倒班年限与男性钢铁工人2型糖尿病患病率的剂量-反应关系

Dose-response relationship between shift work years and diabetes mellitus type 2 in male steel workers

[目的]探讨倒班及倒班年限与男性钢铁工人2型糖尿病(T2DM)患病率的剂量-反应关系。[方法]采用现况研究的方法,调查2015年2月—2016年2月在某钢铁集团公司医院进行职业健康检查和健康体检的全部男性钢铁工人7 415人,用于分析7 209份问卷。收集资料包括男性钢铁工人人口学特征、生活方式、病史、家族史、身高、体重、职业史;采用多因素非条件logistic回归和限制性立方样条模型,分析男性钢铁工人倒班及倒班年限与T2DM之间的关联。[结果]男性钢铁工人T2DM患病率为16.5%。曾经倒班、现在倒班与T2DM患病有关,差别有统计学意义(P<0.05),OR(95%CI)分别为:1.403(1.131~1.740),1.536(1.298~1.817)。调整一般因素和高温暴露等职业因素后,曾经倒班、现在倒班均与T2DM患病率有关联,且有统计学意义(P<0.05),OR(95%CI)分别为:2.792(2.286~3.411)、2.546(2.076~3.124)。曾经倒班年限和T2DM有关联(χ~2=35.00,P<0.000 1),呈非线性相关(χ~2=3.00,P=0.606 8);现在倒班年限和T2DM患病有关(χ~2=49.92,P<0.000 1),呈非线性相关(χ~2=5.33,P=0.148 9)。[结论]倒班年限与男性钢铁工人T2DM患病有关,且呈非线性相关。

[ Objective ] To assess the dose-response relationship between male steel workers＇ shift work years and prevalence of diabetes mellitus type 2 （T2DM）. [ Methods ] A total of 7 415 male steel workers were enrolled to occupational health examination and health examination from February 2015 to February 2016 in a hospital of steel company, and 7 209 questionnaires were included in the current cross- sectional analysis. Data were collected on demographic characteristics, lifestyle, medical history, family history, height, weight, and occupational history of the participants. Multiple non-conditional logistic regression model and restricted cubic spline model were used to assess the relationship between shift work years and prevalence of T2DM in the selected male steel workers. [ Results ] The prevalence rate of T2DM was 16.5% in the participants. Previous shift work （OR=1.403, 95%CI： 1.131-1.740） and current shift work （0R=1.536, 95%CI： 1.298-1.817） were associated with T2DM （P〈0.05）. After adjusting for general factors andoccupational factors such as high temperature exposure, the above two factors were still associated with the prevalence rate of T2DM （P〈 0.05）, with ORs （95%C/） being 2.792 （2.286-3.411） and 2.546 （2.076-3.124）, respectively. There was a significant correlation 0（2=35.00, P〈0.O00 1） and a nonlinear correlation 0（2=3.00, P=0.606 8） between previous shift work years and T2DM. There was also a significant correlation （X2=49.92, P 〈 0.1300 1） and a nonlinear correlation （Z2=5.33, P=0.148 9） between current shift work years and T2DM. [ Conclusion ] Shift work years are associated to the prevalence of T2DM in a nonlinear pattern in male steel workers