Night shift work and cardiovascular disease biomarkers in female nurses

Am J Ind Med. 2020 Mar;63(3):240-248. doi: 10.1002/ajim.23079. Epub 2019 Dec 11.

Abstract

Background: Night shift work is associated with cardiovascular disease, but its associations with cardiovascular disease biomarkers are unclear. We investigated these associations in a study of female nurses.

Methods: We used data from the Nurses' Health Study II for total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, C-reactive protein (CRP), and fibrinogen. The sample sizes for our analysis ranged from 458 (fibrinogen) to 3574 (total cholesterol). From questionnaires, we determined the number of night shifts worked in the 2 weeks before blood collection and total years of rotating night shift work. We used quantile regression to estimate differences in biomarker levels by shift work history, adjusting for potential confounders.

Results: Nurses working 1 to 4 recent night shifts had median HDL cholesterol levels 4.4 mg/dL (95% confidence interval [CI]: 0.3, 7.5) lower than nurses without recent night shifts. However, working ≥5 recent night shifts and years of rotating night shift work were not associated with HDL cholesterol. There was no association between recent night shifts and CRP, but median CRP levels were 0.1 (95% CI: 0.0, 0.2), 0.2 (95% CI: 0.1, 0.4), and 0.2 (95% CI: 0.0, 0.4) mg/L higher among nurses working rotating night shifts for 1 to 5, 6 to 9, and ≥10 years compared with nurses never working rotating night shifts. These associations were attenuated when excluding postmenopausal women and women taking statins. We observed no associations between night shift work and other biomarkers.

Conclusions: We found suggestive evidence of adverse short-term and long-term effects of night shift work on select cardiovascular disease biomarkers.

Keywords: C-reactive protein; biomarkers; lipids; night shift work; nurses; women.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / etiology*
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Chronobiology Disorders / blood*
  • Chronobiology Disorders / etiology
  • Female
  • Fibrinogen / analysis
  • Heart Disease Risk Factors
  • Humans
  • Middle Aged
  • Nurses / statistics & numerical data*
  • Occupational Diseases / blood*
  • Occupational Diseases / etiology
  • Shift Work Schedule / adverse effects*
  • Surveys and Questionnaires
  • Triglycerides / blood
  • Work Schedule Tolerance / physiology

Substances

  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides
  • Fibrinogen
  • C-Reactive Protein
  • Cholesterol