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

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Background: Shift work is becoming increasingly common worldwide. Shift work disrupts the body’s normal circadian rhythm, which could lead to an increased risk of many chronic diseases through the dysregulation of normal 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: This study adopted the method of multi-stage stratified cluster sampling. 1499 oilfield workers in the OHSPIW cohort who participated in the occupational health examination from March 2017 to June 2018 were randomly selected. We evaluated their shift work, sleep quality, T2DM status with questionnaires and plasma RBP4 levels in blood samples. Chi-square tests, t-tests, and multivariate logistic regression analyses were performed. Results: The prevalence rate of T2DM in shift workers (6.56%) was significantly higher than that in day workers (4.21%) (OR=1.599, 95%CI:1.010-2.533), and there was no significant difference in family history of diabetes, hypertension and other chronic heart diseases (P =0.378). The total score of the PSQI was distinctly higher in shift workers (6.89 ± 3.35) than that in day workers (5.99 ± 2.87) (P < 0.001). Adjusting for age, gender, BMI, family income, tobacco smoking, alcohol drinking and PSQI, shift work remained to be a risk factor for T2DM (OR=1.913, 95%CI: 1.167-3.135). The results of pairwise comparison showed that the levels of RBP4 were statistical difference in shift and non-shift without T2DM and shift and non-shift with T2DM group (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 in shift and non-shift group with T2DM was higher than shift and non-shift group 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 9.51μg/mL compared with that of the day workers. Conclusions: Shift work is associated with an increased risk of T2DM and high levels of RBP4. Follow-up of RBP4 may help early detection of T2DM in shift workers.