环境与职业医学2026，Vol.43Issue(7)：836-843,8.DOI:10.11836/JEOM25471
不同轮班工作特征类别的潜类别分析及与护士残余胆固醇的关联
Association between latent classes of shift work characteristics and Remnant cholesterol among nurses
摘要
Abstract
[Background]Dyslipidemia is a major risk factor for cardiovascular disease(CVD).Remnant cholesterol(RC),an emerging lipid biomark-er,has also been recognized as a potential risk factor for CVD development.Currently,epidemiological findings on the impact of shift work on dyslipidemia remain inconsistent,and studies examining its association with RC are particularly limited. [Objective]To analyze latent classes of shift work characteristics among nurses and examine their associations with RC,total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C),thereby providing evidence for promoting lipid health in this occupational population. [Methods]This cross-sectional study utilized data from the baseline survey of the Nurses'Environmental&Occupational Exposure and Health Nexus Cohort(NEON Cohort).Considering geographical distribution and hospital grade,one general hospital was randomly selected from the cohort-covered hospitals in each of the northern,central,and southern regions of Anhui Province.From July 2022 to September 2025,a cross-sectional survey was conducted among practicing nurses who met the inclusion criteria in the selected hospitals.A total of 1 933 nurses completed the baseline questionnaire.After excluding participants with incomplete questionnaires or missing blood bio-chemical indicators,1 079 nurses were finally included in the analysis.Shift work characteristics—including shift work status,night shift frequency,daily working hours,weekly working days,years of work experience,and self-rated work intensity—were assessed using a self-designed Reproductive Health Questionnaire for Nurses.Blood lipid profiles(TC,TG,HDL-C,and LDL-C)were collected,and RC was calculated accordingly.The Wilcoxon rank-sum test and Chi-square test were used to compare RC levels and shift work patterns across demographic variables,respectively.Latent class analysis(LCA)was performed using the poLCA package in R to identify potential patterns of shift work,and the results were visualized using radar charts.Generalized linear models(GLM)and binary logistic regression were used to examine the associations between shift work categories and continuous/dichotomized lipid measures. [Results]Three latent classes of shift work characteristics were identified among nurses:the shift work and high intensity group(38.1%),the low intensity and short hours group(32.0%),and the regular hours and long tenure group(29.9%).Using the low intensity and short hours group as the reference in GLM analysis,the regular hours and long tenure group was significantly associated with elevated levels of RC(β=0.07,95%CI:0.01,0.14),LDL-C(β=0.13,95%CI:0.01,0.24),and TC(β=0.22,95%CI:0.08,0.36).The shift work and high intensity group was also associated with elevated RC levels(β=0.12,95%CI:0.07,0.18).After stratification by age and adjustment for covariates,the association between the regular hours and long tenure group and RC was primarily observed in nurses aged≤ 33 years,whereas its association with LDL-C was prominent in those aged≥ 34 years.The association between the shift work and high intensity group and RC was also predominantly observed in nurses aged≤33 years.Logistic regression showed that,compared with the reference group,the regular hours and long tenure group had significantly increased risks for RC≥1.07 mmol·L-1(OR=2.12,95%CI:1.43,3.13),LDL-C≥3.40 mmol·L-1(OR=1.76,95%CI:1.04,2.98),and TC≥5.20 mmol·L-1(OR=2.04,95%CI:1.38,3.02).The shift work and high intensity group showed a significantly increased risk of RC≥1.07 mmol·L-1(OR=1.96,95%CI:1.36,2.84). [Conclusion]Nurses'shift work characteristics exhibit distinct latent classification patterns,which are significantly associated with RC,LDL-C,and TC levels.Occupational health administrators should consider these pattern-specific impacts on nurses'lipid health and imple-ment rationally designed work schedules to mitigate the adverse lipid health effects of shift work.关键词
轮班工作/护士/残余胆固醇/总胆固醇/甘油三酯/低密度脂蛋白胆固醇/高密度脂蛋白胆固醇Key words
shift work/nurse/remnant cholesterol/total cholesterol/triglycerides/low-density lipoprotein cholesterol/high-density lipoprotein cholesterol分类
医药卫生引用本文复制引用
樊萌,刘水兰,鞠葳,杨娅娟,唐颖,江敏敏,王雅斐,陶芳标,伍晓艳..不同轮班工作特征类别的潜类别分析及与护士残余胆固醇的关联[J].环境与职业医学,2026,43(7):836-843,8.基金项目
国家自然科学基金项目(82373592,82173542) （82373592,82173542）
安徽省自然科学基金项目(2408085QH278) （2408085QH278）
