Shift Workers at Risk for Metabolic Syndrome

Abstract

In this highly digitalized era, sleep disorders are becoming more common and are associated with an increased burden of chronic disease. Shift workers are at an increased risk for both sleep disorders and metabolic syndrome. In this article, the authors outline the connection between circadian discordance, hormonal imbalance, and the development of metabolic syndrome in shift workers. Based on a literature review of animal model studies, observational studies, and clinical trials conducted between August and October of 2018, the authors offer several clinical interventions, including work schedules, light therapy, medications, and dietary habits to improve the circadian synchronicity of shift workers and reduce their risk of morbidity and mortality. It is important for physicians to be familiar with the consequences of shift work and ways to mitigate the risks for this patient population. M any of the human body's neurohormonal cascades, including key metabolic cascades and the sleep-wake cycle, follow 24-hour rhythms. These circadian rhythms evolve in response to a light-dark cycle established by sunrise and sunset along with the daily rhythm of other external factors, such as temperature and noise.Today, people are exposed to synthetic light, heat, and other stimulating cues that do not follow a 24-hour cyclic pattern. These synthetic factors interfere with the carefully coordinated interplay between external regulators and the endogenous maintenance of circadian rhythms. 1 Shift workers are increasingly affected by this phenomenon. 2 This discordance among shift workers has been linked to disruption in the sleep-wake cycle and metabolic pathways, leading to sleep deprivation and an increased risk of metabolic syndrome. 3In this review, we discuss the relationship between metabolic syndrome and shift work. We completed PubMed searches in August and October 2018 using the following keywords: "shift worker demographics," "metabolic syndrome and shift workers," "risk factors associated with metabolic syndrome in shift work," "circadian rhythm and shift work," "cortisol release and shift work," "shift work and exercise habits," "shift work and nutrition habits," "circadian rhythm discordance and metabolic syndrome," "sleep hygiene and shift work disorder," "nutrition and sleep hygiene," "exercise and cortisol release," "sleep disorders and shift work," "sleep disorders and metabolic syndrome," "osteopathic manipulation and sleep latency," "shift work and heart rate variability," and "osteopathic manipulation and heart rate variability." Of the literature reviewed, 38 articles were experimental studies (animal model or clinical trials), 35 were review articles, and 17 were observational studies. Based on this literature

Shiftwork and the Risk of Metabolic Syndrome Among Health Care Workers

“…The circadian rhythm of shiftworkers does not match the sleep-wake cycle, resulting in opposing signals or circadian desynchronization. This disrupts the SCN nucleus network rhythm, leading to disturbances in metabolism 30 …”

Metabolic Syndrome and Its Related Factors among Hospital Employees: A Population-Based Cohort Study

“…Shift and night work appears to have a negative effect on hospital employee health, possibly due to its effect on sleep deprivation, circadian desynchronization, high levels of stress, and behavioural changes in diet and physical activity. These factors could affect glucose tolerance and develop into a subclinical hypercortisol state, which may induce a decrease in HDL-C with increases in TG and FPG [ 16 , 17 , 35 , 36 ]. Prolonged exposure to these factors may also entrain the cardiovascular system to operate at an elevated pressure equilibrium through structural adaptations such as left ventricular hypertrophy and may significantly affect hospital employee health [ 17 , 36 ].…”

The Coronavirus Disease 2019 (COVID-19): Key Emphasis on Melatonin Safety and Therapeutic Efficacy

“…At the same time, the aging and chronification of nosological entities that coexist with COVID-19, particularly those exhibiting insulin resistance, are accompanied by a progressive fall in circulating melatonin [132][133][134]. It is noteworthy that clinical trials and studies with animal models indicate that supplementation with melatonin may be a valid strategy to tackle symptomatology and halt the progression of COVID-19 [134][135][136], perhaps because the indoleamine helps to counteract the debilitating phenotype of aging [137] and predisposing pathologies [133,138,139]. In this regard, based on the orchestration of endocrine, paracrine, and autocrine responses, melatonin may be considered a smart controller of the innate and adaptive immunity [140] and inflammation [141], a neuroimmune-endocrine regulator [142] that collaborates with the maintenance of the internal environment and the mitigation of cell/tissue perturbations.…”