倒班、长工时及其交互作用对医务人员代谢综合征影响研究

doi:10.12183/j.scjpm.2026.0389

华南预防医学 ›› 2026, Vol. 52 ›› Issue (4): 389-394.doi: 10.12183/j.scjpm.2026.0389

倒班、长工时及其交互作用对医务人员代谢综合征影响研究

龚曼佳^1,2, 刘晓曼³, 张丹英², 魏巧丽², 李晓欣², 庄志明², 李旭东^1,2

1.广州医科大学公共卫生学院,广东广州 511436;
2.广东省职业病防治院/广东省职业健康工程技术研究中心/广东省职业病防治重点实验室;
3.中国疾病预防控制中心职业卫生与中毒控制所

收稿日期:2025-07-08 出版日期:2026-04-20 发布日期:2026-05-08
通讯作者: 李旭东,E-mail：lixd116@126.com
作者简介:龚曼佳（2001—）,女,在读硕士研究生,主要研究方向为职业流行病学
基金资助:
中国疾控中心职业卫生所职业健康风险评估与国家职业卫生标准制定（131031109000160004）; 国家重点研发计划项目（2022YFC2503205）; 广东特支计划领军人才项目（0720240123）; 广东省自然科学基金（2023A1515011329）; 广东省职业健康工程技术研究中心建设项目（D：2019A069）

The impact of shift work, long working hours, and their interaction on metabolic syndrome among medical personnel

Gong Manjia^1,2, Liu Xiaoman³, Zhang Danying², Wei Qiaoli², Li Xiaoxin², Zhuang Zhiming², Li Xudong^1,2

1. School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong 511436, China;
2. Guangdong Provincial Prevention and Treatment Center for Occupational Diseases; Guangdong Provincial Engineering Technology Research Center for Occupational Health; Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment;
3. Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention

Received:2025-07-08 Online:2026-04-20 Published:2026-05-08

摘要/Abstract

摘要： 目的研究倒班和长工时暴露水平对医务人员代谢综合征（metabolic syndrome,MS）患病风险的影响差异,并探讨两者对MS的交互作用。方法以珠海市某综合三甲医院医务人员作为调查对象进行问卷调查、体格检查和生化指标检查。采用限制性立方样条（Restricted Cublic Spline, RCS）模型分析倒班年限和周工作时长与MS的剂量-反应关系,采用多因素logistic回归模型分析倒班和长工时与MS的关联,建立相乘模型和相加模型评估倒班和长工时对MS的交互作用。结果 689名医务人员平均年龄为（34.7±8.7）岁,工龄中位数为10.0（5.0,17.0）年,女性509（73.90%）人。倒班作业509（73.9%）人,长工时作业535（77.6%）人,同时存在倒班和长工时作业400（58.1%）人。MS检出132例,检出率为19.2%。RCS结果显示,调整协变量后,倒班年限及周工作时长与MS均存在显著非线性关系（均P<0.05）。倒班年限在12.5年前与MS患病风险呈正相关,12.5年以后呈负相关;周工作时长在41~54 h的MS患病风险显著增加,55 h之后增速减缓。二元logistic回归结果显示,倒班年限0.1~<12.0年和≥12.0年的人群患MS风险明显增加（OR=5.263、95% CI：2.458~11.268;OR=3.515、95% CI：1.796~6.879）,周工作时长41~54 h/周和≥55 h/周的人群患MS风险明显增加（OR=2.014、95% CI：1.057~3.837;OR=4.634、95% CI：2.360~9.098）。在交互模型中倒班和长工时对MS存在乘性交互作用（OR=1.885, 95% CI：1.387~2.561）和相加交互作用（OR=1.316, 95% CI：1.158~1.496）。结论倒班作业与长时间工作会增加医务人员MS患病风险,倒班和长工时对MS患病风险存在交互作用。

关键词: 代谢综合征, 倒班, 长工时, 限制性立方样条, 交互作用

Abstract: Objective To investigate the effects of exposure to shift work and long working hours on the risk of Metabolic Syndrome (MS) among medical personnel and to explore the interaction between these two occupational factors. Methods Taking medical personnel from a comprehensive tertiary hospital for a study involving questionnaires, physical examinations, and biochemical analyses. Restricted Cubic Spline (RCS) models were utilized to analyze the dose-response relationships between the duration of shift work (in years), weekly working hours, and MS. Multivariable logistic regression models were applied to assess the association of shift work and long working hours with MS. Furthermore, both multiplicative and additive models were established to evaluate the interaction effect between shift work and long working hours on MS. Results A total of 689 medical personnel participated, with a mean age of (34.7±8.7) years and a median work tenure of 10.0 (5.0, 17.0) years; 509 (73.90%) participants were female. Among the participants, 509 (73.9%) engaged in shift work, 535 (77.6%) worked long hours, and 400 (58.1%) were exposed to both conditions. MS was detected in 132 participants, yielding a prevalence rate of 19.2%. The RCS models indicated significant non-linear relationships between both the duration of shift work and weekly working hours and the risk of MS after adjusting for covariates (both P<0.05). The risk of MS was positively associated with the duration of shift work up to 12.5 years, after which the association became negative. The risk of MS increased significantly for weekly work durations of 41-54 hours, with the rate of increase slowing after 55 hours. Binary logistic regression results showed a significantly elevated risk of MS in the groups with 0.1-<12.0 years (OR=5.263, 95% CI: 2.458-11.268) and ≥12.0 years of shift work (OR=3.515, 95% CI: 1.796-6.879). Similarly, an increased risk was observed for those working 41-54 hours/week (OR=2.014, 95% CI: 1.057-3.837) and ≥55 hours/week (OR=4.634, 95% CI: 2.360-9.098). In the interaction models, both a significant multiplicative interaction (OR=1.885, 95% CI: 1.387-2.561) and a significant additive interaction (OR=1.316, 95%CI: 1.158-1.496) were observed between shift work and long working hours on the risk of MS. Conclusion Both shift work and long working hours are associated with an increased risk of Metabolic Syndrome in medical personnel. Moreover, a significant interaction effect exists between these two occupational exposures on the risk of developing MS.

Key words: Metabolic syndrome, Shift work, Long working hours, Restricted cubic spline, Interaction effect

中图分类号:

R134

龚曼佳, 刘晓曼, 张丹英, 魏巧丽, 李晓欣, 庄志明, 李旭东. 倒班、长工时及其交互作用对医务人员代谢综合征影响研究[J]. 华南预防医学, 2026, 52(4): 389-394.

Gong Manjia, Liu Xiaoman, Zhang Danying, Wei Qiaoli, Li Xiaoxin, Zhuang Zhiming, Li Xudong. The impact of shift work, long working hours, and their interaction on metabolic syndrome among medical personnel[J]. South China Journal of Preventive Medicine, 2026, 52(4): 389-394.

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倒班、长工时及其交互作用对医务人员代谢综合征影响研究

The impact of shift work, long working hours, and their interaction on metabolic syndrome among medical personnel

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