Long-Term 32-Hours Continuous Shifts Increases Progesterone, IL-1β, TNF-α, IL-6, Eosinophil Count and Attention Performance in Female Pediatric Resident

Yıl 2021, Cilt: 3 Sayı: 3, 245 - 253, 01.09.2021

Pınar Çakan , Sedat Yıldız

https://doi.org/10.37990/medr.975759

Öz

Aim: The study aimed at assessing effects of long-term 32-hours continuous shifts on leptin, melatonin, sex hormones, IL-1β, TNF-α, IL-6, hematological parameters, sleep quality and attention performance in female pediatric residents (FPR).
Materials and Methods: FPR working under 32 hours continuous shifts (08:00-08:00h after 08:00-17:00h, n=10) were compared to female health professionals working in day-time hours (08:00-16:00h, n=10). Vital parameters, glucose, leptin, melatonin, estrogen, progesterone, IL-1β, TNF-α, and IL-6 concentrations, complete blood count (CBC) and erythrocyte sedimentation rate (ESR) were measured. The participants were also requested to fill in sleep quality questionnaires and visual attention test.
Results: In the study; eosinophil ratio (p=0.015), hemoglobin (p=0.010), hematocrit (p=0.012), progesterone (p=0.008), TNF-α, (p=0.000), IL-1beta and (p= 0.003) IL-6 levels (p= 0.000) were found significantly higher in FPR. In addition, it was found that FPR had difficulty in waking up in the mornings (p = 0.000), had bad dreams (p = 0.040), and had poor sleep quality (p = 0.010). FPR had better attention performance (p=0.000).
Conclusion: Although attention performance was higher in FPR, data suggest that long-term continuous 32-hour shift system activates inflammatory response, disturbs ovarian steroid production and reduces sleep quality. Alltogether, these may culminate in inflammatory diseases or reproductive problems.  

Anahtar Kelimeler

Uyku, uzun süreli aralıksız vardiya sistemi, kadın, sitokin, hormon, hematolojik parametreler

Destekleyen Kurum

Inonu University, Scientific Research Projects Unit

Proje Numarası

Project No. 2017/649

Teşekkür

I wold like to thank everyone contributed to this study.

Uzun Süreli 32 Saatlik Aralıksız Vardiyalar, Kadın Pediatri Asistanında Progesteron, Il-1β, Tnf-a, Il-6, Eozinofil Sayısı ve Dikkat Performansını Artırır

Öz

Amaç: Çalışmada, kadın pediatri asistanlarında uzun süreli 32 saatlik aralıksız vardiyaların leptin, melatonin, seks hormonları, IL-1β, TNF-α, IL-6, hematolojik parametreler, uyku kalitesi ve dikkat performansı üzerine etkilerininin değerlendirilmesi amaçlamıştır. FPR).
Materyal ve Metot: 32 saat sürekli vardiyada (08:00-08:00 sonrası 08:00-17:00, n=10) çalışan FPR, gündüz saatlerinde (08:00-16: 00 saat, n=10) çalışan kadın sağlık profesyonelleri ile karşılaştırılmıştır.
Bulgular: Çalışmada; eozinofil oranı (p=0.015), hemoglobin (p=0.010), hematokrit (p=0.012), progesteron (p=0.008), TNF α, (p=0.000), IL-1beta ve (p= 0.003) IL-6 düzeyleri (p= 0.000) FPR’de anlamlı olarak yüksek bulundu. Ayrıca FPR’nin sabahları uyanmakta güçlük çektiği (p=0,000), kötü rüyalar gördüğü (p=0,040) ve uyku kalitesinin kötü olduğu (p=0,010) bulundu. FPR daha iyi dikkat performansı gösterdi (p=0.000).
Sonuç: FPR’de dikkat performansı daha yüksek olmasına rağmen, veriler uzun süreli sürekli 32 saatlik vardiya sisteminin inflamatuar yanıtı aktive ettiğini, over steroid üretimini bozduğunu ve uyku kalitesini azalttığını göstermektedir. Hep birlikte, bunlar iltihaplı hastalıklar veya üreme sorunları ile sonuçlanabilir.

Proje Numarası

Project No. 2017/649

Kaynakça

• 1. Brum MCB, Filho FFD, Schnorr CC, et al. Shift work and its association with metabolic disorders. Diabetol Metab Syndr. 2015;7:45. https://doi.org/10.1186/s13098-015-0041-4.
• 2. Wilson JL. The impact of shift patterns on healthcare professionals. J Nurs Manag. 2002;10:211–9. https://doi.org/10.1046/j.1365-2834.2002.00308.x.
• 3. Harrington JM. Health effects of shift work and extended hours of work. Occup Environ Med. 2001;58:68–72. https://doi.org/10.1136/oem.58.1.68.
• 4. Reinhardt ÉL, Fernandes PACM, Markus RP, et al. Night work effects on salivary cytokines TNF, IL-1β and IL-6. Chronobiol Int. 2019;36:11–26. https://doi.org/10.1080/07420528.2018.1515771.
• 5. Harrington JM. Shift work and health--a critical review of the literature on working hours. Ann Acad Med Singapore. 1994;23:699–705.
• 6. Sallinen M, Kecklund G. Shift work, sleep, and sleepiness - differences between shift schedules and systems. Scand J Work Environ Health. 2010;36:121–33. https://doi.org/10.5271/sjweh.2900.
• 7. Åkerstedt T, Garefelt J, Richter A, et al. Work and Sleep—A Prospective Study of Psychosocial Work Factors, Physical Work Factors, and Work Scheduling. Sleep 2015;38:1129–36. https://doi.org/10.5665/sleep.4828.
• 8. Van Someren EJW, Riemersma-Van Der Lek RF. Live to the rhythm, slave to the rhythm. Sleep Med Rev. 2007;11:465–84. https://doi.org/10.1016/j.smrv.2007.07.003.
• 9. Lo SH, Lin LY, Hwang JS, et al. Working the night shift causes increased vascular stress and delayed recovery in young women. Chronobiol Int. 2010;27:1454–68. https://doi.org/10.3109/07420528.2010.498067.
• 10. Nicol A-M, Botterill JS. On-call work and health: a review. Environ Heal. 2004;3:15. https://doi.org/10.1186/1476-069X-3-15.
• 11. Uehli K, Mehta AJ, Miedinger D, et al. Sleep problems and work injuries: A systematic review and meta-analysis. Sleep Med Rev. 2014;18:61–73. https://doi.org/10.1016/j.smrv.2013.01.004.
• 12. Uthgenannt D, Schoolmann D, Pietrowsky R, et al. Effects of sleep on the production of cytokines in humans. Psychosom Med. 1995;57:97–104. https://doi.org/10.1097/00006842-199503000-00001.
• 13. Krueger JM, Majde JA, Rector DM. Cytokines in immune function and sleep regulation. Handb Clin Neurol. 2011;98:229–40. https://doi.org/10.1016/B978-0-444-52006-7.00015-0.
• 14. McFarlane SI. Shift work and sleep: medical implications and management. Sleep Med Disord Int J. 2017;1:36–42. https://doi.org/10.15406/smdij.2017.01.00008.
• 15. Yeom JH, Sim CS, Lee J, et al. Effect of shift work on hypertension: cross sectional study. Ann Occup Environ Med. 2017;29:11. https://doi.org/10.1186/s40557-017-0166-z.
• 16. Hublin C, Partinen M, Koskenvuo K, et al. Shift-work and cardiovascular disease: A population-based 22-year follow-up study. Eur J Epidemiol. 2010;25:315–23. https://doi.org/10.1007/s10654-010-9439-3.
• 17. Coglianese EE, Qureshi MM, Vasan RS, et al. Usefulness of the blood hematocrit level to predict development of heart failure in a community. Am J Cardiol. 2012;109:241–5. https://doi.org/10.1016/j.amjcard.2011.08.037.
• 18. Sorlie PD, Garcia-Palmieri MR, Costas R, et al. Hematocrit and risk of coronary heart disease: the Puerto Rico Heart Health Program. Am Heart J. 1981;101:456–61. https://doi.org/10.1016/0002-8703(81)90136-8.
• 19. Jacobsen EA, Helmers RA, Lee JJ, et al. The expanding role(s) of eosinophils in health and disease. Blood 2012;120:3882–90. https://doi.org/10.1182/blood-2012-06-330845.
• 20. Costello RW, Jacoby DB, Gleich GJ, et al. Eosinophils and airway nerves in asthma. Histol Histopathol. 2000;15:861–8. https://doi.org/10.14670/HH-15.861.
• 21. Almeida CMO De, Malheiro A. Sleep, immunity and shift workers: A review. Sleep Sci 2016;9:164–8. https://doi.org/10.1016/j.slsci.2016.10.007.
• 22. Sack RL, Blood ML, Lewy AJ. Melatonin rhythms in night shift workers. Sleep 1992;15:434–41. https://doi.org/10.1093/sleep/15.5.434.
• 23. Kim M-J, Son K-H, Park H-Y, et al. Association between shift work and obesity among female nurses: Korean Nurses’ Survey. BMC Public Health 2013;13:1204. https://doi.org/10.1186/1471-2458-13-1204.
• 24. Kennaway DJ, Boden MJ, Varcoe TJ. Circadian rhythms and fertility. Mol Cell Endocrinol. 2012;349:56–61. https://doi.org/10.1016/j.mce.2011.08.013.
• 25. Chung FF, Yao CCC, Wan GH. The associations between menstrual function and life style/working conditions among nurses in Taiwan. J Occup Health. 2005;47:149–56. https://doi.org/10.1539/joh.47.149.
• 26. McDonald AD, McDonald JC, Armstrong B, et al. Fetal death and work in pregnancy. Br J Ind Med. 1988;45:148–57. https://doi.org/10.1136/oem.45.3.148.
• 27. Blake KR, Bastian B, O’Dean SM, et al. High estradiol and low progesterone are associated with high assertiveness in women. Psychoneuroendocrinology 2017;75:91–9. https://doi.org/10.1016/j.psyneuen.2016.10.008.
• 28. Axelsson J, Rehman J, Akerstedt T, et al. Effects of Sustained Sleep Restriction on Mitogen-Stimulated Cytokines, Chemokines and T Helper 1/ T Helper 2 Balance in Humans. PLoS One 2013;8:e82291. https://doi.org/10.1371/journal.pone.0082291.
• 29. Irwin M, Smith TL, Gillin JC. Electroencephalographic sleep and natural killer activity in depressed patients and control subjects. Psychosom Med. 1992;54:10–21. https://doi.org/10.1097/00006842-199201000-00002.
• 30. Meier-Ewert HK, Ridker PM, Rifai N, et al. Effect of sleep loss on C-Reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004;43:678–83. https://doi.org/10.1016/j.jacc.2003.07.050.
• 31. Copertaro A, Bracci M, Gesuita R, et al. Influence of shift-work on selected immune variables in nurses. Ind Health. 2011;49:597–604. https://doi.org/10.2486/indhealth.MS1210.
• 32. Garg SK, Maurer H, Reed K, et al. Diabetes and cancer: Two diseases with obesity as a common risk factor. Diabetes, Obes Metab. 2014;16:97–110. https://doi.org/10.1111/dom.12124.
• 33. Blaes A, Prizment A, Koene RJ, et al. Cardio-oncology Related to Heart Failure: Common Risk Factors Between Cancer and Cardiovascular Disease. Heart Fail Clin. 2017;13:367–80. https://doi.org/10.1016/j.hfc.2016.12.006.
• 34. Bonnet MH, Arand DL. 24-Hour metabolic rate in insomniacs and matched normal sleepers. Sleep 1995;18:581–8. https://doi.org/10.1093/sleep/18.7.581.
• 35. Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med. 2007;3:519–28. https://doi.org/10.5664/jcsm.26918.
• 36. Dantzer R. Cytokine-induced sickness behaviour: A neuroimmune response to activation of innate immunity. Eur J Pharmacol. 2004;500:399–411. https://doi.org/10.1016/j.ejphar.2004.07.040.
• 37. Yang CM, Lo HS. ERP evidence of enhanced excitatory and reduced inhibitory processes of auditory stimuli during sleep in patients with primary insomnia. Sleep 2007;30:585–92. https://doi.org/10.1093/sleep/30.5.585.
• 38. Burch JB, Yost MG, Johnson W, et al. Melatonin, sleep, and shift work adaptation. J Occup Environ Med. 2005;47:893–901. https://doi.org/10.1097/01.jom.0000177336.21147.9f.
• 39. Black PH. Stress and the inflammatory response: A review of neurogenic inflammation. Brain Behav Immun. 2002;16:622–53. https://doi.org/10.1016/S0889-1591(02)00021-1.
• 40. Corcoran MP, Meydani M, Lichtenstein AH, et al. Sex hormone modulation of proinflammatory cytokine and C-reactive protein expression in macrophages from older men and postmenopausal women. J Endocrinol. 2010;206:217–24. https://doi.org/10.1677/JOE-10-0057.