{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:00:05Z","timestamp":1780470005619,"version":"3.54.1"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"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>The relationship between shift work, occupational physical activity (OPA), and CKM syndrome remains unclear. The present study aimed to investigate the independent and joint associations of these two factors with CKM syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study conducted a baseline survey in 2013 and a follow-up in 2023, with a total of 690 workers finally enrolled. CKM syndrome was diagnosed according to the American Heart Association (AHA) criteria. Participants were classified into fixed day shifts and shift work, and OPA into light\/moderate and heavy\/very heavy groups. Poisson regression was adopted to explore the associations of shift work and OPA with CKM syndrome, as well as their joint effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Compared with fixed day shifts, shift work was associated with CKM syndrome (RR\u202f=\u202f1.568, 95% CI: 1.328\u20131.852); two-shift (RR\u202f=\u202f1.677, 95% CI: 1.391\u20132.022), three-shift (RR\u202f=\u202f1.502, 95% CI: 1.223\u20131.844), four-shift (RR\u202f=\u202f1.529, 95% CI: 1.235\u20131.892). The risk of CKM syndrome showed a dose\u2013response relationship with cumulative night shift exposure. Workers with heavy or very heavy OPA had a higher risk of CKM syndrome (RR\u202f=\u202f1.432, 95% CI: 1.239\u20131.654) than those with light or moderate OPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both shift work and heavy or very heavy OPA increase the risk of CKM syndrome. The risk rises with increasing cumulative night shift exposure. Workers with both shift work and heavy or very heavy OPA have the highest risk. Therefore, early screening for CKM syndrome should be strengthened among shift workers and those with heavy OPA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1831468","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:00:23Z","timestamp":1780466423000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between shift work, occupational physical activity and cardiovascular-kidney-metabolic syndrome: a cohort study in China"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiangran","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Medical 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