Metabolic effects of circadian rhythm disruption in hospital healthcare personnel
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Publicación 10. Vol 6. Num 3.1 (Español (España))
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Published:
Sep 2, 2023
Keywords:
Metabolism, circadian rhythm, quality of life, obesity, sleep, dyslipidemia, overweight.
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Abstract
Introduction: The circadian rhythm regulates metabolic changes in 24-hour cycles. In healthcare workers with night shifts, lower quality of life, emotional fatigue, and obesity are observed. Studies indicate sleep and dietary disturbances, with possible traits of anxiety or depression. Metabolic and cardiovascular diseases worsen with disruptions in the sleep-wake cycle. Objective: To establish the metabolic effects of circadian rhythm disruption in hospital healthcare workers. Methodology: This study is a narrative literature review on the metabolic effects of circadian rhythm disruption in hospital healthcare workers. Articles from the last 5 years in English and Spanish, from various sources and countries, were included. Relevant keywords were used, and studies without open access were excluded. Results were synthesized in a database with information on author, year, study type, population, and observed metabolic effects. Results: Circadian rhythm disruption in healthcare workers is associated with changes in the ability to process stimuli and alterations in clock genes affecting metabolic health. Increased fasting glucose levels and alterations in phospholipid metabolism, with elevated triglycerides and HDL, were observed. Night shift workers experience sleep disorders, chronic fatigue, work-related stress, and reduced performance compared to conventional schedules, increasing the risk of occupational accidents. Conclusion: Circadian rhythm disruption in healthcare workers is linked to diabetes, hypertension, and metabolic syndrome. Rotating night shift workers every 2 months normalizes the circadian rhythm and reduces long-term metabolic effects. Prolonged night shifts without adequate rest cause physical problems and increase the risk of depression and Burnout syndrome. Night work affects attention and critical judgment, posing risks to patients. Lack of staff, insufficient rest periods, and poor diet are major contributors to circadian disruption.
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Flores Romero, K. D., & Hugo Merino, G. A. (2023). Metabolic effects of circadian rhythm disruption in hospital healthcare personnel. ConcienciaDigital, 6(3.1), 202-229. https://doi.org/10.33262/concienciadigital.v6i3.1.2689
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References
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Carmona, P., Mendez, N., Ili, C. G., y Brebi, P. (2020). The role of clock genes in fibrinolysis regulation: Circadian disturbance and its effect on fibrinolytic activity. Frontiers in Physiology, 11, 129. https://pubmed.ncbi.nlm.nih.gov/32231582/
Castillo-Guerra, B., Guiance-Gómez, L., Méndez-Pérez, C., y Pérez-Aguilera, A. F. (2022). Impacto de los turnos de trabajo en la calidad del sueño del personal de enfermería en dos hospitales de tercer nivel de Canarias. Medicina y Seguridad del Trabajo, 68(267), 105-117. Enlace
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Deng, N., Kohn, T. P., Lipshultz, L. I., y Pastuszak, A. W. (2018). The Relationship Between Shift Work and Men's Health. Sexual Medicine Reviews, 6(3), 446-456. https://doi.org/10.1016/j.sxmr.2017.11.009
Gallegos, C., García, A., Ramírez, C., Borrani, J., Azevedo, C. V. M., y Valdez, P. (2019). Circadian and homeostatic modulation of the attentional blink. Chronobiology International, 36(3), 343–352. https://pubmed.ncbi.nlm.nih.gov/30488723/
Hattatoğlu, D. G., Aydin, Ş., Aydin, C., y Yildiz, B. P. (2021). El efecto de la higiene del sueño y el deterioro del sueño en la calidad de vida de los profesionales de la salud que trabajan por turnos. Noro Psikiyatri Arsivi, 58(1), 11–15. http://dx.doi.org/10.29399/npa.24827
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Kuhlman, S. J., Craig, L. M., y Duffy, J. F. (2018). Introduction to Chronobiology. Cold Spring Harbor Perspectives in Biology, 10(9), a033613. https://doi.org/10.1101/cshperspect.a033613
Leembruggen, A. J. L., Stamp, L. A., Bornstein, J. C., y Hao, M. M. (2022). Circadian Control of Gastrointestinal Motility. Advances in Experimental Medicine and Biology, 1383, 191–203. https://doi.org/10.1007/978-3-031-05843-1_18
Ljevak, I., et al. (2022). The Impact Of Shift Work On The Metabolism And Circadian Rhythm In Nurses And Medical Technicians. Acta Clinica Croatica, 60(3), 476-482. doi: 10.20471/Acc.2021.60.03.19
Malicki, M., Karuga, F. F., Szmyd, B., Sochal, M., y Gabryelska, A. (2022). Obstructive Sleep Apnea, Circadian Clock Disruption, and Metabolic Consequences. Metabolites, 13(1), 60. https://doi.org/10.3390/metabo13010060
Meza-Miranda, E. R., y Ovelar-Grance, P. S. (2022). Evaluación del estado nutricional, los patrones de alimentación y realización de actividad física de los médicos residentes del Hospital General de Luque del año 2020. Memorias del Instituto de Investigaciones en Ciencias de la Salud, 20(1), 46–52. http://dx.doi.org/10.18004/mem.iics/1812-9528/2022.020.01.46
Mogavero, F., van Zwieten, K., Buitelaar, J. K., Glennon, J. C., y Henckens, M. J. A. G. (2022). Deviant circadian rhythmicity, corticosterone variability and trait testosterone levels in aggressive mice. The European Journal of Neuroscience, 55(6), 1492–1503. https://doi.org/10.1111/ejn.15632
Nena, E., Katsaouni, M., Steiropoulos, P., Theodorou, E., Constantinidis, T. C., y Tripsianis, G. (2018). Effect of Shift Work on Sleep, Health, and Quality of Life of Healthcare Workers. Indian Journal of Occupational and Environmental Medicine, 22(1), 29-34. https://doi.org/10.4103/ijoem.IJOEM_4_18
Pan, X., Mota, S., y Zhang, B. (2020). Circadian Clock Regulation on Lipid Metabolism and Metabolic Diseases. Advances in Experimental Medicine and Biology, 1276, 53–66. https://doi.org/10.1007/978-981-15-6082-8_5
Peña-Rodríguez, I. A., Nieto-Olarte, L. P., Sánchez-Preciado, D. M., y Cortés-Lugo, R. L. (2019). Relación entre estrés percibido y calidad de sueño en enfermeras de turnos nocturnos y rotativos. Revista Colombiana de Enfermería, 18(3), e014. https://repositorio.unbosque.edu.co/handle/20.500.12495/4352
Rangel Ramírez, L. E., y Ramírez, C. I. (2019). Deterioro cognitivo, síntomas de depresión y calidad de sueño en médicos residentes de posgrados clínicos y quirúrgicos. Neurología Argentina, 11(4), 183–191. https://www.elsevier.es/es-revista-neurologia-argentina-301-articulo-deterioro-cognitivo-sintomas-depresion-calidad-S1853002819300631
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Ríos, M. S., Martínez, J. D., y Servín, N. A. (2022). Calidad del sueño y satisfacción laboral en médicos residentes. Medicina Clínica y Social, 6(1), 26-32. http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S2521-22812022000100026&lng=en
Romero, M. B. (2020). Hábitos alimenticios en el personal de salud y rendimiento laboral. Universidad Nacional de Rosario, Facultad de Ciencias Médicas.
Ruan, W., Yuan, X., y Eltzschig, H. K. (2021). Circadian Rhythm as a Therapeutic Target. Nature Reviews Drug Discovery, 20(4), 287–307. https://doi.org/10.1038/s41573-020-00109-w
Shan, Z., Li, Y., Zong, G., Guo, Y., Li, J., Manson, J. E., ... y Bhupathiraju, S. N. (2018). Rotating night shift work and adherence to unhealthy lifestyle in predicting risk of type 2 diabetes: results from two large US cohorts of female nurses. The BMJ, 363, k4641. https://doi.org/10.1136/bmj.k4641
Song, S., Tien, C. L., Cui, H., Basil, P., Zhu, N., Gong, Y., ... y Sun, Z. (2022). Myocardial Rev-erb-Mediated Diurnal Metabolic Rhythm and Obesity Paradox. Circulation, 145(6), 448–464. https://doi.org/10.1161/CIRCULATIONAHA.121.056076
Stewart, N. H., et al. (2019). The Impact of Sleep and Circadian Disorders on Physician Burnout. Chest. https://doi.org/10.1016/j.chest.2019.07.008
Sulli, G., Lam, M. T. Y., y Panda, S. (2019). Interplay between Circadian Clock and Cancer: New Frontiers for Cancer Treatment. Trends in Cancer, 5(8), 475–494. https://doi.org/10.1016/j.trecan.2019.07.002
Vasey, C., McBride, J., y Penta, K. (2021). Circadian rhythm dysregulation and restoration: The role of melatonin. Nutrients, 13(10), 3480. https://pubmed.ncbi.nlm.nih.gov/34684482/
Wong, A. T. Y., Fensom, G. K., Key, T. J., Onland-Moret, N. C., Tong, T. Y. N., y Travis, R. C. (2021). Urinary Melatonin in Relation to Breast Cancer Risk: Nested Case-Control Analysis in the DOM Study and Meta-analysis of Prospective Studies. Cancer Epidemiology, Biomarkers & Prevention, 30(1), 97–103. https://doi.org/10.1158/1055-9965.EPI-20-0822
Zee, P. C., y Abbott, S. M. (2020). Circadian Rhythm Sleep-Wake Disorders. Continuum (Minneapolis, Minn.), 26(4), 988–1002. https://doi.org/10.1212/CON.0000000000000884
Zhang, Y., Cordina-Duverger, E., Komarzynski, S., Attari, A., Huang, Q., Aristizabal, G., ... y Risch, H. A. (2022). Salud digital circadiana y del sueño en trabajadores de turnos hospitalarios individuales: un estudio transversal de telemonitorización. SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.4120418
Asgari, E., Shiraseb, F., Mirzababaei, A., Tangestani, H., y Mirzaei, K. (2023). Positive interaction between CG, CC genotypes of cryptochrome circadian clocks 1, and energy-adjusted dietary inflammatory index on high sensitivity C-reactive protein level in women with central obesity. Clinical Nutr Res, 12(1), 7–20. Enlace
Booker, L. A., Magee, M., Rajaratnam, S. M. W., Sletten, T. L., y Howard, M. E. (2018). Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review. Sleep Medicine Reviews, 41, 220-233. https://doi.org/10.1016/j.smrv.2018.03.005
Books, C., Coody, L. C., Kauffman, R., y Abraham, S. (2017). Night Shift Work and Its Health Effects on Nurses. Health Care Management (Frederick), 36(4), 347-353. https://doi.org/10.1097/HCM.0000000000000177
Bowles, N. P., Thosar, S. S., Herzig, M. X., & Shea, S. A. (2018). Chronotherapy for Hypertension. Current Hypertension Reports, 20(11), 97. https://doi.org/10.1007/s11906-018-0897-4
Carmona, P., Mendez, N., Ili, C. G., y Brebi, P. (2020). The role of clock genes in fibrinolysis regulation: Circadian disturbance and its effect on fibrinolytic activity. Frontiers in Physiology, 11, 129. https://pubmed.ncbi.nlm.nih.gov/32231582/
Castillo-Guerra, B., Guiance-Gómez, L., Méndez-Pérez, C., y Pérez-Aguilera, A. F. (2022). Impacto de los turnos de trabajo en la calidad del sueño del personal de enfermería en dos hospitales de tercer nivel de Canarias. Medicina y Seguridad del Trabajo, 68(267), 105-117. Enlace
Chellappa, S. L., Vujovic, N., Williams, J. S., y Scheer, F. A. J. L. (2019). Impact of Circadian Disruption on Cardiovascular Function and Disease. Trends in Endocrinology & Metabolism, 30(10), 767–779. https://doi.org/10.1016/j.tem.2019.07.008
Deng, N., Kohn, T. P., Lipshultz, L. I., y Pastuszak, A. W. (2018). The Relationship Between Shift Work and Men's Health. Sexual Medicine Reviews, 6(3), 446-456. https://doi.org/10.1016/j.sxmr.2017.11.009
Gallegos, C., García, A., Ramírez, C., Borrani, J., Azevedo, C. V. M., y Valdez, P. (2019). Circadian and homeostatic modulation of the attentional blink. Chronobiology International, 36(3), 343–352. https://pubmed.ncbi.nlm.nih.gov/30488723/
Hattatoğlu, D. G., Aydin, Ş., Aydin, C., y Yildiz, B. P. (2021). El efecto de la higiene del sueño y el deterioro del sueño en la calidad de vida de los profesionales de la salud que trabajan por turnos. Noro Psikiyatri Arsivi, 58(1), 11–15. http://dx.doi.org/10.29399/npa.24827
Hulsegge, G., Loef, B., van Kerkhof, L. W., Roenneberg, T., van der Beek, A. J., y Proper, K. I. (2018). Shift work, sleep disturbances and social jet lag in healthcare workers. Journal of Sleep Research. https://doi.org/10.1111/jsr.12802
Karhula, K., Koskinen, A., Ervasti, J., Hakola, T., Isoviita, V. M., Kivimäki, I., ... y Lallukka, T. (2022). Características de las horas de trabajo de los médicos de hospitales y calidad del sueño: un análisis transversal de las horas de trabajo realizadas y los datos de encuestas. BMC Health Services Research, 22(1), 943. http://dx.doi.org/10.1186/s12913-022-08336-0
Kervezee, L., Kosmadopoulos, A., y Boivin, D. B. (2018). Metabolic and cardiovascular consequences of shift work: The role of circadian disruption and sleep disturbances. European Journal of Neuroscience, October. https://doi.org/10.1111/ejn.14216
Kuhlman, S. J., Craig, L. M., y Duffy, J. F. (2018). Introduction to Chronobiology. Cold Spring Harbor Perspectives in Biology, 10(9), a033613. https://doi.org/10.1101/cshperspect.a033613
Leembruggen, A. J. L., Stamp, L. A., Bornstein, J. C., y Hao, M. M. (2022). Circadian Control of Gastrointestinal Motility. Advances in Experimental Medicine and Biology, 1383, 191–203. https://doi.org/10.1007/978-3-031-05843-1_18
Ljevak, I., et al. (2022). The Impact Of Shift Work On The Metabolism And Circadian Rhythm In Nurses And Medical Technicians. Acta Clinica Croatica, 60(3), 476-482. doi: 10.20471/Acc.2021.60.03.19
Malicki, M., Karuga, F. F., Szmyd, B., Sochal, M., y Gabryelska, A. (2022). Obstructive Sleep Apnea, Circadian Clock Disruption, and Metabolic Consequences. Metabolites, 13(1), 60. https://doi.org/10.3390/metabo13010060
Meza-Miranda, E. R., y Ovelar-Grance, P. S. (2022). Evaluación del estado nutricional, los patrones de alimentación y realización de actividad física de los médicos residentes del Hospital General de Luque del año 2020. Memorias del Instituto de Investigaciones en Ciencias de la Salud, 20(1), 46–52. http://dx.doi.org/10.18004/mem.iics/1812-9528/2022.020.01.46
Mogavero, F., van Zwieten, K., Buitelaar, J. K., Glennon, J. C., y Henckens, M. J. A. G. (2022). Deviant circadian rhythmicity, corticosterone variability and trait testosterone levels in aggressive mice. The European Journal of Neuroscience, 55(6), 1492–1503. https://doi.org/10.1111/ejn.15632
Nena, E., Katsaouni, M., Steiropoulos, P., Theodorou, E., Constantinidis, T. C., y Tripsianis, G. (2018). Effect of Shift Work on Sleep, Health, and Quality of Life of Healthcare Workers. Indian Journal of Occupational and Environmental Medicine, 22(1), 29-34. https://doi.org/10.4103/ijoem.IJOEM_4_18
Pan, X., Mota, S., y Zhang, B. (2020). Circadian Clock Regulation on Lipid Metabolism and Metabolic Diseases. Advances in Experimental Medicine and Biology, 1276, 53–66. https://doi.org/10.1007/978-981-15-6082-8_5
Peña-Rodríguez, I. A., Nieto-Olarte, L. P., Sánchez-Preciado, D. M., y Cortés-Lugo, R. L. (2019). Relación entre estrés percibido y calidad de sueño en enfermeras de turnos nocturnos y rotativos. Revista Colombiana de Enfermería, 18(3), e014. https://repositorio.unbosque.edu.co/handle/20.500.12495/4352
Rangel Ramírez, L. E., y Ramírez, C. I. (2019). Deterioro cognitivo, síntomas de depresión y calidad de sueño en médicos residentes de posgrados clínicos y quirúrgicos. Neurología Argentina, 11(4), 183–191. https://www.elsevier.es/es-revista-neurologia-argentina-301-articulo-deterioro-cognitivo-sintomas-depresion-calidad-S1853002819300631
Reyes Narvaez, S., y Canto, M. O. (2020). Conocimientos sobre alimentación saludable en estudiantes de una universidad pública. Revista Chilena de Nutrición, 47(1), 67-72. https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75182020000100067&lng=es
Ríos, M. S., Martínez, J. D., y Servín, N. A. (2022). Calidad del sueño y satisfacción laboral en médicos residentes. Medicina Clínica y Social, 6(1), 26-32. http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S2521-22812022000100026&lng=en
Romero, M. B. (2020). Hábitos alimenticios en el personal de salud y rendimiento laboral. Universidad Nacional de Rosario, Facultad de Ciencias Médicas.
Ruan, W., Yuan, X., y Eltzschig, H. K. (2021). Circadian Rhythm as a Therapeutic Target. Nature Reviews Drug Discovery, 20(4), 287–307. https://doi.org/10.1038/s41573-020-00109-w
Shan, Z., Li, Y., Zong, G., Guo, Y., Li, J., Manson, J. E., ... y Bhupathiraju, S. N. (2018). Rotating night shift work and adherence to unhealthy lifestyle in predicting risk of type 2 diabetes: results from two large US cohorts of female nurses. The BMJ, 363, k4641. https://doi.org/10.1136/bmj.k4641
Song, S., Tien, C. L., Cui, H., Basil, P., Zhu, N., Gong, Y., ... y Sun, Z. (2022). Myocardial Rev-erb-Mediated Diurnal Metabolic Rhythm and Obesity Paradox. Circulation, 145(6), 448–464. https://doi.org/10.1161/CIRCULATIONAHA.121.056076
Stewart, N. H., et al. (2019). The Impact of Sleep and Circadian Disorders on Physician Burnout. Chest. https://doi.org/10.1016/j.chest.2019.07.008
Sulli, G., Lam, M. T. Y., y Panda, S. (2019). Interplay between Circadian Clock and Cancer: New Frontiers for Cancer Treatment. Trends in Cancer, 5(8), 475–494. https://doi.org/10.1016/j.trecan.2019.07.002
Vasey, C., McBride, J., y Penta, K. (2021). Circadian rhythm dysregulation and restoration: The role of melatonin. Nutrients, 13(10), 3480. https://pubmed.ncbi.nlm.nih.gov/34684482/
Wong, A. T. Y., Fensom, G. K., Key, T. J., Onland-Moret, N. C., Tong, T. Y. N., y Travis, R. C. (2021). Urinary Melatonin in Relation to Breast Cancer Risk: Nested Case-Control Analysis in the DOM Study and Meta-analysis of Prospective Studies. Cancer Epidemiology, Biomarkers & Prevention, 30(1), 97–103. https://doi.org/10.1158/1055-9965.EPI-20-0822
Zee, P. C., y Abbott, S. M. (2020). Circadian Rhythm Sleep-Wake Disorders. Continuum (Minneapolis, Minn.), 26(4), 988–1002. https://doi.org/10.1212/CON.0000000000000884
Zhang, Y., Cordina-Duverger, E., Komarzynski, S., Attari, A., Huang, Q., Aristizabal, G., ... y Risch, H. A. (2022). Salud digital circadiana y del sueño en trabajadores de turnos hospitalarios individuales: un estudio transversal de telemonitorización. SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.4120418