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Original Article
- Association between hearing loss and high-sensitivity C-reactive protein: the Kangbuk Samsung Cohort Study
- Jihoon Kim, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Seonghyun Kwon, Jinsook Jeong, Woncheol Lee
- Ann Occup Environ Med 2023;35:e38. Published online September 11, 2023
- DOI: https://doi.org/10.35371/aoem.2023.35.e38
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Abstract
Abstract in Korean
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ePub Background Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs.
Methods We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age.
Results In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02–1.34); the OR was 0.99 (95% CI: 0.80–1.22) in those under 40 and 1.28 (1.08–1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92–1.19); the OR was 1.10 (95% CI: 0.90–1.35) in those under 40 and 1.20 (1.01–1.43) in those over 40.
Conclusions This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.
- 청력손실과 고감도 C-반응단백의 연관성
목적
청력손실은 심혈관질환 발생 및 사망률 증가와 관련 있다. 청력손실과 심혈관질환의 병인은 공통으로 염증반응을 포함한다. 몇몇 연구에서 청력손실 환자의 염증성 바이오마커 수치가 증가했음을 연구하였으나 유의하지 않은 결과를 제시하였다. 따라서 본 단면연구 및 종단연구에서는 청력손실이 심혈관질환과 어떠한 관련성이 있는지 알아보기 위해 청력손실과 염증성 바이오마커인 고감도 C-반응단백의 연관성을 연구하였다.
방법
2012년부터 2018년까지 우리 기관에서 건강검진을 받은 18세 이상의 근로자를 대상으로 단면연구를 수행하였다 (n=566,507). 이후 2012년부터 2018년까지 우리 기관에서 건강검진을 2회 이상 받은 18세 이상의 근로자를 대상으로 종단연구를 수행하였다 (n=173,794). 청력손실은 3분법에 의한 순음청력역치가 양측 모두 20 dB 이상인 경우로 정의하였다. 추적관찰 동안 고감도 C-반응단백의 증가는 혈중 농도 3 mg/L 초과인 경우로 정의하였다. 청력손실 발생에 따른 고감도 C-반응단백 증가의 위험을 분석하기 위해 로지스틱 회귀분석과 일반화 추정방정식을 활용하였다. 또한 연령에 따라 계층화하여 추가적인 분석을 하였다.
결과
단면연구에서 최종참가자 204,091명 중 난청 유병률은 0.02% 이었다. 다변량 보정 교차비는 1.17 (95% 신뢰구간 1.02-1.34) 이었다. 40세 이하와 초과인 군에서는 각각 0.99 (0.80-1.22) 와 1.28 (1.08-1.53) 이었다. 종단연구에서 추적관찰 동안 고감도 C-반응단백 수치는 청력손실군 2,349 명 중 272 명, 비청력손실군 116,301명 중 11,049 명에서 증가하였다. 다변수 보정 교차비는 1.05 (95% 신뢰구간 0.92-1.19) 이었다. 40세 이하와 초과인 군에서는 각각 1.10 (0.90-1.35) 과 1.20 (1.01-1.43) 이었다.
결론
본 단면연구 및 종단연구에서는 40세 초과하는 근로자에서 청력손실과 고감도 C-반응단백의 증가에 유의한 연관성이 있음을 확인하였다.
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Research Article
- The effect of shift work on high sensitivity C-reactive protein level among female workers
- Ho Sung Kwak, Hyoung Ouk Park, Young Ouk Kim, Jun Seok Son, Chan Woo Kim, Jun Ho Lee, Young Hoo Shin, Seung Hyun Park, Eui Yup Chung, Chang Ho Chae
- Ann Occup Environ Med 2019;31:e5. Published online May 28, 2019
- DOI: https://doi.org/10.35371/aoem.2019.31.e5
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Abstract
PDFPubReaderePub
Background This study assessed the association between shift work and high-sensitivity C-reactive protein (hs-CRP) level, a risk factor for cardiovascular disease (CVD), in female workers in electronics manufacturing services (EMS).
Methods Female EMS workers who received special medical examinations for workers in Gyeongnam, Korea between January 2017 and December 2017 were enrolled in this study. Their age, marital status, education level, alcohol consumption, smoking habit, regular exercise, quality of sleep, work stress, and depression were investigated, and blood tests were conducted. The t- and χ2 tests were conducted to compare the general and biochemical characteristics between daytime and shift worker groups. Age-adjusted partial correlation analysis was performed to examine the linear relationship between hs-CRP level and other risk factors for CVDs. In addition, the difference in hs-CRP levels according to work schedule was analyzed by ANCOVA after adjusting for variables that could affect the hs-CRP level.
Results Although the average hs-CRP levels did not differ significantly between daytime and shift workers (0.92 ± 1.87 and 1.07 ± 2.20 mg/dL, respectively), shift workers tended to show a higher hs-CRP level (
p = 0.067). After adjusting for variables that can affect the hs-CRP level, the estimated average hs-CRP level was significantly higher in shift workers (1.325 ± 0.156 mg/dL) than that in daytime workers (0.652 ± 0.350 mg/dL) (p = 0.003).Conclusions The results of this study identified a relationship between shift work and hs-CRP level increase in women. Because multiple studies have reported associations between increased hs-CRP and CVD, follow-up of hs-CRP may help early detection of CVD in shift workers.
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Citations
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Research Article
- Night shift work and inflammatory markers in male workers aged 20–39 in a display manufacturing company
- Seong-Woo Kim, Eun-Chul Jang, Soon-Chan Kwon, Wook Han, Min-Sung Kang, Young-Hyeon Nam, Yong-Jin Lee
- Ann Occup Environ Med 2016;28:48. Published online September 20, 2016
- DOI: https://doi.org/10.1186/s40557-016-0135-y
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Abstract
PDFPubReaderePub
Background This study aimed to determine the association between shift work and inflammatory markers, which are independent risk factors of cardiovascular diseases, in male manual workers at a display manufacturing company.
Methods This study was conducted between June 1 and July 31, 2015 on 244 male manual workers aged 20–39 years old at a display manufacturing company and investigated age, marital status, education level, alcohol consumption habit, smoking habit, regular exercise habit, sleep duration, sleep debt, sleep insufficiency, past medical history, current and past shift work experience, duration of shift work, and weekly work hours through face-to-face interviews using structured questionnaires and performed blood tests. Study participants were divided into daytime, former shift, and current shift workers based on the work schedule. Chi-square tests and one-way analyses of variance were performed to compare inflammatory markers and cardiovascular disease risk factors, and analyses of covariance were conducted after adjusting for variables potentially affecting inflammatory markers.
Results High-sensitivity C-reactive protein (hs-CRP; mean ± standard deviation) levels in daytime, former shift, and current shift workers were 0.65 ± 0.43, 0.75 ± 0.43, and 0.86 ± 0.72 mg/L, respectively (
p = 0.029). The leukocyte count (mean ± standard deviation) was 5,556 ± 1,123, 6,210 ± 1,366, and 6,530 ± 1,216 cells/μL, respectively (p < 0.001). Both hs-CRP level and leukocyte count were significantly higher in current shift workers than in daytime workers, and leukocyte count was higher in former shift workers than in daytime workers. After adjusting for variables potentially affecting inflammatory markers, hs-CRP levels (adjusted mean ± standard deviation) in daytime and current shift workers were 0.59 ± 0.06 and 0.92 ± 0.07 mg/L, respectively (p = 0.002). The leukocyte count (adjusted mean ± standard deviation) was 5,557 ± 124 and 6,498 ± 144 cells/μL, respectively (p < 0.001).Conclusions A significant association between shift work and increases in inflammatory markers was confirmed. Because chronic low-grade inflammation plays an important role in the development of cardiovascular diseases, regular follow-up of inflammatory markers as a marker of cardiovascular diseases in shift workers may serve as an early indicator in predicting the effects of shift work on health.
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