轮班工作和代谢功能障碍相关的脂肪变性肝病：一项观察性研究的系统综述

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

International Archives of Occupational and Environmental Health Pub Date : 2025-09-17 DOI:10.1007/s00420-025-02171-6

Bingya Ma, Yihang Fan, Wenjun Fan

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引用次数: 0

摘要

目的：轮班工作扰乱昼夜节律，可能增加代谢紊乱的风险，包括非酒精性脂肪性肝病，最近被重新定义为代谢功能障碍相关的脂肪性肝病（MASLD），及其进行性形式，代谢功能障碍相关的脂肪性肝炎。本系统综述旨在综合轮班工作与MASLD之间关系的观察性研究。方法：在PubMed、Scopus和Web of Science数据库中进行全面的文献检索，截止到2024年11月25日，遵循系统评价和元分析指南的首选报告项目。根据预先规定的纳入和排除标准提取和汇总数据。采用美国国立卫生研究院质量评估工具评价纳入研究的质量。数据提取和质量评估均由两位作者独立进行，分歧通过共识解决。结果：9项研究符合标准并纳入综述，包括不同的职业群体。大多数研究报告轮班工作与MASLD之间存在正相关，在长期或频繁轮班工作的工人中观察到更强的影响。亚组分析和相互作用分析表明，性别、年龄、生活方式、睡眠类型和职业因素可能会改变这种关联，而体重指数被认为是倒班工作与MASLD之间关系的潜在中介。然而，方法上的问题，如不精确的暴露和结果测量以及缺乏时变分析，限制了因果解释。结论：系统评价支持轮班工作与MASLD风险增加之间的关联。进一步的前瞻性研究需要严格的设计和多样化的人群，以及更有力的机制证据，以建立轮班工作和MASLD之间的因果关系。

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Shift work and metabolic dysfunction-associated steatotic liver disease: a systematic review of observational studies.

Objective: Shift work disrupts the circadian rhythm and may increase the risk of metabolic disorders, including nonalcoholic fatty liver disease, recently redefined as metabolic dysfunction-associated steatotic liver disease (MASLD), and its progressive form, metabolic dysfunction-associated steatohepatitis. This systematic review aimed to synthesize observational studies on the association between shift work and MASLD.

Methods: A comprehensive literature search was conducted in the PubMed, Scopus, and Web of Science databases up to November 25, 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted and summarized based on pre-specified inclusion and exclusion criteria. The National Institutes of Health quality assessment tool was used to evaluate the quality of the included studies. Both data extraction and quality assessment were conducted independently by two authors, with disagreements resolved through consensus.

Results: Nine studies met the criteria and were included in the review, including various occupational groups. Most studies reported a positive association between shift work and MASLD, with stronger effects observed in workers exposed to long-term or frequent shift work. Subgroup and interaction analyses suggested that gender, age, lifestyle, chronotype, and occupational factors may modify this association, while body mass index was identified as a potential mediator of the relationship between shift work and MASLD. However, methodological issues, such as imprecise exposure and outcome measurements and a lack of time-varying analysis, limit causal interpretation.

Conclusion: The systematic review supports an association between shift work and increased MASLD risk. Further prospective studies with rigorous designs and diverse populations, as well as stronger mechanistic evidence, are needed to establish a causal link between shift work and MASLD.

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来源期刊

International Archives of Occupational and Environmental Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

6.70%

发文量

127

审稿时长

3 months

期刊介绍： International Archives of Occupational and Environmental Health publishes Editorials, Review Articles, Original Articles, and Letters to the Editor. It welcomes any manuscripts dealing with occupational or ambient environmental problems, with a special interest in research at the interface of occupational health and clinical medicine. The scope ranges from Biological Monitoring to Dermatology, from Fibers and Dust to Human Toxicology, from Nanomaterials and Ultra-fine Dust to Night- and Shift Work, from Psycho-mental Distress and Burnout to Vibrations. A complete list of topics can be found on the right-hand side under For authors and editors. In addition, all papers should be based on present-day standards and relate to: -Clinical and epidemiological studies on morbidity and mortality -Clinical epidemiological studies on the parameters relevant to the estimation of health risks -Human experimental studies on environmental health effects. Animal experiments are only acceptable if relevant to pathogenic aspects. -Methods for studying the topics mentioned above.