 454 (7.6) | 95 (9.4) | |
Current | 3503 (51.0) | 2997 (51.1) | 506 (50.2) | |
Alcohol consumption, n (%) | 0.233 | |||
Never | 3936 (57.3) | 3353 (57.2) | 583 (57.8) | |
Ever | 393 (5.7) | 325 (5.6) | 68 (6.7) | |
Current | 2540 (37.0) | 2182 (37.2) | 358 (35.5) | |
Education level, n (%) | <0.001 | |||
Primary or illiterate | 86 (1.3) | 71 (1.2) | 15 (1.5) | |
Middle or high school | 5326 (77.5) | 4483 (76.5) | 843 (83.6) | |
University or college | 1457 (21.2) | 1306 (22.3) | 151 (15.0) | |
Physical activity, n (%) | 0.270 | |||
Low | 80 (1.2) | 70 (1.2) | 10 (1.0) | |
Moderate | 522 (7.6) | 457 (7.8) | 65 (6.4) | |
High | 6267 (91.2) | 5333 (91.0) | 934 (92.6) | |
Duration of night shift work (years), n (%) | <0.001 | |||
Day work | 1029 (15.0) | 896 (15.3) | 133 (13.2) | |
Q1 (1–12) | 1471 (21.4) | 1317 (22.5) | 154 (15.3) | |
Q2 (13–20) | 1495 (21.8) | 1328 (22.7) | 167 (16.6) | |
Q3 (21–28) | 1314 (19.1) | 1102 (18.8) | 212 (21.0) | |
Q4 (29–43) | 1560 (22.7) | 1217 (20.8) | 343 (34.0) | |
Brightness of bedroom ambient LAN, n (%) | 0.856 | |||
Darkest level | 3782 (55.1) | 3222 (55.0) | 560 (55.5) | |
Middle level | 2276 (33.1) | 1949 (33.2) | 327 (32.4) | |
Lightest level | 811 (11.8) | 689 (11.8) | 122 (12.1) | |
Living duration of current residence, n (%) | 0.899 | |||
<5 years | 2191 (31.9) | 1862 (31.8) | 329 (32.6) | |
6–10 years | 1642 (23.9) | 1400 (23.9) | 242 (24.0) | |
11–20 years | 1682 (24.5) | 1444 (24.6) | 238 (23.4) | |
>20 years | 1354 (19.7) | 1154 (19.7) | 200 (19.8) | |
Number of times light on (times/night), n (%) | 0.645 | |||
0 | 4194 (61.1) | 3584 (61.2) | 610 (60.5) | |
1 | 2172 (31.6) | 1854 (31.6) | 318 (31.5) | |
≥2 | 503 (7.3) | 422 (7.2) | 81 (8.0) | |
Sleep duration (h), mean ± SD | 6.8 ± 1.2 | 6.8 ± 1.2 | 6.8 ± 1.2 | 0.005 |
Insomnia, n (%) | 0.990 | |||
No | 4560 (66.4) | 3890 (66.4) | 670 (66.4) | |
Yes | 2309 (33.6) | 1970 (33.6) | 339 (33.6) | |
Diabetes, n (%) | 0.150 | |||
No | 6147 (89.5) | 5257 (89.7) | 890 (88.2) | |
Yes | 722 (10.5) | 603 (10.3) | 119 (11.8) | |
Fasting blood glucose (mmol/L), median (IQR) | 5.8 (5.4 to 6.3) | 5.8 (5.4 to 6.3) | 5.9 (5.5 to 6.4) | <0.001 |
Hypertension, n (%) | <0.001 | |||
No | 5109 (74.4) | 4447 (75.9) | 662 (65.6) | |
Yes | 1760 (25.6) | 1413 (24.1) | 347 (34.4) | |
Systolic blood pressure (mmHg), mean ± SD | 129.0 ± 16.0 | 128.5 ± 15.8 | 131.8 ± 17.2 | <0.001 |
Diastolic blood pressure (mmHg), mean ± SD | 82.5 ± 10.4 | 82.2 ± 10.2 | 84.7 ± 11.0 | <0.001 |
Hyperuricemia, n (%) | <0.001 | |||
No | 4586 (66.8) | 4070 (60.5) | 516 (51.1) | |
Yes | 2283 (33.2) | 1790 (30.6) | 493 (48.9) | |
Serum uric acid (μmol/L), mean ± SD | 385.8 ± 94.2 | 385.3 ± 94.7 | 389.2 ± 91.1 | 0.244 |
a Proteinuria (mg/dl), n (%) | <0.001 | |||
A1 (<30) | 6745 (98.2) | 5772 (98.5) | 973 (96.4) | |
A2-A3 (≥30) | 124 (1.8) | 88 (1.5) | 36 (3.6) |
Exposure Metrics | Decreased eGFR | OR (95% CI) | |||
---|---|---|---|---|---|
No, n (%) | Yes, n (%) | Model 1 | Model 2 | Model 3 | |
Duration of night shift (years) | |||||
Day work | 896 (15.3) | 133 (13.2) | 1.00 | 1.00 | 1.00 |
Q1 (1–12) | 1317 (22.5) | 154 (15.3) | 0.79 (0.61 to 1.01) | 1.10 (0.85 to 1.42) | 1.03 (0.79 to 1.34) |
Q2 (13–20) | 1328 (22.7) | 167 (16.6) | 0.84 (0.66 to 1.08) | 1.12 (0.87 to 1.44) | 1.01 (0.78 to 1.31) |
Q3 (21–28) | 1102 (18.8) | 212 (21.0) | 1.29 (1.02 to 1.63) | 1.32 (1.04 to 1.68) | 1.28 (1.01 to 1.64) |
Q4 (29–43) | 1217 (20.8) | 343 (34.0) | 1.89 (1.52 to 2.36) | 1.40 (1.12 to 1.75) | 1.37 (1.09 to 1.73) |
p for trend | <0.001 | <0.001 | 0.001 | ||
Brightness of bedroom ambient LAN | |||||
Darkest level | 3222 (55.0) | 560 (55.5) | 1.00 | 1.00 | 1.00 |
Middle level | 1949 (33.3) | 327 (32.4) | 0.96 (0.83 to 1.12) | 0.91 (0.78 to 1.06) | 0.90 (0.77 to 1.05) |
Lightest level | 689 (11.8) | 122 (12.1) | 0.99 (0.80 to 1.23) | 0.97 (0.78 to 1.21) | 0.94 (0.75 to 1.18) |
Groups | Duration of Night Shifts (Years) | |||||
---|---|---|---|---|---|---|
Day Work | Q1 (1–12) | Q2 (13–20) | Q3 (21–28) | Q4 (29–43) | p for Interaction | |
Sex | 0.128 | |||||
Male, OR (95% CI) | 1.00 | 0.99 (0.74 to 1.31) | 1.02 (0.78 to 1.35) | 1.36 (1.04 to 1.76) | 1.40 (1.12 to 1.79) | |
Female, OR (95% CI) | 1.00 | 0.88 (0.40 to 1.95) | 0.65 (0.29 to 1.47) | 0.65 (0.29 to 1.47) | 0.79 (0.34 to 1.87) | |
BMI | 0.725 | |||||
<25, OR (95% CI) | 1.00 | 1.13 (0.77 to 1.67) | 1.23 (0.84 to 1.80) | 1.48 (1.02 to 2.13) | 1.57 (1.11 to 2.20) | |
≥25, OR (95% CI) | 1.00 | 0.92 (0.64 to 1.32) | 0.84 (0.59 to 1.19) | 1.11 (0.79 to 1.55) | 1.18 (0.85 to 1.63) | |
Brightness of bedroom ambient LAN | 0.905 | |||||
Darkest level, OR (95% CI) | 1.00 | 1.03 (0.71 to 1.49) | 1.05 (0.74 to 1.51) | 1.37 (0.97 to 1.94) | 1.45 (1.04 to 2.03) | |
Middle or Lightest level, OR (95% CI) | 1.00 | 1.06 (0.73 to 1.54) | 1.00 (0.68 to 1.47) | 1.23 (0.86 to 1.76) | 1.32 (0.95 to 1.83) | |
Diabetes | 0.724 | |||||
No, OR (95% CI) | 1.00 | 0.98 (0.7 to 1.30) | 0.99 (0.76 to 1.30) | 1.26 (0.97 to 1.63) | 1.29 (1.01 to 1.66) | |
Yes, OR (95% CI) | 1.00 | 1.56 (0.66 to 3.69) | 1.11 (0.44 to 2.82) | 1.49 (0.64 to 3.47) | 1.88 (0.91 to 3.90) | |
Hypertension | 0.683 | |||||
No, OR (95% CI) | 1.00 | 1.01 (0.74 to 1.38) | 0.95 (0.69 to 1.29) | 1.20 (0.89 to 1.62) | 1.38 (1.03 to 1.84) | |
Yes, OR (95% CI) | 1.00 | 1.06 (0.65 to 1.72) | 1.21 (0.76 to 1.94) | 1.50 (0.96 to 2.32) | 1.37 (0.91 to 2.06) | |
Hyperuricemia | 0.077 | |||||
No, OR (95% CI) | 1.00 | 0.98 (0.68 to 1.42) | 1.28 (0.90 to 1.82) | 1.37 (0.98 to 1.91) | 1.56 (1.15 to 2.12) | |
Yes, OR (95% CI) | 1.00 | 1.02 (0.69 to 1.49) | 0.78 (0.53 to 1.15) | 1.16 (0.80 to 1.70) | 1.13 (0.78 to 1.64) | |
Insomnia | 0.833 | |||||
No, OR (95% CI) | 1.00 | 0.99 (0.72 to 1.36) | 0.96 (0.70 to 1.32) | 1.21 (0.89 to 1.63) | 1.38 (1.04 to 1.84) | |
Yes, OR (95% CI) | 1.00 | 1.11 (0.70 to 178) | 1.10 (0.70 to 1.75) | 1.41 (0.91 to 2.20) | 1.42 (0.93 to 2.15) | |
Short sleep duration | 0.896 | |||||
No, OR (95% CI) | 1.00 | 1.16 (0.77 to 1.74) | 1.15 (0.77 to 1.71) | 1.50 (1.03 to 2.19) | 1.49 (1.05 to 2.12) | |
Yes, OR (95% CI) | 1.00 | 0.98 (0.69 to 1.38) | 0.92 (0.65 to 1.30) | 1.13 (0.81 to 1.59) | 1.31 (0.95 to 1.81) |
Mediators | Effect Size (95% CI) | p-Value |
---|---|---|
Systolic blood pressure (mmHg) | ||
ACME | −0.021 (−0.060 to 0.006) | 0.160 |
ADE | −1.188 (−1.916 to −0.458) | <0.001 |
Total effect | −1.210 (−1.924 to −0.483) | <0.001 |
Proportion of mediation | 0.018 (−0.006 to 0.073) | 0.160 |
Diastolic blood pressure (mmHg) | ||
ACME | −0.077 (−0.134 to −0.030) | <0.001 |
ADE | −1.133 (−1.851 to −0.409) | <0.001 |
Total effect | −1.210 (−1.925 to −0.483) | <0.001 |
Proportion of mediation | 0.064 (0.024 to 0.167) | <0.001 |
Fasting blood glucose (mmol/L) | ||
ACME | 0.037 (−0.021 to 0.093) | 0.200 |
ADE | −1.231 (−1.919 to −0.504) | <0.001 |
Total effect | −1.194 (−1.885 to −0.463) | <0.001 |
Proportion of mediation | −0.031 (−0.113 to 0.018) | <0.001 |
Serum uric acid (μmol/L) | ||
ACME | −0.002 (−0.019 to 0.010) | 0.730 |
ADE | −1.286 (−2.068 to −0.545) | 0.004 |
Total effect | −1.288 (−2.070 to −0.548) | 0.004 |
Proportion of mediation | 0.002 (−0.009 to 0.015) | 0.730 |
Sleep duration (hours) | ||
ACME | 0.031 (−0.049 to 0.112) | 0.480 |
ADE | −1.243 (−1.893 to −0.503) | <0.001 |
Total effect | −1.213 (−1.867 to −0.485) | <0.001 |
Proportion of mediation | −0.025 (−0.125 to 0.045) | <0.001 |
AIS score | ||
ACME | −0.014 (−0.047 to 0.005) | 0.210 |
ADE | −1.200 (−1.882 to −0.466) | <0.001 |
Total effect | −1.214 (−1.896 to −0.489) | <0.001 |
Proportion of mediation | 0.012 (−0.006 to 0.053) | 0.210 |
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Zhang, S.; Wang, Y.; Zhu, Y.; Li, X.; Song, Y.; Yuan, J. Rotating Night Shift Work, Exposure to Light at Night, and Glomerular Filtration Rate: Baseline Results from a Chinese Occupational Cohort. Int. J. Environ. Res. Public Health 2020, 17, 9035. https://doi.org/10.3390/ijerph17239035
Zhang S, Wang Y, Zhu Y, Li X, Song Y, Yuan J. Rotating Night Shift Work, Exposure to Light at Night, and Glomerular Filtration Rate: Baseline Results from a Chinese Occupational Cohort. International Journal of Environmental Research and Public Health. 2020; 17(23):9035. https://doi.org/10.3390/ijerph17239035
Chicago/Turabian StyleZhang, Shengkui, Yongbin Wang, Ying Zhu, Xiaoming Li, Yang Song, and Juxiang Yuan. 2020. "Rotating Night Shift Work, Exposure to Light at Night, and Glomerular Filtration Rate: Baseline Results from a Chinese Occupational Cohort" International Journal of Environmental Research and Public Health 17, no. 23: 9035. https://doi.org/10.3390/ijerph17239035