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夜间及全天候消防员的轮班时间表是否会导致收缩压和舒张压昼夜节律的τ值偏离24小时?

Do night and around-the-clock firefighters' shift schedules induce deviation in tau from 24 hours of systolic and diastolic blood pressure circadian rhythms?

作者信息

Reinberg Alain E, Smolensky Michael H, Riedel Marc, Riedel Cedric, Brousse Eric, Touitou Yvan

机构信息

a Unité de Chronobiologie , Fondation A. de Rothschild , Paris cedex , France.

b Department of Biomedical Engineering, Cockrell School of Engineering , The University of Texas at Austin , Austin , TX , USA.

出版信息

Chronobiol Int. 2017;34(8):1158-1174. doi: 10.1080/07420528.2017.1343833. Epub 2017 Sep 18.

Abstract

Systolic (S) and diastolic (D) blood pressures (BP) [SBP and DBP] are circadian rhythmic with period (τ) in healthy persons assumed to be maintained at 24.0h. We tested this assumption in a sample of 30 healthy career (mean >12 yrs) 30-to-46 yr-old male Caucasian French firefighters (FFs) categorized into three groups according to work schedule and duties: Group A - 12 FFs working 12h day, 12h night, and occasionally 24h shifts and whose primary duties are firefighting plus paramedical and road rescue services; Group B - 9 FFs working mostly 12h day and 12h night shifts and whose duties are answering incoming emergency calls and coordinating service vehicle dispatch from fire stations with Group A personnel; Group C - 9 day shift (09:00-17:00h) FFs charged with administrative tasks. SBP and DBP, both in winter and in summer studies of the same FFs, were sampled by ambulatory BP monitoring every 1h between 06:00-23:00h and every 2h between 23:01-05:59h, respectively, their approximate off-duty wake and sleep spans, for 7 consecutive days. Activity (wrist actigraphy) was also sampled at 1-min intervals. Prominent τ of each variable was derived by a power spectrum program written for unequal-interval time series data, and between-group differences in incidence of τ≠24h of FFs were assessed by chi square test. Circadian rhythm disruption (τ≠24h) of either the SBP or DBP rhythm occurred almost exclusively in night and 24h shift FFs of Group A and B, but almost never in day shift FFs of Group C, and it was not associated with altered τ from 24.0h of the circadian activity rhythm. In summer, occurrence of τ≠24 for FFs of Group A and B differed from that for FFs of Group C in SBP (p=0.042) and DBP (p=0.015); no such differences were found in winter (p>0.10). Overall, manifestation of prominent τ≠24h of SBP or DBP time series was greater in summer than winter, 27.6% versus 16.7%, when workload of Group B FFs, i.e. number of incoming emergency telephone calls, and of Group A FFs, i.e. number of dispatches for provision of emergency services, was, respectively, two and fourfold greater and number of 12h night shifts worked by Group B FFs and number of 24h shifts worked by Group A FFs was, respectively, 92% and 25% greater. FFs of the three groups exhibited no winter-summer difference in τ≠24h of SBP or SDP; however, τ≠24h of DBP in Group B FFs was more frequent in summer than winter (p=0.046). Sleep/wake cycle disruption, sleep deprivation, emotional and physical stress, artificial light-at-night, and altered nutrient timings are hypothesized causes of τ≠24h for BP rhythms of affected Groups A and B FFs, but with unknown future health effects.

摘要

在健康人群中,收缩压(S)和舒张压(D)[即收缩压(SBP)和舒张压(DBP)]具有昼夜节律,其周期(τ)假定维持在24.0小时。我们在30名健康从业者(平均工作年限>12年)的样本中检验了这一假设,这些从业者为30至46岁的法国白人男性消防员(FFs),根据工作时间表和职责分为三组:A组 - 12名消防员,工作时间为12小时白班、12小时夜班,偶尔有24小时轮班,其主要职责是灭火以及提供辅助医疗和道路救援服务;B组 - 9名消防员,主要工作时间为12小时白班和12小时夜班,其职责是接听来电紧急呼叫,并与A组人员协调消防站服务车辆的调度;C组 - 9名日班(09:00 - 17:00)消防员,负责行政任务。在对同一批消防员进行的冬季和夏季研究中,分别在06:00 - 23:00期间每小时、23:01 - 05:59期间每两小时通过动态血压监测对SBP和DBP进行采样,这分别是他们大致的非工作清醒和睡眠时段,连续7天。活动情况(手腕活动记录仪)也以1分钟的间隔进行采样。每个变量的显著τ值由针对不等间隔时间序列数据编写的功率谱程序得出,FFs中τ≠24小时发生率的组间差异通过卡方检验进行评估。SBP或DBP节律的昼夜节律紊乱(τ≠24小时)几乎只发生在A组和B组的夜班和24小时轮班消防员中,但几乎从未发生在C组的日班消防员中,并且它与昼夜活动节律的τ值偏离24.0小时无关。在夏季,A组和B组消防员的SBP(p = 0.042)和DBP(p = 0.015)中τ≠24小时的发生率与C组消防员不同;冬季未发现此类差异(p>0.10)。总体而言,SBP或DBP时间序列中显著τ≠24小时的表现夏季比冬季更明显,分别为27.6%和16.7%,此时B组消防员的工作量,即来电紧急电话数量,以及A组消防员的工作量,即提供紧急服务的调度次数,分别增加了两倍和四倍,并且B组消防员的12小时夜班工作次数和A组消防员的24小时轮班工作次数分别增加了92%和25%。三组消防员在SBP或SDP的τ≠24小时方面没有冬夏差异;然而,B组消防员DBP的τ≠24小时在夏季比冬季更频繁(p = 0.046)。睡眠/觉醒周期紊乱、睡眠剥夺、情绪和身体压力、夜间人造光以及营养摄入时间改变被假定为受影响的A组和B组消防员BP节律中τ≠24小时的原因,但对未来健康的影响尚不清楚。

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