The impact of shift work on glycemic characteristics assessed by CGM and its association with metabolic indices in non-diabetic subjects

• Published in: Acta diabetologica Vol. 57; no. 1; pp. 53 - 61
• Main Authors: Ye, Lingxia, Gu, Weiqiong, Chen, Yufei, Li, Xuelin, Shi, Juan, Lv, Ankang, Hu, Jingfen, Zhang, Ru, Liu, Ruixin, Hong, Jie, Wang, Jiqiu, Zhang, Yifei
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.01.2020; Springer Nature B.V
• Subjects: Adult; Blood glucose; Blood Glucose - analysis; Blood Glucose - metabolism; Blood Glucose Self-Monitoring; Cross-Sectional Studies; Daytime; Diabetes; Diabetes mellitus; Glucose; Glucose metabolism; Glucose monitoring; Glucose tolerance; Glucose Tolerance Test; Glycemic Index; Health Education and psycho-social aspects; Humans; Hyperglycemia; Hyperglycemia - etiology; Hyperglycemia - metabolism; Hypoglycemia; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Middle Aged; Nighttime; Original Article; Shift Work Schedule - adverse effects; Workers; Young Adult; Glycemic characteristics; Continuous glucose monitoring; Non-diabetic subjects; Metabolic indices; Shift work
• ISSN: 0940-5429; 1432-5233; 1432-5233
• DOI: 10.1007/s00592-019-01372-z

Aim To explore the glycemic characteristics of non-diabetic shift workers and associations with metabolic indices. Methods In this cross-sectional study, 450 non-diabetic males, including 238 shift workers, aged 23–58 years, were recruited after a screening oral glucose tolerance test. Blood samples and anthropometric data were collected. Hundred and fifty of them finished a continuous glucose monitoring for 3–7 days. Results Compared to daytime workers, shift workers presented with larger WHR ( p  < 0.001), higher HOMA-IR ( p  < 0.001), higher hs-CRP level ( p  < 0.001) and worse lipid profiles. In glycemic characteristics, shift workers with normal glucose regulation had a similar mean blood glucose (MBG), daytime MBG, percentage of time of hyperglycemia, hypoglycemia, euglycemia, and fluctuation parameters, including standard deviation of blood glucose (SDBG), mean amplitude of glycemic excursions (MAGE) and mean of daily differences ( p  > 0.05, respectively), while they had a higher nighttime MBG ( p  = 0.026) and blood glucose (BG) at 3 a.m. ( p  = 0.015). For subjects with impaired glucose regulation, both groups had no difference in any clinical characteristics or glycemic parameters ( p  > 0.05, respectively). Further regression analysis revealed the association between MBG/SDBG/MAGE/nighttime MBG/BG at 3 a.m. and age/WHR/hs-CRP/TC. Conclusion For non-diabetic shift workers, the glycemic characteristic was the elevated nighttime glycemia, presented as higher nighttime MBG and BG at 3 a.m. And both metrics were closely associated with central obesity. Elevated nighttime glycemia was an early signal of glucose metabolism disorder in shift workers.