{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:27:57Z","timestamp":1793046477972,"version":"4.5.0"},"reference-count":38,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Accumulated evidence implies that night shift work may trigger liver dysfunction. Non-alcoholic fatty liver (NAFL) is suggested to be a necessary mediator in this process. This study aimed to examine the relationship between night shift work and elevated level of alanine transaminase (e-ALT) of workers and investigate the potential mediation effect of NAFL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included all male workers from the baseline survey of a cohort of night shift workers. Information on demographics, lifestyle and lifetime working schedule was collected by face-to-face interview. Liver sonography was used to identify NAFL cases. Serum ALT level was detected by an automatic biochemical analyser. e-ALT was defined as ALT &gt;40\u2009U\/L. Logistic regression models were used to evaluate ORs, and mediation analysis was employed to examine the mediation effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 4740 male workers, 39.5% were night shift workers. Night shift workers had an increased risk of e-ALT (OR, 1.19, 95%\u2009CI 1.00 to 1.42). With the increase in night shift years, the OR of e-ALT increased from 1.03 (95% CI 0.77 to 1.36) to 1.60 (95% CI 1.08 to 2.39) among workers without NAFL. A similar trend was not found among workers with NAFL. In addition, no significant mediation effect of NAFL in the association between night shift work and e-ALT was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Night shift work is positively associated with abnormal liver function, in particular among workers without NAFL. Shift work involving circadian disruption is likely to exert a direct effect on liver dysfunction rather than rely on the mediation effect of NAFL.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2018-105273","type":"journal-article","created":{"date-parts":[[2019,2,16]],"date-time":"2019-02-16T15:45:27Z","timestamp":1550331927000},"page":"83-89","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Night shift work and abnormal liver function: is non-alcohol fatty liver a necessary mediator?"],"prefix":"10.1136","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2618-201X","authenticated-orcid":false,"given":"Feng","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuzhuo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suyang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5080-8727","authenticated-orcid":false,"given":"Miaomiao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenting","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Yeung-shan Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg J","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Kwok","family":"Wing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9096-692X","authenticated-orcid":false,"given":"Jelle J","family":"Vlaanderen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4082-8163","authenticated-orcid":false,"given":"Roel C H","family":"Vermeulen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Ying-yang","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lap Ah","family":"Tse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,12,4]]},"reference":[{"key":"2020050723124315000_76.2.83.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2014.05.004"},{"key":"2020050723124315000_76.2.83.2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys075"},{"key":"2020050723124315000_76.2.83.3","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12036"},{"key":"2020050723124315000_76.2.83.4","doi-asserted-by":"crossref","unstructured":"Chalasani N , Younossi Z , Lavine JE , et al . The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology 2018;67.doi:10.1002\/hep.29367","DOI":"10.1002\/hep.29367"},{"key":"2020050723124315000_76.2.83.5","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27406"},{"key":"2020050723124315000_76.2.83.6","unstructured":"Bureau of Labor Statistics. Workers on flexible and shift schedules in 2004 summary. Washington, DC, US A: Bureau of Labor Statistics, 2005."},{"key":"2020050723124315000_76.2.83.7","doi-asserted-by":"crossref","first-page":"210","DOI":"10.3390\/ijerph14020210","article-title":"Association of sleep duration, sleep quality and shift-work schedule in relation to hypertension prevalence in Chinese adult males: a cross-sectional survey","volume":"14","author":"Lu","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"2020050723124315000_76.2.83.8","doi-asserted-by":"publisher","DOI":"10.3109\/07420528.2013.872120"},{"key":"2020050723124315000_76.2.83.9","doi-asserted-by":"publisher","DOI":"10.1177\/1010539512469248"},{"key":"2020050723124315000_76.2.83.10","doi-asserted-by":"publisher","DOI":"10.2486\/indhealth.36.218"},{"key":"2020050723124315000_76.2.83.11","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1007\/s10620-016-4401-1","article-title":"Shiftwork Is Not Associated with Increased Risk of NAFLD: Findings from the National Health and Nutrition Examination Survey","volume":"62","author":"Balakrishnan","year":"2017","journal-title":"Dig Dis Sci"},{"key":"2020050723124315000_76.2.83.12","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.5654"},{"key":"2020050723124315000_76.2.83.13","first-page":"110","article-title":"Sleep Quality","volume":"3","author":"Sb","year":"2013","journal-title":"and Obesity"},{"key":"2020050723124315000_76.2.83.14","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12194"},{"key":"2020050723124315000_76.2.83.15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001141"},{"key":"2020050723124315000_76.2.83.16","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13299"},{"key":"2020050723124315000_76.2.83.17","doi-asserted-by":"crossref","first-page":"190","DOI":"10.3109\/07420529309073887","article-title":"Circadian rhythms of serum concentrations of 12 enzymes of clinical interest","volume":"10","author":"Rivera-Coll","year":"1993","journal-title":"Chronobiol Int"},{"key":"2020050723124315000_76.2.83.18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.4454"},{"key":"2020050723124315000_76.2.83.19","doi-asserted-by":"crossref","unstructured":"Sun M , Feng W , Wang F , et al . Night shift work exposure profile and obesity: baseline results from a Chinese night shift worker cohort. PLoS One 2018;13:e0196989.doi:10.1371\/journal.pone.0196989","DOI":"10.1371\/journal.pone.0196989"},{"key":"2020050723124315000_76.2.83.20","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.diabres.2008.05.006","article-title":"Relationship between insulin resistance and serum alanine aminotransferase as a surrogate of NAFLD (nonalcoholic fatty liver disease) in obese Korean children","volume":"81","author":"Yoo","year":"2008","journal-title":"Diabetes Res Clin Pract"},{"key":"2020050723124315000_76.2.83.21","doi-asserted-by":"crossref","first-page":"9","DOI":"10.7863\/jum.1984.3.1.9","article-title":"Fatty infiltration of the liver: ultrasonographic and computed tomographic correlation","volume":"3","author":"Scatarige","year":"1984","journal-title":"J Ultrasound Med"},{"key":"2020050723124315000_76.2.83.22","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i28.9330"},{"key":"2020050723124315000_76.2.83.23","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v059.i09"},{"key":"2020050723124315000_76.2.83.24","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.11.043"},{"key":"2020050723124315000_76.2.83.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2006.04.026"},{"key":"2020050723124315000_76.2.83.26","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1210\/er.2016-1083","article-title":"Circadian rhythm and sleep disruption: causes, metabolic consequences, and countermeasures","volume":"37","author":"Potter","year":"2016","journal-title":"Endocr Rev"},{"key":"2020050723124315000_76.2.83.27","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2014.892296"},{"key":"2020050723124315000_76.2.83.28","doi-asserted-by":"publisher","DOI":"10.1177\/0748730416657921"},{"key":"2020050723124315000_76.2.83.29","doi-asserted-by":"publisher","DOI":"10.3109\/07420528.2013.837478"},{"key":"2020050723124315000_76.2.83.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2014.07.021"},{"key":"2020050723124315000_76.2.83.31","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.5665\/sleep.4244","article-title":"Cell injury and repair resulting from sleep loss and sleep recovery in laboratory rats","volume":"37","author":"Everson","year":"2014","journal-title":"Sleep"},{"key":"2020050723124315000_76.2.83.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(98)70599-2"},{"key":"2020050723124315000_76.2.83.33","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-013-0981-4"},{"key":"2020050723124315000_76.2.83.34","doi-asserted-by":"crossref","unstructured":"Toyama Y , Tanizawa K , Kubo T , et al . Impact of Obstructive Sleep Apnea on Liver Fat Accumulation According to Sex and Visceral Obesity. PLoS One 2015;10:e0129513.doi:10.1371\/journal.pone.0129513","DOI":"10.1371\/journal.pone.0129513"},{"key":"2020050723124315000_76.2.83.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.03.035"},{"key":"2020050723124315000_76.2.83.36","doi-asserted-by":"publisher","DOI":"10.1038\/498427a"},{"key":"2020050723124315000_76.2.83.37","doi-asserted-by":"crossref","first-page":"19","DOI":"10.25122\/jml-2017-0019","article-title":"Non-invasive imaging techniques in assessing non-alcoholic fatty liver disease: a current status of available methods","volume":"10","author":"L\u0103p\u0103dat","year":"2017","journal-title":"J Med Life"},{"key":"2020050723124315000_76.2.83.38","first-page":"1085","article-title":"Epidemiological survey of prevalence of fatty liver in a general adult population in urban area of Guangdong Province","volume":"29","author":"Zhou","year":"2008","journal-title":"Guangdong Medical Journal"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2018-105273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T07:41:50Z","timestamp":1601106110000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2018-105273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,4]]},"references-count":38,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,1,15]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/oemed-2018-105273"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2018-105273","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,4]]}}}