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

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.

Prevalence And Correlation Analysis Between Post-Traumatic Stress Disorder And Analgesic Use In Survivors Of ICU In China.

Objectives: To investigate the prevalence of post-traumatic stress disorder in intensive care unit survivors, and disorder's correlation with analgesia use. METHODS: The single-centre retrospective cohort study was conducted at the First Affiliated Hospital of Jinan University, China, and comprised data from February 2021 to January 2022 related to patients of either gender aged =18 years who were admitted to the intensive care unit and were successfully transferred out to the general ward. Post- traumatic stress disorder Checklist-Civilian Version scale was used for follow-up within one month of getting transferred out of intensive care. Data was analysed using Empower Stats. RESULTS: Of the 121 patients with mean age 54.34±18.19 years, 52(43%) were positive for post-traumatic stress disorder; 32(61.5%) males and 20(38.5%) females with mean age 54.48±19.56 years.The remaining 69(57%) patients were negative; 40(58%) males and 29(42%) females with mean age 54.23±17.24 years (p>0.05). The positive rate of re- experiencing symptoms was noted in 68(56.20%) patients. Analgesia usage was positive in 61(50.4%) cases and negative in 60(49.6%) cases. Compared to the non-analgesic group, the risk of post-traumatic stress disorder occurrence in the analgesic group wassignificantly high (p=0.018). The duration of analgesia usage 24-48h was also significant (p=0.017). CONCLUSIONS: There was a high prevalence of post-traumatic stress disorder in intensive care unit survivors, which was affected by the use of analgesicsin intensive care settings.

Sub-Health Status Survey and Influential Factor Analysis in Chinese during Coronavirus Disease 2019 Pandemic.

PURPOSE: This study aimed to investigate sub-health status (SHS) of people living in China during the Coronavirus disease 2019 (COVID-19) COVID-19 pandemic. COVID-19 is a severe acute respiratory syndrome coronavirus (SARS-CoV) infection-induced acute infectious disease, which is featured by universal susceptibility and strong infectivity, and SHS (a status of low quality health) refers to a status of low-quality health. COVID-19 has gradually developed into a global pandemic, making the public in a high stress situation in physiological, psychological and social states in the short term. METHODS: From March 6 to 11, 2020, a large-scale cross-sectional survey was conducted by convenient sampling, and SHS assessment scale was used in the questionnaire. The ordinal logistic regression analysis was used to identify the factors affecting SHS. RESULTS: In this study, 17,078 questionnaires were delivered with 16,820 effective questionnaires collected, and 10,715 subjects (63.7%) were found with SHS, with moderate SHS primarily. Physiological sub-scale scored the highest, followed by psychological and social sub-scales. Ordinal logistic regression analysis indicated that man, only-child, workers and farmers were risk factors of SHS. Protective factors of SHS included living in rural areas and townships, laid-off retirees and education degree. CONCLUSION: It shows many people in China place in a poor health status during COVID-19 pandemic. It is necessary that relevant departments pay more attention to people with poor health such as men, only-child, urban people, workers and farmers, and groups with high education degree during and after pandemic stabilization.

Course, risk factors, and mental health outcomes of excessive daytime sleepiness in rural Chinese adolescents: A one-year prospective study.

BACKGROUND: This study aimed to examine the one-year incidence and persistence of excessive daytime sleepiness (EDS) in rural Chinese adolescents and their risk factors. In addition, we also aimed to explore the potential bidirectional associations of EDS with anxiety symptoms and depressive symptoms. METHODS: A total of 3736 adolescents from 5 high schools from rural area in the south China were eligible for follow-up. Among them, 2787 responded to follow-up after one year. EDS was defined as having a total score of the Epworth Sleepiness Scale over 10. RESULTS: The one-year persistence rate and incidence rate of EDS were 27.6% and 9.3%, respectively. After controlling for age and sex, new incident EDS was significantly associated with perceived high study stress, depressive symptoms, insomnia symptoms, and high life events at baseline. Baseline EDS predicted new onsets of depression and anxiety at follow-up. Cross-lagged analyses further revealed that there were bidirectional associations between EDS and anxiety symptom and between EDS and depressive symptoms. Persistent EDS was only associated with eveningness chronotype. In particular, short sleep duration and obesity were associated with neither new incidence nor persistence of EDS in this population. LIMITATIONS: All measures relied on self-reported questionnaires rather than objective assessments, which might have led to report bias. CONCLUSIONS: We have identified a number of risk factors of the one-year incidence of EDS (such as perceived high study stress, depressive symptoms, insomnia symptoms, and high life events) and persistence of EDS (eveningness chronotype) in rural adolescents. There is a reciprocal relationship of EDS with anxiety and depression. In this population, sleep loss and obesity seem not related to the course of EDS.

Association between FSP, CVHI, inflammatory cytokines and the incidence of primary stroke.

This case-control study was designed to establish a new risk-prediction model for primary stroke using Framingham stroke profile (FSP), cerebral vascular hemodynamic indexes (CVHI) and plasma inflammatory cytokines including hs-CRP, IL-6, TNF-α and Lp-PLA2. A total of 101 primary stroke patients admitted to Dongguan Houjie Hospital between August 2014 and June 2015 were assigned into the case group, and 156 age- and gender-matched healthy subjects from the Houjie Community were allocated into the control group. The prognostic values of FSP, CVHI and inflammatory cytokines including high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and lipoprotein-associated phospholipase A2 (Lp-PLA2) were assessed by multivariate logistic regression analysis. Seven risk-prediction models (FSP, CVHI, inflammatory cytokine, FSP+CVHI, FSP+inflammatory cytokine, CVHI+inflammatory cytokine, CVHI+FSP+inflammatory cytokine) were successfully established and the prognostic values were statistically compared by ROC curve and Z test. For FSP, the stroke risk was significantly elevated by 2.85 times when the FSP score was increased by 1 level (P=0.043), increased by 3.25 times for CVHI (P=0.036), 6.53 times for IL-6 (P=0.003), and 7.75 times for Lp-PLA2 (P=0.000). The sensitivity of FSP+CVHI+inflammatory cytokine and CVHI+inflammatory cytokine models was higher than 90%. For model specificity, the specificity of FSP+CVHI+inflammatory cytokine model alone exceeded 90%. FSP, CVHI, IL-6 and Lp-PLA2 are independent risk factors of stroke. Integrating IL-6 and Lp-PLA2 into the models can significantly enhance the risk prediction accuracy of primary stroke. Combined application of FSP+CVHI+inflammatory cytokine is of potential for risk prediction of primary stroke.