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1Yonsei University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
3Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
4Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Copyright © 2022 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTION
Conception or design: C.W.A., S.L., H.S.P., N.H., Y.L. Acquisition, analysis, or interpretation of data: C.W.A., S.S., S.L., N.H. Drafting the work or revising: S.S., H.S.P. Final approval of the manuscript: H.S.P., Y.L.
Values are expressed as mean±standard deviation, number (%), or median (interquartile range).
BMI, body mass index; HOMA-IR, homeostasis model assessment-insulin resistance; HDL, high-density lipoprotein; 25(OH)D, 25-hydroxyvitamin D; NWO, normal-weight obesity.
Significant differences between groups: a(Shift worker–Daytime worker); b(Shift worker–Evening or night worker); c(Daytime worker–Evening or night worker).
Adjusted for age, sex, BMI, current smoking, physical activity, educational attainment, type of work, working hours, hypertension, energy intake, 25(OH)D level, and ln(HOMA-IR).
CI, confidence interval; BMI, body mass index; 25(OH)D, 25-hydroxy vitamin D; ln(HOMA-IR), log-transformed homeostasis model assessment-insulin resistance.
Model 1: Crude model without any adjustment; Model 2: Model 1+age, sex; Model 3: Model 2+body mass index; Model 4: Model 3+type of work, working hours, current smoking, physical activity, and educational attainment; Model 5: Model 4+hypertension, energy intake, 25-hydroxy-vitamin D, and log-transformed homeostasis model assessment-insulin resistance.
OR, odds ratio; CI, confidence interval.
Characteristic | Total (n=3,800) | Daytime worker (n=3,336) | Evening or night worker (n=235) | Shift worker (n=229) | P value | |
---|---|---|---|---|---|---|
Age, yr | 46.0±13.9 | 46.4±14.0 | 42.6±12.5 | 43.7±13.7 | <0.001a,c | |
Male sex | 2,001 (52.7) | 1,736 (52.0) | 110 (46.8) | 155 (67.7) | <0.001a,b | |
Type of work | <0.001a,b,c | |||||
Manual worker | 1,742 (45.8) | 1,555 (46.6) | 59 (25.1) | 128 (55.9) | ||
Office worker | 1,295 (34.1) | 1,194 (35.8) | 56 (23.8) | 45 (19.7) | ||
Service worker | 763 (20.1) | 587 (17.6) | 120 (51.1) | 56 (24.4) | ||
Working hours, hr/wk | 49 (40–60) | 48 (40–60) | 54 (42–70) | 51 (40–65) | <0.001a,c | |
Working hour tertiles, hr | <0.001a,c | |||||
36–44 | 1,308 (34.4) | 1,176 (35.2) | 61 (26.0) | 71 (31.0) | ||
45–55 | 1,245 (32.8) | 1,122 (33.6) | 61 (26.0) | 62 (27.1) | ||
56 | 1,247 (32.8) | 1,038 (31.2) | 113 (48.0) | 96 (41.9) | ||
Weight, kg | 58.7±8.5 | 58.6±8.5 | 58.6±8.0 | 61.1±8.5 | <0.001a,b | |
BMI, kg/m2 | 22.0±2.0 | 22.0±2.0 | 21.8±2.1 | 22.1±2.0 | 0.336 | |
Waist circumference, cm | 77.2±7.5 | 77.1±7.4 | 76.5±7.4 | 78.6±9.1 | 0.006a,b | |
Current smoker | 951 (25.0) | 806 (24.2) | 75 (31.9) | 70 (30.6) | 0.004c | |
Alcohol drinker | 3,010 (79.2) | 2,608 (78.2) | 202 (86.1) | 200 (87.3) | <0.001a,c | |
Physical activity | 2,193 (57.7) | 1,947 (58.3) | 126 (53.6) | 120 (52.4) | 0.089 | |
Educational attainment | <0.001c | |||||
Elementary school or lower | 800 (21.1) | 749 (22.5) | 27 (11.5) | 24 (10.5) | ||
Middle school | 433 (11.4) | 382 (11.4) | 26 (11.1) | 25 (10.9) | ||
High school | 1,222 (34.0) | 1,066 (32.0) | 115 (48.9) | 111 (48.5) | ||
College or higher | 1,275 (33.6) | 1,139 (34.1) | 67 (28.5) | 69 (30.1) | ||
Household income | 0.040 | |||||
Low | 468 (12.4) | 431 (13.0) | 21 (9.0) | 16 (7.1) | ||
Middle-low | 898 (23.8) | 781 (23.6) | 50 (26.7) | 67 (29.6) | ||
Middle-high | 1,166 (30.9) | 1,017 (30.7) | 78 (33.8) | 71 (31.4) | ||
High | 1,237 (32.6) | 1,083 (32.7) | 82 (35.5) | 72 (31.9) | ||
Hypertension | 651 (17.1) | 582 (17.5) | 39 (16.6) | 30 (13.1) | 0.234 | |
Diabetes mellitus | 216 (5.7) | 195 (5.9) | 6 (2.6) | 15 (6.6) | 0.092 | |
Energy intake, g/day | 1,923 (1,481–2,488) | 1,906 (1,482–2,469) | 1,875 (1,380–2,382) | 2,100 (1,590–2,648) | 0.005a,b | |
Fasting glucose, mg/dL | 94.9±20.3 | 94.9±19.0 | 91.9±16.7 | 96.8±35.4 | 0.031b | |
Insulin, pmol/L | 8.6±3.5 | 8.6±3.3 | 8.3±3.6 | 8.7±5.9 | 0.419 | |
HOMA-IR | 2.03±1.04 | 2.03±0.97 | 1.90±0.91 | 2.11±1.90 | 0.081 | |
Cholesterol, mg/dL | 183.7±34.0 | 184.3±34.1 | 178.6±32.7 | 180.3±33.0 | 0.014c | |
HDL cholesterol, mg/dL | 49.7±10.8 | 49.6±10.8 | 51.1±10.4 | 49.0±10.7 | 0.079 | |
Triglyceride, mg/dL | 92 (64–140) | 92 (64–139) | 90 (62–138) | 94 (62–150) | 0.850 | |
25(OH)D, ng/mL | 19.2±7.3 | 19.4±7.3 | 17.9±6.4 | 17.2±6.7 | <0.001a,c | |
NWO | 666 (17.5) | 580 (17.4) | 33 (14.0) | 53 (23.1) | 0.030b |
Variable | Unadjusted |
Adjusted |
|||
---|---|---|---|---|---|
Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | ||
Working pattern | |||||
Daytime | 1.00 (1.00–1.00) | reference | 1.00 (1.00–1.00) | reference | |
Night/Evening | 0.78 (0.53–1.13) | 0.190 | 0.79 (0.52–1.18) | 0.249 | |
Shift work | 1.43 (1.04–1.97) | 0.028 | 1.47 (1.04–2.09) | 0.031 | |
Age, yr | 1.00 (1.00–1.01) | 0.158 | 1.01 (1.00–1.02) | 0.024 | |
Sex (ref. men) | 0.96 (0.81–1.14) | 0.651 | 0.98 (0.78–1.23) | 0.888 | |
BMI, kg/m2 | 1.60 (1.51–1.69) | <0.001 | 1.60 (1.51–1.70) | <0.001 | |
Current smoker | 0.80 (0.65–0.97) | 0.026 | 0.88 (0.70–1.12) | 0.311 | |
Alcohol drinker | 0.88 (0.72–1.08) | 0.225 | |||
Physical activity | 0.73 (0.62–0.87) | <0.001 | 0.79 (0.66–0.95) | 0.011 | |
Educational attainment | 1.09 (1.01–1.18) | 0.020 | 1.12 (0.99–1.27) | 0.075 | |
Household income | 1.05 (0.96–1.14) | 0.272 | |||
Type of work | |||||
Manual worker | 1.00 (1.00–1.00) | reference | 1.00 (1.00–1.00) | reference | |
Office worker | 1.50 (1.24–1.81) | <0.001 | 1.62 (1.23–2.12) | 0.001 | |
Service worker | 1.24 (0.98–1.55) | 0.068 | 1.12 (0.86–1.46) | 0.388 | |
Working hour, hr/wk | 1.00 (0.99–1.01) | 0.859 | 1.00 (0.99–1.01) | 0.990 | |
Hypertension | 1.60 (1.30–1.96) | <0.001 | 1.31 (1.03–1.68) | 0.028 | |
Diabetes mellitus | 1.29 (0.92–1.81) | 0.134 | |||
Energy intake, 10 g/day | 0.98 (0.97–0.99) | 0.001 | 0.98 (0.96–0.99) | <0.001 | |
25(OH)D, ng/mL | 0.96 (0.95–0.98) | <0.001 | 0.96 (0.95–0.98) | <0.001 | |
ln(HOMA-IR) | 2.75 (2.23–3.40) | <0.001 | 1.54 (1.21–1.95) | <0.001 |
Daytime (reference) | Night/Evening OR (95% CI) | P value | Daytime (reference) | Shift work OR (95% CI) | P value | Night/Evening (reference) | Shift work OR (95% CI) | P value | |
---|---|---|---|---|---|---|---|---|---|
Model 1 | 1 | 0.78 (0.53–1.13) | 0.190 | 1 | 1.43 (1.04–1.97) | 0.028 | 1 | 1.84 (1.14–2.98) | 0.012 |
Model 2 | 1 | 0.79 (0.54–1.15) | 0.223 | 1 | 1.45 (1.05–2.00) | 0.023 | 1 | 1.83 (1.13–2.96) | 0.014 |
Model 3 | 1 | 0.78 (0.52–1.15) | 0.207 | 1 | 1.43 (1.02–2.01) | 0.038 | 1 | 1.84 (1.12–3.05) | 0.017 |
Model 4 | 1 | 0.81 (0.54–1.22) | 0.321 | 1 | 1.57 (1.11–2.22) | 0.010 | 1 | 1.93 (1.16–3.23) | 0.012 |
Model 5 | 1 | 0.79 (0.52–1.18) | 0.249 | 1 | 1.47 (1.04–2.09) | 0.031 | 1 | 1.87 (1.11–3.14) | 0.018 |
Values are expressed as mean±standard deviation, number (%), or median (interquartile range). BMI, body mass index; HOMA-IR, homeostasis model assessment-insulin resistance; HDL, high-density lipoprotein; 25(OH)D, 25-hydroxyvitamin D; NWO, normal-weight obesity. Significant differences between groups: a(Shift worker–Daytime worker); b(Shift worker–Evening or night worker); c(Daytime worker–Evening or night worker).
Adjusted for age, sex, BMI, current smoking, physical activity, educational attainment, type of work, working hours, hypertension, energy intake, 25(OH)D level, and ln(HOMA-IR). CI, confidence interval; BMI, body mass index; 25(OH)D, 25-hydroxy vitamin D; ln(HOMA-IR), log-transformed homeostasis model assessment-insulin resistance.
Model 1: Crude model without any adjustment; Model 2: Model 1+age, sex; Model 3: Model 2+body mass index; Model 4: Model 3+type of work, working hours, current smoking, physical activity, and educational attainment; Model 5: Model 4+hypertension, energy intake, 25-hydroxy-vitamin D, and log-transformed homeostasis model assessment-insulin resistance. OR, odds ratio; CI, confidence interval.