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2 "Subclinical hypothyroidism"
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Original Article
The relationship between shift work pattern and thyroid stimulating hormone in female workers
Hun Jeong, Chang Ho Chae, Jun Ho Lee, Hyo Won Chong
Ann Occup Environ Med 2023;35:e14.   Published online June 22, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e14
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Shift work is known to cause changes in the circadian rhythm of the human body and adversely affect not only physical health but also mental health. Some studies have demonstrated the correlation between shift work and thyroid stimulating hormone (TSH), a hormone that changes according to the diurnal rhythm, but few studies have reported the different TSH levels according to the shift work type. This study aimed to investigate changes in TSH according to the shift work type.

Methods

This study included 1,318 female workers who had a medical checkup at a university hospital in Changwon from 2015 to 2019. Shift work types were classified as non-shift work, regular 2 shifts, and irregular three shifts, and a TSH ≥ 4.2 mIU/L was defined as abnormal. A general linear model (GLM) was used to compare the TSH levels and the risk of subclinical hypothyroidism in each year, and a binary logistic analysis was performed using a generalized estimation equation (GEE) to compare the risk of subclinical hypothyroidism over the 5-year period.

Results

Of the 1,318 participants included in this study, 363, 711, and 244 were non-shift, two-shift, and irregular three-shift workers, respectively. In the GEE analysis, after adjusting for age, body mass index, smoking, and alcohol consumption, the odds ratios (ORs) were 1.81 (95% confidence interval [CI]: 1.15–2.86; p = 0.011) in 2 shifts and 2.02 (95% CI: 1.23–3.32; p = 0.006) in irregular three shifts, compared to non-shift.

Conclusions

Our results showed that shift work had a higher risk of subclinical hypothyroidism than non-shift work and that there was a significant difference in the risk of subclinical hypothyroidism according to the shift work type. These findings suggest that the shift work type can be considered in future thyroid function tests and evaluations.

여성근로자에서 교대근무유형과 갑상선 자극 호르몬과의 연관성
목적
교대근무는 인체의 일중리듬에 변화를 일으키고 심혈관 질환, 소화기 질환 및 대사증후군과 같은 신체적 건강 뿐만 아니라 수면장애, 우울감 등을 포함한 정신건강에도 유해한 영향을 끼치는 것으로 알려져 있다. 일중리듬에 의해 변화하는 호르몬 중 하나인 갑상선 자극 호르몬(TSH)의 농도가 교대근무와의 연관성을 보여주는 연구들이 있으나 교대근무 유형에 따른 차이를 살펴본 연구는 부족한 실정이다. 본 연구는 교대근무의 유형에 따른 TSH의 변화를 알아보고자 하였다.
방법
2015년부터 2019년까지 창원의 일개 대학병원의 건강진단을 받은 1,318명의 여성근로자를 대상으로 연구를 진행하였다. 교대근무유형은 비교대근무, 규칙적 2교대 및 불규칙 3교대로 분류하였으며 TSH ≥ 4.2mIU/L인 경우 이상이 있는 것으로 정의하였다. 연도별로 TSH의 농도를 비교하기 위하여 일반선형모델을 사용하였으며 5년간의 불현성 갑상선기능저하증의 위험도를 비교하기 위하여 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행하였다.
결과
연구 대상자 1,318명 중 비교대근무자는 총 363명, 2교대 근무자는 총 711명, 불규칙 3교대 근무자는 총 244명이었다. 연령, 체질량지수(BMI), 흡연, 음주를 보정하고 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행한 결과, 비교대근무자를 기준으로 하였을 때, OR은 2교대 근무자에서 1.81(95% CI 1.15-2.86, P=0.011), 불규칙 3교대 근무자에서 2.02(95% CI 1.23-3.32, P=0.006)로 나왔다.
결론
본 연구의 결과는 교대근무가 비교대근무에 비해 불현성 갑상선기능저하증의 위험도가 높았으며 교대근무의 유형에 따른 불현성 갑상선기능저하증의 위험도에 있어 유의미한 차이를 보였다. 이는 이전 연구들의 결과를 뒷받침할 뿐만 아니라 향후 갑상선 기능 검사 및 평가에 있어 교대근무의 유형이 고려대상이 될 수 있을 것으로 생각된다.
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Research Article
Relationship between thyroid stimulating hormone and night shift work
So-Hyun Moon, Bum-Joon Lee, Seong-Jin Kim, Hwan-Cheol Kim
Ann Occup Environ Med 2016;28:53.   Published online October 6, 2016
DOI: https://doi.org/10.1186/s40557-016-0141-0
AbstractAbstract PDFPubReaderePub
Background

Night shift work has well-known adverse effects on health. However, few studies have investigated the relationship between thyroid diseases and night shift work. This study aimed to examine night shift workers and their changes in thyroid stimulating hormones (TSH) levels over time.

Methods

Medical check-up data (2011–2015) were obtained from 967 female workers at a university hospital in Incheon, Korea. Data regarding TSH levels were extracted from the records, and 2015 was used as a reference point to determine night shift work status. The relationships between TSH levels and night shift work in each year were analyzed using the general linear model (GLM). The generalized estimating equation (GEE) was used to evaluate the repeated measurements over the 5-year period.

Results

The GEE analysis revealed that from 2011 to 2015, night shift workers had TSH levels that were 0.303 mIU/L higher than the levels of non-night shift workers (95 % CI: 0.087–0.519 mIU/L, p = 0.006) after adjusting for age and department. When we used TSH levels of 4.5 ≥ mIU/L to identify subclinical hypothyroidism, night shift workers exhibited a 1.399 fold higher risk of subclinical hypothyroidism (95 % CI: 1.050–1.863, p = 0.022), compared to their non-night shift counterparts.

Conclusions

This result of this study suggests that night shift workers may have an increased risk of thyroid diseases, compared to non-night shift workers.


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