工作时长与肥胖发生风险的剂量反应关系  

Dose-response relationship between working hours and obesity risk

作　　者：高银燕[1] 甘婷 江丽丽 唐代茂 丁国武[1] GAO Yin-yan;GAN Ting;JIANG Li-li;TANG Dai-mao;DING Guo-wu(Institute of Social Medicine and Health Management,School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China;Institute of Epidemiology and Statistics,School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China;Institute of Occupational and Environmental Health,School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学公共卫生学院社会医学与卫生事业管理研究所,甘肃兰州730000 [2]兰州大学公共卫生学院流行病与卫生统计学研究所,甘肃兰州730000 [3]兰州大学公共卫生学院劳动卫生与环境卫生学研究所,甘肃兰州730000

出　　处：《环境与职业医学》2019年第11期989-994,共6页Journal of Environmental and Occupational Medicine

摘　　要：[背景]随着社会经济的发展,工作时长对肥胖的影响日益受到人们的关注,但目前国内外均缺乏分析工作时长与肥胖之间的剂量反应关系研究。[目的]探索不同工作时长与肥胖的关联及二者之间的剂量反应关系。[方法]研究资料来源于中国健康与营养调查(China Health and Nutrition Survey,CHNS),选取具有完整人口统计学、每周工作时长和体质量指数等调查数据的18~65岁人群作为研究对象。以每周工作35~48 h为对照,通过多因素COX回归分析每周工作时长不超过34 h、49~55 h以及至少56 h对肥胖发生风险的影响,利用限制性立方样条模型分析工作时长与肥胖之间的剂量反应关系。[结果]共纳入9 319个调查样本,其中男性5 005人,女性4 314人。年龄(39.2±13.0)岁,平均随访8.66年。截至最后一次随访调查,共有640人发生肥胖,肥胖发生率为6.9%。多因素COX回归结果显示,与对照组相比,每周工作时长不超过34 h和每周工作时长至少56 h者的肥胖发生风险较高,其风险比(HR)及其95%可信区间(95%CI)分别为1.33(1.07~1.65)和1.36(1.13~1.65),尚未发现每周工作49~55 h与肥胖之间的关联。从不同性别来看,每周工作时长至少56 h与男性的肥胖发生风险有关联,其HR及其95%CI为1.40(1.09~1.79);每周工作时长不超过34 h则与女性的肥胖发生风险有关联,其HR及其95%CI为1.42(1.04~1.94)。从不同工作类型来看,每周工作时长至少56 h与体力劳动者的肥胖发生风险相关,其HR及其95%CI为1.34(1.07~1.67),尚未发现每周工作时长与非体力劳动者肥胖发生风险之间的关联。工作时长和肥胖呈"U"型剂量反应关系(总趋势P <0.05,非线性P <0.05),当每周工作时长小于50 h,肥胖发生风险随着工作时长的增加而降低,超过50 h后肥胖发生风险随着工作时长的增加而上升。[结论]短时间工作和长时间工作均有可能与肥胖的发生风险有关联,工作时长与肥胖发生风险呈[Background] With the development of social economy, the influence of working time on obesity has received increasing attention. However, there is a lack of studies on the dose-response relationship between working hours and obesity.[Objective] This study evaluates the association between different working hours and obesity and the dose-response relationship between them.[Methods] The data were obtained from the China Health and Nutrition Survey(CHNS), and subjects aged 18-65 years with completed demographics, weekly working hours, and body mass index were included. Using working 35-48 h per week as reference, multivariate COX regressions were conducted to assess the associations between weekly working hours( ≤ 34 h, 49-55 h, and ≥ 56 h) and the risk of obesity. Restricted cubic spline models were used to analyze the dose-response relationship between working hours and obesity.[Results] A total of 9 319 individuals were included, including 5 005 males and 4 314 females.Their age was(39.2±13.0) years, and the mean follow-up time was 8.66 years. By the last follow-up, a total of 640 participants developed obesity, and the incidence rate of obesity was 6.9%. The results of multivariate COX regression showed that the hazard ratio(HR) and 95% confidence interval(95% CI) of obesity was 1.33(1.07-1.65) and 1.36(1.13-1.65) respectively for the groups working ≤ 34 h and ≥ 56 h per week compared with the reference group, and the association between working 49-55 h per week and obesity was not found. Regarding sexes, working ≥ 56 h per week was associated with the risk of obesity of males(HR=1.40, 95% CI: 1.09-1.79), and working ≤ 34 h per week was associated with the risk of obesity of females(HR=1.42, 95% CI: 1.04-1.94). Regarding types of work, working ≥ 56 h per week was associated with the risk of obesity in manual workers(HR=1.34, 95% CI: 1.07-1.67), and the association in nonmanual workers was not observed. There was a U-shaped dose-response relationship between working hours and obesity(Ptrend < 0.05,

关 键 词：工作时长 肥胖 剂量反应关系 中国健康与营养调查 

分 类 号：R132[医药卫生—劳动卫生]