Shift work aggravates metabolic syndrome development among early-middle-aged males with elevated ALT

Yu-Cheng Lin; Tun-Jen Hsiao; Pau-Chung Chen
December 2009
World Journal of Gastroenterology;12/7/2009, Vol. 15 Issue 45, p5654
Academic Journal
AIM: To examine whether shift work accelerates metabolic syndrome (MetS) development among early middle-aged males with elevated alanine aminotransferase (e-ALT). METHODS: A retrospective, observational follow-up study on MetS development at a 5-year interval was conducted using health examination data. Nine hundred and ninety six male employees not fulfilling MetS criteria screening were enrolled. Age, MetS-components, liver enzymes, serological markers for viral hepatitis, abdominal ultrasound, insulin resistance status, lifestyles, and workplace factors were analyzed. RESULTS: The prevalence of elevated serum ALT (> 40 U/L, e-ALT) baseline was 19.1%. There were 381 (38.3%) workers with long-term exposures to day-night rotating work (RSW). 14.2% subjects developed MetS during follow-up. After 5 years, the workers with e-ALT had significantly unfavorable changes in MetS-components, and higher rates of MetS development, vs subjects with normal baseline ALT levels. Workers with both baseline e-ALT and 5-year persistent RSW (pRSW) exposure had the highest rate of MetS development. Also, e-ALT-plus-pRSW workers had significant increase in MetS-components at follow-up, compared with the other subgroups. After controlling for potential confounders, e-ALT-plus-pRSW workers posed a significant risk for MetS development (odds ratio, 2.7; 95% confidence interval, 1.4-5.3, vs workers without baseline e-ALT nor pRSW). CONCLUSION: We suggest that all early middle-aged male employees with e-ALT should be evaluated and managed for MetS. Particularly in terms of job arrangements, impacts of long-term RSW on MetS development should be assessed for male employees having baseline e-ALT.


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