Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women

Overview

Journal PLoS Med

Specialty General Medicine

Date 2011 Dec 14

PMID 22162955

Citations 325

Authors

An Pan

Eva S Schernhammer

Qi Sun

Frank B Hu

Affiliations

Soon will be listed here.

Abstract

Background: Rotating night shift work disrupts circadian rhythms and has been associated with obesity, metabolic syndrome, and glucose dysregulation. However, its association with type 2 diabetes remains unclear. Therefore, we aimed to evaluate this association in two cohorts of US women.

Methods And Findings: We followed 69,269 women aged 42-67 in Nurses' Health Study I (NHS I, 1988-2008), and 107,915 women aged 25-42 in NHS II (1989-2007) without diabetes, cardiovascular disease, and cancer at baseline. Participants were asked how long they had worked rotating night shifts (defined as at least three nights/month in addition to days and evenings in that month) at baseline. This information was updated every 2-4 years in NHS II. Self-reported type 2 diabetes was confirmed by a validated supplementary questionnaire. We documented 6,165 (NHS I) and 3,961 (NHS II) incident type 2 diabetes cases during the 18-20 years of follow-up. In the Cox proportional models adjusted for diabetes risk factors, duration of shift work was monotonically associated with an increased risk of type 2 diabetes in both cohorts. Compared with women who reported no shift work, the pooled hazard ratios (95% confidence intervals) for participants with 1-2, 3-9, 10-19, and ≥20 years of shift work were 1.05 (1.00-1.11), 1.20 (1.14-1.26), 1.40 (1.30-1.51), and 1.58 (1.43-1.74, p-value for trend <0.001), respectively. Further adjustment for updated body mass index attenuated the association, and the pooled hazard ratios were 1.03 (0.98-1.08), 1.06 (1.01-1.11), 1.10 (1.02-1.18), and 1.24 (1.13-1.37, p-value for trend <0.001).

Conclusions: Our results suggest that an extended period of rotating night shift work is associated with a modestly increased risk of type 2 diabetes in women, which appears to be partly mediated through body weight. Proper screening and intervention strategies in rotating night shift workers are needed for prevention of diabetes.

Citing Articles

Incidence rates of prediabetes and diabetes associated with sedentary behavior and night shifts among peruvian workers (2014-2021).

Vera-Ponce V, Zuzunaga-Montoya F, Sanchez-Tamay N, Bustamante-Rodriguez J, De Carrillo C Dialogues Health. 2025; 6:100204.

PMID: 39896886 PMC: 11782889. DOI: 10.1016/j.dialog.2025.100204.

Circadian metabolism regulates the macrophage inflammatory response.

Sun Y, Jiang W, Horng T Life Metab. 2025; 1(3):224-233.

PMID: 39872076 PMC: 11749265. DOI: 10.1093/lifemeta/loac037.

Associations of maternal night shift work during pregnancy with DNA methylation in offspring: a meta-analysis in the PACE consortium.

Marques I, Domenech-Panicello C, Geurtsen M, Hoang T, Richmond R, Polinski K Clin Epigenetics. 2025; 17(1):12.

PMID: 39844285 PMC: 11756212. DOI: 10.1186/s13148-024-01810-y.

Leptin Receptor Deficiency-Associated Diabetes Disrupts Lacrimal Gland Circadian Rhythms and Contributes to Dry Eye Syndrome.

Pei X, Ba M, Yang T, Xuan S, Huang D, Qi D Invest Ophthalmol Vis Sci. 2025; 66(1):19.

PMID: 39774625 PMC: 11721485. DOI: 10.1167/iovs.66.1.19.

Circadian Deregulation: Back Facing the Sun Toward Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Development.

Verdelho Machado M Nutrients. 2025; 16(24.

PMID: 39770915 PMC: 11679855. DOI: 10.3390/nu16244294.

References

Kroenke C, Spiegelman D, Manson J, Schernhammer E, Colditz G, Kawachi I . Work characteristics and incidence of type 2 diabetes in women. Am J Epidemiol. 2006; 165(2):175-83. DOI: 10.1093/aje/kwj355. View

Knutsson A, Karlsson B, Ornkloo K, Landstrom U, Lennernas M, Eriksson K . Postprandial responses of glucose, insulin and triglycerides: influence of the timing of meal intake during night work. Nutr Health. 2002; 16(2):133-41. DOI: 10.1177/026010600201600207. View

Manson J, Rimm E, Stampfer M, Colditz G, Willett W, Krolewski A . Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet. 1991; 338(8770):774-8. DOI: 10.1016/0140-6736(91)90664-b. View

. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997; 20(7):1183-97. DOI: 10.2337/diacare.20.7.1183. View

Field A, Coakley E, Must A, Spadano J, Laird N, Dietz W . Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001; 161(13):1581-6. DOI: 10.1001/archinte.161.13.1581. View

Carpenter L, Beral V, Fraser P, Booth M . Health related selection and death rates in the United Kingdom Atomic Energy Authority workforce. Br J Ind Med. 1990; 47(4):248-58. PMC: 1035146. DOI: 10.1136/oem.47.4.248. View

Fonken L, Workman J, Walton J, Weil Z, Morris J, Haim A . Light at night increases body mass by shifting the time of food intake. Proc Natl Acad Sci U S A. 2010; 107(43):18664-9. PMC: 2972983. DOI: 10.1073/pnas.1008734107. View

Mikuni E, Ohoshi T, Hayashi K, Miyamura K . Glucose intolerance in an employed population. Tohoku J Exp Med. 1983; 141 Suppl:251-6. DOI: 10.1620/tjem.141.suppl_251. View

Sallinen M, Kecklund G . Shift work, sleep, and sleepiness - differences between shift schedules and systems. Scand J Work Environ Health. 2010; 36(2):121-33. DOI: 10.5271/sjweh.2900. View

10.

. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group. Diabetes. 1979; 28(12):1039-57. DOI: 10.2337/diab.28.12.1039. View

11.

Scheer F, Hilton M, Mantzoros C, Shea S . Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci U S A. 2009; 106(11):4453-8. PMC: 2657421. DOI: 10.1073/pnas.0808180106. View

12.

Morikawa Y, Nakagawa H, Miura K, Soyama Y, Ishizaki M, Kido T . Shift work and the risk of diabetes mellitus among Japanese male factory workers. Scand J Work Environ Health. 2005; 31(3):179-83. DOI: 10.5271/sjweh.867. View

13.

Feskanich D, Rimm E, Giovannucci E, Colditz G, Stampfer M, Litin L . Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. J Am Diet Assoc. 1993; 93(7):790-6. DOI: 10.1016/0002-8223(93)91754-e. View

14.

Antunes L, Levandovski R, Dantas G, Caumo W, Hidalgo M . Obesity and shift work: chronobiological aspects. Nutr Res Rev. 2010; 23(1):155-68. DOI: 10.1017/S0954422410000016. View

15.

Lund J, Arendt J, Hampton S, English J, Morgan L . Postprandial hormone and metabolic responses amongst shift workers in Antarctica. J Endocrinol. 2001; 171(3):557-64. DOI: 10.1677/joe.0.1710557. View

16.

Scott A, Ladou J . Shiftwork: effects on sleep and health with recommendations for medical surveillance and screening. Occup Med. 1990; 5(2):273-99. View

17.

Haus E, Smolensky M . Biological clocks and shift work: circadian dysregulation and potential long-term effects. Cancer Causes Control. 2006; 17(4):489-500. DOI: 10.1007/s10552-005-9015-4. View

18.

Hu F, Manson J, Stampfer M, Colditz G, Liu S, Solomon C . Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001; 345(11):790-7. DOI: 10.1056/NEJMoa010492. View

19.

Ayas N, White D, Al-Delaimy W, Manson J, Stampfer M, Speizer F . A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care. 2003; 26(2):380-4. DOI: 10.2337/diacare.26.2.380. View

20.

Suwazono Y, Sakata K, Okubo Y, Harada H, Oishi M, Kobayashi E . Long-term longitudinal study on the relationship between alternating shift work and the onset of diabetes mellitus in male Japanese workers. J Occup Environ Med. 2006; 48(5):455-61. DOI: 10.1097/01.jom.0000214355.69182.fa. View