Association Between Long Working Hours And Chronic Kidney Disease According To Diabetic Status Ⅱ
Jan 24, 2024
RESULTS
General Characteristics of the Study Population The 14,839 total participants were divided into the non-DM group (N ¼ 12,703) and the DM group (N ¼ 2136). The groups were compared according to working hours. In the non-DM group, 5851 participants worked <40 h/week, 3324 participants worked 41 to 52 h/week, and 3528 participants worked >52 h/week. In the DM group, 989 participants worked <40 h/week, 465 participants worked 41 to 52 h/week, and 682 participants worked >52 h/week.
In the non-DM group, an age difference was observed according to working hours. Participants with longer working hours tended to be male-dominant and were less likely to be physically active. In addition, the proportions of current smokers and participants with problem drinking were larger in the longer working hour groups. A higher prevalence of obesity and hypertension was observed in the groups with longer working hours. The prevalence of CKD did not differ among working hour groups (P ¼ 0.2074).
In the DM group, an age difference was observed according to working hours. Participants with longer working hours tended to be male. The proportion of current smokers was higher in the group with longer working hours. No difference was observed in the prevalence of obesity and hypertension among the working-hour groups. In addition, there was no difference in the prevalence of CKD among the working hour groups (P ¼ 0.0977). The detailed general characteristics of the study population are presented in Table 1.
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Association Between Working Hours and CKD According to Diabetic Status
The association between working hours and CKD is shown in Table 2. The association was assessed according to diabetic status, and the interaction between diabetic status and working hours was also analyzed. The overall P for interaction in the crude model was 0.1584. The P for interaction was 0.0683 in the adjusted model 1 (adjusted for age, sex, educational status, household income, physical activity, smoking and drinking status, obesity, hypertension, worker type, and working schedule). In the crude model, P for interaction was 0.0553 and 0.5105 in the 41 to 52, and >52 h/week groups, respectively, compared with the 40 h/week group. In the adjusted model, there was an interaction effect in the 41 to 52 h/ week group (P ¼ 0.0212) but not in >52 h/week group (P ¼ 0.2490).
The crude model presented the relationship between working hours and CKD without any adjustment. Those working for 40 h/ week were set as the reference group. In participants without DM, the OR of having CKD in the 41 to 52 and >52 h/week groups was 0.85 (95% CI 0.62–1.18, P ¼ 0.3312) and 0.75 (95% CI 0.53–1.05, P ¼ 0.0955), respectively. In those with DM, the OR was 1.44 (95% CI 0.94–2.19, P ¼ 0.0908) in the 41 to 52 h/week group and 0.90 (95% CI 0.59–1.36, P ¼ 0.6080) in the >52 h/week group.
The model after adjusting for covariates including age, sex, educational status, household income, physical activity, smoking and drinking status, obesity, hypertension, and working environment (adjusted model 1) was also analyzed. In the non-DM group, compared with participants who worked 40 h/week, those who worked 41 to 52 h/week showed an OR of 0.92 (95% CI 0.66–1.27, P ¼ 0.6021), and those who worked >52 h/week showed an OR of 0.72 (95% CI 0.50–1.03, P ¼ 0.0695). In the DM group, the 41 to 52 h/week group had 1.85 times higher odds of having CKD (adjusted OR 1.85, 95% CI 1.15–2.96, P ¼ 0.0112) than the <40 h/week group. The OR in the >52 h/week group, compared with the 40 h/week group, was 0.97 (95% CI 0.61–1.53, P ¼ 0.8786).
An additional analysis was performed to determine whether there was an association between long working hours and CKD after adjusting for diabetes-related factors. Additional adjustment for the duration of diabetes and control of HbA1c was performed (adjusted model 2). In the adjusted model 2, the OR was 1.92 (95% CI 1.20– 3.08, P ¼ 0.0063) in participants who worked 41 to 52 h/week and 1.01 (95% CI 0.62–1.62, P ¼ 0.9781) in those who worked >52 h/ week.
Association Between Working Hours and CKD in Multiple Working Hour Criteria
The association between working hours and CKD was analyzed according to multiple working hour criteria. The association was analyzed based on three different working hour criteria in participants with diabetes. Each model was analyzed after adjusting for covariates including age, sex, educational status, household income, physical activity, smoking and drinking status, obesity, hypertension, working environments, and diabetes-related factors.
In criterion 1, participants were classified into those who work 40 h/week, 41 to 60 h/week, >60 h/week. Those working for 40 h/week were set as the reference group. The OR of having CKD in the 41 to 60 h/week group and >60 h/week group was 1.61 (95% CI 1.05–2.47, P ¼ 0.0294) and 0.95 (95% CI 0.53–1.68, P ¼ 0.8470), respectively.
In criterion 2, participants were classified into those who work 35 h/week, 36 to 50 h/week, >50 h/week. Those working for 35 h/week were set as the reference group. The OR of having CKD in the 35 to 50 h/week group and >50 h/week group was 2.27 (95% CI 1.40–3.68, P ¼ 0.0009) and 1.35 (95% CI 0.80–2.27, P ¼ 0.2655), respectively.
In criterion 3, participants were classified into seven groups ( 35 h/week, 36–40 h/week, 41–45 h/week, 46–50 h/week, 51– 55 h/week, 56–60 h/week, and > 60 h/week) and those working for 35 h/week were set as the reference group. The OR of having CKD was significantly higher in 36 to 40 h/week group (adjusted OR 1.91, 95% CI 1.03–3.53, P ¼ 0.0399), 41 to 45 h/week group (adjusted OR 2.77, 95% CI 1.43–5.38, P ¼ 0.0026), and 46 to 50 h/ week group (adjusted OR 2.50, 95% CI 1.35–4.61, P ¼ 0.0035). The detailed results are presented in Table 3.
