Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures

Abstract Background Previous research has made use of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index to explore the association between shiftwork (SW) and insulin resistance (IR). However, the limitations of the HOMA-IR index restrict its use. This study aimed to investigate...

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Main Authors: Mirella Youssef Tawfik, Shaimaa A. A. M. Amer, Ahmed Mahmoud Fouad
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-21243-9
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author Mirella Youssef Tawfik
Shaimaa A. A. M. Amer
Ahmed Mahmoud Fouad
author_facet Mirella Youssef Tawfik
Shaimaa A. A. M. Amer
Ahmed Mahmoud Fouad
author_sort Mirella Youssef Tawfik
collection DOAJ
description Abstract Background Previous research has made use of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index to explore the association between shiftwork (SW) and insulin resistance (IR). However, the limitations of the HOMA-IR index restrict its use. This study aimed to investigate the relationship between SW and IR in professional drivers using four alternative non-insulin-based IR surrogate measures (NIRS), and to determine the predictors of elevated NIRS. Methods A comparative cross-sectional study was conducted on professional drivers at four Egyptian companies, where 187 SW were compared to 193 dayworkers (DW). Measurements included: sociodemographic, work, and clinical characteristics. Laboratory and NIRS data included: triglyceride glucose (TyG), triglyceride glucose-body mass index (TyG-BMI), triglyceride to high density lipoprotein cholesterol (TG/HDL-C), and metabolic score of insulin resistance (METS-IR). Further assessments included insomnia severity index (ISI), and perceived stress scale (PSS-10). Results Shiftwork-drivers showed significantly higher levels of NIRS compared to DW-drivers. Shiftwork was significantly associated with elevated TyG (OR: 5.04, 95% CI: 1.98–12.84), TyG-BMI (OR: 4.50, 95% CI: 2.45–8.26), and METS-IR (OR: 6.30, 95% CI: 2.72–14.58). Significant interactions between SW and insomnia or meal-timing habits existed, where SW-drivers with clinically significant insomnia had 11 times higher odds of elevated TyG compared to DW drivers without insomnia. Likewise, SW-drivers experiencing poor meal timing habits had 5.5- and 6.8-times higher odds of elevated TG/HDL-C and METS-IR, respectively, compared to DW divers without poor meal timing habits. Other significant predictors for elevated NIRS included: age, income, stress, overweight/obesity, and poor meal timing habits. Conclusions This study demonstrates a significant association between shiftwork and elevated insulin resistance in professional drivers. Insomnia and poor meal timing habits significantly increases the odds of insulin resistance among professional drivers, suggesting interventions targeting sleep quality, meal timing, and stress management.
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spelling doaj-art-c9d6ca34110048b8a9cf23e9a32153ee2025-01-19T12:41:52ZengBMCBMC Public Health1471-24582025-01-0125111310.1186/s12889-024-21243-9Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measuresMirella Youssef Tawfik0Shaimaa A. A. M. Amer1Ahmed Mahmoud Fouad2Department of Public health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal UniversityDepartment of Public health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal UniversityDepartment of Public health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal UniversityAbstract Background Previous research has made use of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index to explore the association between shiftwork (SW) and insulin resistance (IR). However, the limitations of the HOMA-IR index restrict its use. This study aimed to investigate the relationship between SW and IR in professional drivers using four alternative non-insulin-based IR surrogate measures (NIRS), and to determine the predictors of elevated NIRS. Methods A comparative cross-sectional study was conducted on professional drivers at four Egyptian companies, where 187 SW were compared to 193 dayworkers (DW). Measurements included: sociodemographic, work, and clinical characteristics. Laboratory and NIRS data included: triglyceride glucose (TyG), triglyceride glucose-body mass index (TyG-BMI), triglyceride to high density lipoprotein cholesterol (TG/HDL-C), and metabolic score of insulin resistance (METS-IR). Further assessments included insomnia severity index (ISI), and perceived stress scale (PSS-10). Results Shiftwork-drivers showed significantly higher levels of NIRS compared to DW-drivers. Shiftwork was significantly associated with elevated TyG (OR: 5.04, 95% CI: 1.98–12.84), TyG-BMI (OR: 4.50, 95% CI: 2.45–8.26), and METS-IR (OR: 6.30, 95% CI: 2.72–14.58). Significant interactions between SW and insomnia or meal-timing habits existed, where SW-drivers with clinically significant insomnia had 11 times higher odds of elevated TyG compared to DW drivers without insomnia. Likewise, SW-drivers experiencing poor meal timing habits had 5.5- and 6.8-times higher odds of elevated TG/HDL-C and METS-IR, respectively, compared to DW divers without poor meal timing habits. Other significant predictors for elevated NIRS included: age, income, stress, overweight/obesity, and poor meal timing habits. Conclusions This study demonstrates a significant association between shiftwork and elevated insulin resistance in professional drivers. Insomnia and poor meal timing habits significantly increases the odds of insulin resistance among professional drivers, suggesting interventions targeting sleep quality, meal timing, and stress management.https://doi.org/10.1186/s12889-024-21243-9ShiftworkInsulin resistanceNon-insulin-based IR surrogatesProfessional drivers, Egypt
spellingShingle Mirella Youssef Tawfik
Shaimaa A. A. M. Amer
Ahmed Mahmoud Fouad
Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures
BMC Public Health
Shiftwork
Insulin resistance
Non-insulin-based IR surrogates
Professional drivers, Egypt
title Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures
title_full Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures
title_fullStr Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures
title_full_unstemmed Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures
title_short Shiftwork and insulin resistance in professional drivers: exploring the association using non-insulin-based surrogate measures
title_sort shiftwork and insulin resistance in professional drivers exploring the association using non insulin based surrogate measures
topic Shiftwork
Insulin resistance
Non-insulin-based IR surrogates
Professional drivers, Egypt
url https://doi.org/10.1186/s12889-024-21243-9
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