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      Shift work is associated with an increased risk of type 2 diabetes and elevated RBP4 level: cross sectional analysis from the OHSPIW cohort study

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          Abstract

          Background

          Shift work, with its growing prevalence globally, disrupts the body's inherent circadian rhythm. This disruption may escalate the risk of chronic diseasesxacerbate chronic disease risk by dysregulating physiological, behavioral, and psychosocial pathways. This study aimed to evaluate the effect of shift work on type 2 diabetes (T2DM) and Retinol binding protein 4 (RBP4) level.

          Methods

          The current study employed a multi-stage stratified cluster sampling technique, examining 1499 oilfield workers from the OHSPIW cohort who participated in occupational health assessments between March 2017 and June 2018.The evaluation involved shift work, sleep quality, T2DM status with questionnaires and plasma RBP4 levels in blood samples. Statistical analysis includes, Chi-square tests, t-tests, multivariate logistic regression analyses, and multivariate linear mixed models.

          Results

          The prevalence rate of T2DM in shift workers (6.56%) was significantly higher than in day workers (4.21%) (OR = 1.60, 95% CI: 1.01–2.53), with no significant difference found in the family history of diabetes, hypertension, or other chronic heart diseases ( P = 0.378). The shift worker (6.89 ± 3.35) also exhibited distinctly higher PSQI scores than day workers (5.99 ± 2.87) ( P < 0.001). Adjusting the age, gender, BMI, family income, tobacco smoking, alcohol drinking and PSQI, hailed shift work as a risk factor for T2DM (OR = 1.91, 95% CI: 1.17–3.14). The pairwise comparison revealed significant differences in RBP4 levels across different groups: shift and non-shift workers both with and without T2DM ( P < 0.001). The RBP4 level of the shift group without T2DM was higher than the non-shift group without T2DM ( P < 0.05). The levels of RBP4 level in shift and non-shift groups with T2DM was higher than those without T2DM ( P < 0.05). The multivariate linear mixed model showed that when age, gender, BMI, diabetes, PSQI, family income, smoking and drinking remained unchanged, the RBP4 level of the shift workers increased by an average of 9.51 μg/mL compared with the day workers.

          Conclusions

          Shift work is associated with an increased risk of T2DM and high levels of RBP4. Follow-up of RBP4 could facilitateearly detection of T2DM among shift workers.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-023-16091-y.

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          Most cited references43

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          Impact of sleep debt on metabolic and endocrine function

          The Lancet, 354(9188), 1435-1439
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            Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects.

            Insulin resistance has a causal role in type 2 diabetes. Serum levels of retinol-binding protein 4 (RBP4), a protein secreted by adipocytes, are increased in insulin-resistant states. Experiments in mice suggest that elevated RBP4 levels cause insulin resistance. We sought to determine whether serum RBP4 levels correlate with insulin resistance and change after an intervention that improves insulin sensitivity. We also determined whether elevated serum RBP4 levels are associated with reduced expression of glucose transporter 4 (GLUT4) in adipocytes, an early pathological feature of insulin resistance. We measured serum RBP4, insulin resistance, and components of the metabolic syndrome in three groups of subjects. Measurements were repeated after exercise training in one group. GLUT4 protein was measured in isolated adipocytes. Serum RBP4 levels correlated with the magnitude of insulin resistance in subjects with obesity, impaired glucose tolerance, or type 2 diabetes and in nonobese, nondiabetic subjects with a strong family history of type 2 diabetes. Elevated serum RBP4 was associated with components of the metabolic syndrome, including increased body-mass index, waist-to-hip ratio, serum triglyceride levels, and systolic blood pressure and decreased high-density lipoprotein cholesterol levels. Exercise training was associated with a reduction in serum RBP4 levels only in subjects in whom insulin resistance improved. Adipocyte GLUT4 protein and serum RBP4 levels were inversely correlated. RBP4 is an adipocyte-secreted molecule that is elevated in the serum before the development of frank diabetes and appears to identify insulin resistance and associated cardiovascular risk factors in subjects with varied clinical presentations. These findings provide a rationale for antidiabetic therapies aimed at lowering serum RBP4 levels. Copyright 2006 Massachusetts Medical Society.
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              Insulin-sensitive obesity.

              The association between obesity and impaired insulin sensitivity has long been recognized, although a subgroup of obese individuals seems to be protected from insulin resistance. In this study, we systematically studied differences in adipose tissue biology between insulin-sensitive (IS) and insulin-resistant (IR) individuals with morbid obesity. On the basis of glucose infusion rate during euglycemic hyperinsulinemic clamps, 60 individuals with a BMI of 45 +/- 1.3 kg/m(2) were divided into an IS and IR group matched for age, sex, and body fat prior to elective surgery. We measured fat distribution, circulating adipokines, and parameters of inflammation, glucose, and lipid metabolism and characterized adipose tissue morphology, function, and mRNA expression in abdominal subcutaneous (sc) and omental fat. IS compared with IR obese individuals have significantly lower visceral fat area (138 +/- 27 vs. 316 +/- 91 cm(2)), number of macrophages in omental adipose tissue (4.9 +/- 0.8 vs. 13.2 +/- 1.4%), mean omental adipocyte size (528 +/- 76 vs. 715 +/- 81 pl), circulating C-reactive protein, progranulin, chemerin, and retinol-binding protein-4 (all P values <0.05), and higher serum adiponectin (6.9 +/- 3.4 vs. 3.4 +/- 1.7 ng/ml) and omental adipocyte insulin sensitivity (all P values <0.01). The strongest predictors of insulin sensitivity by far were macrophage infiltration together with circulating adiponectin (r(2) = 0.98, P < 0.0001). In conclusion, independently of total body fat mass, increased visceral fat accumulation and adipose tissue dysfunction are associated with IR obesity. This suggests that mechanisms beyond a positive caloric balance such as inflammation and adipokine release determine the pathological metabolic consequences in patients with obesity.
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                Author and article information

                Contributors
                liujiwen123123@126.com
                964345951@qq.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                14 June 2023
                14 June 2023
                2023
                : 23
                : 1139
                Affiliations
                [1 ]GRID grid.13394.3c, ISNI 0000 0004 1799 3993, Departments of Public Health, , Xinjiang Medical University, ; Urumqi, 830011 China
                [2 ]GRID grid.412631.3, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, , Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, ; Urumqi, 830011 China
                [3 ]GRID grid.13394.3c, ISNI 0000 0004 1799 3993, College of Medical Engineering and Technology, , Xinjiang Medical University, ; Urumqi, 830011 China
                Article
                16091
                10.1186/s12889-023-16091-y
                10265876
                37312059
                2c84943a-6fe3-4682-b9e9-2d9912083f1d
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 21 August 2022
                : 9 June 2023
                Funding
                Funded by: the National Natural Science Foundation of China
                Award ID: 82060589
                Award ID: 82060589
                Award ID: 82060589
                Award ID: 82060589
                Award ID: 82060589
                Award ID: 82060589
                Award ID: 82060589
                Award ID: 82060589
                Award ID: 82060589
                Award Recipient :
                Funded by: the State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Asia Fund
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award ID: SKL-HIDCA-2021-17
                Award Recipient :
                Funded by: the open project of Key Laboratory of Special Environment and Health Research, Department of Science and Technology, Xinjiang Uygur Autonomous Region
                Award ID: SKL-SEHR-2021-05
                Award ID: SKL-SEHR-2021-05
                Award ID: SKL-SEHR-2021-05
                Award ID: SKL-SEHR-2021-05
                Award ID: SKL-SEHR-2021-05
                Award ID: SKL-SEHR-2021-05
                Award ID: SKL-SEHR-2021-05
                Award ID: SKL-SEHR-2021-05
                Award Recipient :
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                © BioMed Central Ltd., part of Springer Nature 2023

                Public health
                shift work,type 2 diabetes,retinol binding protein 4,sleep quality,oil workers
                Public health
                shift work, type 2 diabetes, retinol binding protein 4, sleep quality, oil workers

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