Association between night shift work and the risk of type 2 diabetes mellitus: a cohort-based meta-analysis

Abstract

Background: The impact of night shift work on the incidence of type 2 diabetes mellitus (T2DM) is not well understood. This meta-analysis assesses the association between night shift work and the risk of developing T2DM and explores this relationship across various subgroups.

Methods: We systematically searched PubMed, Web of Science, EBSCO, and the Cochrane Library from their inception until February 2024. We employed hazard ratios (HR) and 95% confidence intervals (95%CI) to quantify the association between night shift work and T2DM risk.

Results: Our analysis synthesized data from 9 articles encompassing 10 cohort studies. Overall, night shift workers exhibited a 30% increased incidence of T2DM compared to their daytime counterparts (HR = 1.30, 95% CI: [1.18, 1.43], P < 0.001). Among females, night shift workers had a higher incidence of T2DM (HR = 1.28, 95% CI: [1.16, 1.41]); however, in males, the association was not statistically significant (95% CI: [0.89, 2.63]). For individuals with a body mass index (BMI) > 30 kg/m², night shift work was associated with an increased T2DM risk (HR = 1.14, P = 0.007), whereas there was no significant association for those with a BMI ≤ 30 kg/m² (P = 0.255). Further, the risk of T2DM increased with longer durations of night shift work; workers with more than 10 years of night shift work faced a higher T2DM risk than those with 10 years or fewer (HR for > 10 years = 1.17, 95% CI: [1.10, 1.24]; HR for ≤ 10 years = 1.06, 95% CI: [1.03, 1.10]).

Conclusion: Findings suggest potential link between night shift work and T2DM risk. Longer durations of night shift work may increase the risk of T2DM. There may be gender differences (greater harm in women, but the male sample size is small) and obesity differences.

Keywords: BMI; Gender; Meta-analysis; Night shift work; Risk; Type 2 diabetes mellitus.

Fig. 1

Flow diagram of the selection process

Fig. 2

Forest plot of a meta-analysis assessing the association between night shift work and the risk of T2DM in all participants (p < 0.001)

Fig. 3

Forest plots of a meta-analysis assessing the association between night shift work and the risk of T2DM in sex-specific subgroups (a: male, p = 0.128; b: female, p < 0.001)

Fig. 4

Forest plots of a meta-analysis assessing the association between night shift work and the risk of T2DM across BMI subgroups (a: BMI ≤ 30 kg/m², p = 0.255; b: BMI > 30 kg/m², p = 0.007)

Fig. 5

Forest plots of a meta-analysis assessing the association between night shift work and the risk of T2DM across night shift duration subgroups (a: ≤10 years, p < 0.001; b: >10 years, p < 0.001)