{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:59:50Z","timestamp":1780898390232,"version":"3.54.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Taxi drivers face occupational exposures that are associated with cardiovascular disease (CVD) risk, including prolonged sedentary behavior, irregular meal patterns, and psychosocial stress. However, comprehensive assessments of metabolic health in this population, particularly with standardized comparisons to the general population, are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study analyzed data from 5,999 Beijing taxi drivers undergoing annual health examinations (2022\u20132023). Metabolic risk factors were assessed and metabolic syndrome (MetS) was defined using the 2009 harmonized criteria. Carotid ultrasound was performed in 4,582 participants (76.37%) to detect subclinical atherosclerosis. Age-standardized prevalence ratios (SPRs) were calculated by comparing taxi drivers with the Beijing general population. A parallel occupational health survey (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f5,922) from the same population characterized work conditions and lifestyle factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the Beijing general population, male taxi drivers exhibited significantly elevated metabolic risk: hypertension (SPR\u202f=\u202f2.25, 95% CI: 2.16\u20132.33), obesity (SPR\u202f=\u202f2.19, 95% CI: 2.10\u20132.28), carotid plaque (SPR\u202f=\u202f2.00, 95% CI: 1.91\u20132.10), and fatty liver disease (SPR\u202f=\u202f1.76, 95% CI: 1.71\u20131.82; all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Occupational survey data showed substantial adverse work exposures: 62.25% had worked \u226520\u202fyears as taxi drivers, 36.31% reported insufficient rest (&amp;lt;4\u202fdays\/month), 58.17% reported difficulty accessing restrooms, and 53.31% reported meal-related difficulties during work. Among those with carotid ultrasound data, 40.77% had carotid plaque. MetS (\u22653 of 5 components) was independently associated with carotid plaque (adjusted OR\u202f=\u202f1.28, 95% CI: 1.11\u20131.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The association remained robust in inverse probability weighting (OR\u202f=\u202f1.27, 95% CI: 1.10\u20131.47), modified Poisson regression (PR\u202f=\u202f1.12, 95% CI: 1.05\u20131.19), and analyses using alternative central obesity definitions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Chinese taxi drivers bear a substantially elevated burden of metabolic disorders compared with the general population. The high prevalence of adverse occupational exposures provides important context for understanding these findings. Targeted occupational health interventions addressing lifestyle and work conditions in this population may be warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1812128","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:34:10Z","timestamp":1780896850000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic syndrome and carotid plaque in Chinese taxi drivers: a cross-sectional study of 5,999 participants"],"prefix":"10.3389","volume":"14","author":[{"given":"Xinxiang","family":"Guo","sequence":"first","affiliation":[{"name":"Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Rheumatism and Immunology, Peking University Shenzhen Hospital","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Cui","sequence":"additional","affiliation":[{"name":"Senior Department of Hepatology, The Fifth Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Yu","sequence":"additional","affiliation":[{"name":"Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Shan","sequence":"additional","affiliation":[{"name":"Gastrointestinal Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e2138920","DOI":"10.1001\/jamanetworkopen.2021.38920","article-title":"Psychosocial risk factors and cardiovascular disease and death in a population-based cohort from 21 low-, middle-, and high-income countries","volume":"4","author":"Santosa","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"daae087","DOI":"10.1093\/heapro\/daae087","article-title":"Epidemiology of non-communicable diseases among professional drivers in low- and middle-income countries: a mixed-methods systematic review","volume":"39","author":"Njiro","year":"2024","journal-title":"Health Promot Int"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"81","DOI":"10.4103\/jpgm.JPGM_297_19","article-title":"Prevalence of hypertension among professional drivers: evidence from 2000 to 2017\u2014a systematic review and meta-analysis","volume":"66","author":"Krishnamoorthy","year":"2020","journal-title":"J Postgrad Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1080\/00015385.2022.2045753","article-title":"Prevalence of hypertension and its associated factors among professional drivers: a population-based study","volume":"78","author":"Ebrahimi","year":"2023","journal-title":"Acta Cardiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"121503","DOI":"10.1016\/j.envres.2025.121503","article-title":"Night shift work and indicators of cardiovascular risk: a systematic review and meta-analysis","volume":"276","author":"Erdem","year":"2025","journal-title":"Environ Res"},{"key":"ref7","first-page":"200","article-title":"Prevalence of cardiovascular risk factors among taxi drivers in Yazd, Iran, 2016","volume":"6","author":"Rezaei Hachesu","year":"2017","journal-title":"J Community Health Res"},{"key":"ref8","first-page":"85","article-title":"Metabolic syndrome and 10-year cardiovascular diseases risk among male taxi drivers in 2016: a cross-sectional study in Yazd, Iran","volume":"7","author":"Rezaei Hachesu","year":"2018","journal-title":"J Community Health Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e70037","DOI":"10.1002\/hsr2.70037","article-title":"A closer look at depression and sleep quality relation: a cross-sectional study of taxi drivers in Tabriz metropolis","volume":"7","author":"Abedi","year":"2024","journal-title":"Health Sci Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"6588","DOI":"10.19082\/6588","article-title":"Risky behaviors of taxi drivers in Bandar Abbas, Iran","volume":"10","author":"Razmara","year":"2018","journal-title":"Electron Physician"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1016\/j.echo.2020.04.021","article-title":"Recommendations for the assessment of carotid arterial plaque by ultrasound for the characterization of atherosclerosis and evaluation of cardiovascular risk: from the American Society of Echocardiography","volume":"33","author":"Johri","year":"2020","journal-title":"J Am Soc Echocardiogr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.atherosclerosis.2011.06.044","article-title":"Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis","volume":"220","author":"Inaba","year":"2012","journal-title":"Atherosclerosis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"927","DOI":"10.3233\/WOR-213525","article-title":"Cardiovascular health status of taxi\/for-hire vehicle drivers in the United States: a systematic review","volume":"69","author":"Mirpuri","year":"2021","journal-title":"Work"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2944","DOI":"10.1186\/s12889-024-20465-1","article-title":"Working conditions of commercial drivers: a scoping review of psychosocial work factors, health outcomes, and interventions","volume":"24","author":"Amoadu","year":"2024","journal-title":"BMC Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1007\/s11524-016-0045-x","article-title":"Cardiovascular risk factors of taxi drivers","volume":"93","author":"Elshatarat","year":"2016","journal-title":"J Urban Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1002\/hep.24452","article-title":"Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis","volume":"54","author":"Hernaez","year":"2011","journal-title":"Hepatology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1159\/000343145","article-title":"Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011)","volume":"34","author":"Touboul","year":"2012","journal-title":"Cerebrovasc Dis"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3912","DOI":"10.1093\/eurheartj\/ehae178","article-title":"2024 ESC guidelines for the management of elevated blood pressure and hypertension","volume":"45","author":"McEvoy","year":"2024","journal-title":"Eur Heart J"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.2337\/dc25-S002","article-title":"2. Diagnosis and classification of diabetes: standards of care in diabetes\u20142025","volume":"48","year":"2025","journal-title":"Diabetes Care"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"221","DOI":"10.3760\/cma.j.cn112148-20230119-00038","article-title":"Chinese guideline for lipid management (2023)","volume":"51","author":"Zhao","year":"2023","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"ref21","first-page":"83","article-title":"Predictive values of body mass index and waist circumference for risk factors of related diseases in Chinese adults","volume":"15","author":"Zhou","year":"2002","journal-title":"Biomed Environ Sci"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; National Heart, Lung, and Blood Institute; American Heart Association; world heart federation; international atherosclerosis society; and International Association for the Study of obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref23","volume-title":"Beijing Health Examination Statistical Report (2022\u20132023) [EB\/OL]","year":"2023"},{"key":"ref24","first-page":"1","article-title":"Statistical methods in cancer research. Volume II: the design and analysis of cohort studies","volume":"82","author":"Breslow","year":"1987","journal-title":"IARC Sci Publ"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified Poisson regression approach to prospective studies with binary data","volume":"159","author":"Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"268","DOI":"10.7326\/M16-2607","article-title":"Sensitivity analysis in observational research: introducing the E-value","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann Intern Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"107812","DOI":"10.1016\/j.ypmed.2023.107812","article-title":"Association of sedentary time with risk of cardiovascular diseases and cardiovascular mortality: a systematic review and meta-analysis of prospective cohort studies","volume":"179","author":"Onagbiye","year":"2024","journal-title":"Prev Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1007\/s00420-023-02014-2","article-title":"Relationship between night shift and sleep problems, risk of metabolic abnormalities of nurses: a 2 years follow-up retrospective analysis in the National Nurse Health Study (NNHS)","volume":"96","author":"Zhang","year":"2023","journal-title":"Int Arch Occup Environ Health"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"30","DOI":"10.3390\/jcdd6030030","article-title":"Skipping breakfast and the risk of cardiovascular disease and death: a systematic review of prospective cohort studies in primary prevention settings","volume":"6","author":"Ofori-Asenso","year":"2019","journal-title":"J Cardiovasc Dev Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"632","DOI":"10.21037\/atm.2019.10.115","article-title":"Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review","volume":"7","author":"Ji","year":"2019","journal-title":"Ann Transl Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"3265","DOI":"10.2147\/JMDH.S470589","article-title":"The association between smoking behavior and the risk of hypertension: review of the observational and genetic evidence","volume":"17","author":"Jareebi","year":"2024","journal-title":"J Multidiscip Healthc"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1161\/CIRCGENETICS.115.001225","article-title":"Effect of smoking on blood pressure and resting heart rate: a Mendelian randomization meta-analysis in the CARTA consortium","volume":"8","author":"Linneberg","year":"2015","journal-title":"Circ Cardiovasc Genet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1161\/ATVBAHA.113.300156","article-title":"Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis","volume":"34","author":"Messner","year":"2014","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"786","DOI":"10.2105\/AJPH.2014.302122","article-title":"Step on it! Impact of a workplace new York City taxi driver health intervention to increase necessary health care access","volume":"105","author":"Gany","year":"2015","journal-title":"Am J Public Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1007\/s11606-025-09559-7","article-title":"Primary care uptake interventions in taxi, app-based, and other for-hire vehicle drivers: the HAILL cluster randomized controlled trial","volume":"41","author":"Gany","year":"2026","journal-title":"J Gen Intern Med"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/s11524-013-9858-z","article-title":"Supporting south Asian taxi drivers to exercise through pedometers (SSTEP) to decrease cardiovascular disease risk","volume":"91","author":"Gany","year":"2014","journal-title":"J Urban Health"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1812128\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:34:12Z","timestamp":1780896852000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1812128\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":36,"alternative-id":["10.3389\/fpubh.2026.1812128"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1812128","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"article-number":"1812128"}}