Kev Koom Tes Ntawm Cov Sijhawm Ua Haujlwm Ntev Thiab Kab Mob Raum Ntev Raws Li Kev Mob Ntshav Qab Zib

Lub Hom Phiaj:Txoj kev tshawb no tsom los tshawb xyuas kev sib raug zoo ntawm cov sijhawm ua haujlwm ntev thiabmob raum mob(CKD) raws limob ntshav qab zib muaj xwm txheej. Txoj kev:Kaum ob txhiab xya puas peb tus neeg ua haujlwm puv sijhawm tsis muaj ntshav qab zib thiab 2136 nrog ntshav qab zib tau suav nrog hauv txoj kev tshawb no. Cov neeg koom nrog tau muab faib ua pawg raws sijhawm ua haujlwm: 40, 41-52, ib>52h/ lis. Ntau lub logistic regression tau siv los ntsuas kev sib koom ua ke ntawm cov sij hawm ua haujlwm thiab CKD ntau.Cov txiaj ntsig:Cov neeg koom nrog ntshav qab zib uas ua haujlwm 41 txog 52 teev / lub lis piam tau pom 1.85 npaug ntau dua ntawm CKD (95% CI 1.15–2.96;P¼ 0.0112) piv nrog cov neeg ua haujlwm 40 h / lub lis piam tom qab kho rau covariates. Kev sib cuam tshuam ntawm ntshav qab zib thiab cov sijhawm ua haujlwm ntev tau pom (P rau kev sib tham¼ 0.0212) hauv tus qauv.Xaus:Lub sijhawm ua haujlwm ntev yog txuam nrogCKD hauv cov neeg koomnrog ntshav qab zib. Kev sib cuam tshuam ntawm cov sij hawm ua hauj lwm ntev thiab mob ntshav qab zib ua rau CKD kev loj hlob tuaj yeem tshwm sim.

Ntsiab lus:mob raum mob, ntshav qab zib mellitus, kab mob tsis sib kis, ua haujlwm dhau sijhawm, sijhawm ua haujlwm

Nyem qhov no kom tau txais Natural organic CISTANCHE EXTRACT nrog 25% ECHINACOSIDE thiab 9% ACTEOSIDE rau lub raum ua haujlwm

Mob ntshav qab zib mellitus(DM) yog ib yam kab mob uas tshwm sim los ntawm pancreatic beta-cell dysfunction thiab tuaj yeem kuaj tau raws li kev yoo mov plasma qabzib (FPG) qib, kev kuaj ntshav qabzib, lossis glycated hemoglobin (HbA1c) qib.1 DM yog ib qho ntawm cov kab mob ntau tshaj plaws, thiab nws txoj kev pheej hmoo tseem nce ntxiv. Hauv xyoo 2017, lub ntiaj teb kev mob ntshav qab zib tau kwv yees li 8.8% hauv cov neeg koom nrog hnub nyoog nruab nrab ntawm 20 thiab 79 xyoo, uas xav tias yuav nce 9.9% los ntawm 2045. Tsis tas li ntawd, tag nrho cov kev siv nyiaj ntawm 727 billion nyiaj tau siv rau kev saib xyuas DM hauv 2017, uas xav tias yuav nce 776 billion nyiaj los ntawm 2045.2 Ntawm ntaumob ntshav qab zib, mob raum mob(CKD) yog ib qho tseem ceeb tshaj plaws. CKD txhais tau tias yog qhov tsis zoo ntawm lub raum cov qauv thiab kev ua haujlwm rau 3 lub hlis, ua rau muaj kab mob hnyav.3 Qhov kev nthuav dav ntawm CKD yog kwv yees li 8% mus rau 16% thoob ntiaj teb thiab tshwj xeeb tshaj yog nyob rau hauv cov teb chaws tsim.4 Hauv Kaus Lim Qab Teb, cov kwv yees li ntawm CKD nyob rau hauv cov neeg laus yog 8.2%. Mob ntshav qab zib nephropathy yog ib qho ntawm feem ntau ua rau CKD.6,7 Cov kab mob ntshav qab zib hauv lub raum tseem tseem nce ntxiv, ua rau muaj kev noj qab haus huv ntau heev.8,9

Txawm hais tias DM muaj ntau yam teeb meem 10–12 thiab ua rau cov neeg tuag ntau ntxiv, 13 cov neeg mob ntshav qab zib tseem tuaj yeem ua lub neej zoo thiab ua haujlwm.14 Qhov chaw ua haujlwm cuam tshuam rau ntau yam kev noj qab haus huv. Kev ua haujlwm ua haujlwm ua haujlwm tuaj yeem ua rau pw tsaug zog tsis zoo15 thiab tej zaum yuav ua rau muaj kev pheej hmoo rau ntau yam kev noj qab haus huv, 16 suav nrog kev kub siab.17 Cov neeg ua haujlwm yuav raug cuam tshuam rau cov tshuaj phem hauv qhov chaw ua haujlwm.18,19 Lub sijhawm ua haujlwm txuas ntxiv kuj muaj ntau yam tsis zoo rau kev noj qab haus huv. . Ib txoj kev tshawb fawb meta-analysis qhia tias cov sij hawm ua hauj lwm ntev tuaj yeem ua rau kev noj qab haus huv thiab kev noj qab haus huv ntawm kev ua hauj lwm.20 Park li al qhia tias cov sij hawm ua hauj lwm ntev ua rau tsis hnov ​​lus.21

South Kauslim yog ib lub tebchaws uas muaj sijhawm ua haujlwm ntev tshaj plaws thoob ntiaj teb. Cov neeg Kaus Lim Qab Teb ua haujlwm rau qhov nruab nrab ntawm 1993 teev ib xyoos ib zaug, qhov nruab nrab cov sijhawm ua haujlwm hauv cov tebchaws suav nrog hauv Lub Koom Haum rau Kev Sib Koom Tes thiab Kev Txhim Kho yog 1734 teev hauv 2018.22.

Lub sijhawm siv rau kev ua haujlwm yog qhov hloov pauv tau ntawm ntau tusCov xwm txheej muaj feem cuam tshuam nrog CKD. Nws yog ib qho tseem ceeb los txiav txim siab seb cov sij hawm ua hauj lwm ntev yog ib qho kev ywj pheejkev pheej hmoo rau CKD. Txawm li cas los xij, cov ntaub ntawv pov thawj koom nrog cov sij hawm ua haujlwm ntev nrog CKD feem ntau tsis tuaj txog tam sim no. Ib txoj kev tshawb fawb hla ntu tau tshaj tawm tias muaj kev sib koom ua ke ntawm kev ua haujlwm ua haujlwm thiab CKD hauv cov neeg ua haujlwm phau ntawv.23 Lwm qhov kev tshawb fawb pom tias muaj kev sib koom ua ke ntawm CKD thiab lub sijhawm pw tsaug zog ntawm cov neeg ua haujlwm ua haujlwm.24 Txawm li cas los xij, rau qhov zoo tshaj plaws ntawm peb txoj kev paub, tsis muaj kev tshawb nrhiav kev sib raug zoo ntawm cov sij hawm ua hauj lwm thiab CKD. Yog li, qhov kev tshawb fawb no tsom los txiav txim siab txog kev sib raug zoo ntawm cov sij hawm ua haujlwm ntev thiab CKD.

Txoj Kev Kawm

Cov pejxeem

The study data were obtained from the 2010 to 2017 Korean National Health and Nutrition Examination Survey (KNHANES). The KNHANES is a cross-sectional nationwide survey that has been conducted by the Korea Centers for Disease Control and Prevention since 1998.25 The survey provides a representative sample of the noninstitutionalized South Korean population residing in Korea, using a complex, poststratified, multistage clustered probability design. A total of 64,759 participants enrolled in the KNHANES from 2010 to 2017. Among them, 27,393 full-time employees who worked >15 teev / lub lim tiam nrog cov lus teb siv tau txog cov sij hawm ua haujlwm tau raug soj ntsuam rau kev tsim nyog rau txoj kev tshawb no. Peb tsis suav cov neeg koom nrog hnub nyoog<40 years (N ¼ 19,605). Participants with missing data for assessing the CKD status and diabetic status were also excluded from the eligible participants (N ¼ 2726). A total of 14,839 participants were finally considered eligible for analysis after excluding 196 participants with missing data on covariates. The participants were divided into 12,703 participants without diabetes and 2136 participants with diabetes (Fig. 1).

Lub Sijhawm Ua Haujlwm

The International Labor Organization recommends regulating the hours of work, with a 40-h workweek in developed countries and a 48-h workweek in developing countries being considered normal working hours.26 In Korea, the Labor Standards Act legislates 40 h/week and 8 h/day as the statutory weekly working hours, allowing extended work up to an additional 12 h based on agreements between employers and employees. To evaluate the working hours, the participants of KNHANES were asked the following question: ''How many hours per week on average do you work at your workplace, including overtime work and night overtime? (excluding mealtime).'' Considering the above-mentioned standards, we categorized full-time employees into three groups according to working hours ( 40 h/week, 41–52 h/week, and >52 h / lub lis piam). Tsis tas li ntawd, cov txheej txheem ua haujlwm ntau dua thiab nthuav dav ntxiv tau siv los tshuaj xyuas cov ncauj lus kom ntxaws sib txawv.

Mob ntshav qab zib

Cov neeg koom nrog txoj kev tshawb fawb tau muab cais raws li tus neeg mob ntshav qab zib (nrog lossis tsis muaj DM). DM tuaj yeem kuaj tau raws li FPG lossis HbA1c.1 Kev Ntsuas HbA1c muaj qee qhov zoo ntawm FPG kev ntsuas hauv kev kuaj mob DM, suav nrog kev muaj cov qauv ntshav tsis yoo mov thiab kev ruaj ntseg ntawm cov kab mob lom.27 Kev kuaj ntshav yoo mov tau sau thiab HbA1c tau txheeb xyuas siv Kev ua haujlwm siab ua kua chromatography (HLC{5}}G8,

CKD Status

Kev Hloov Kho Kev Noj Qab Haus Huv Hauv Lub Raum Kab Mob (MDRD) sib npaug yog paub tias yog ib qho qauv tseeb rau kev kwv yees tus glomerular filtration rate (GFR).28 Kwv yees GFR (eGFR) suav nrog MDRD kab zauv tuaj yeem siv los ntsuas lub raum kev ua haujlwm.29 Hauv qhov no txoj kev tshawb no, GFR raug xam raws li cov ntshav creatinine qib raws li MDRD qhov sib npaug raws li hauv qab no: 175 ntshav creatinine 1.154 hnub nyoog 0.203 (0.742 yog poj niam).30 Serum creatinine qib tau ntsuas los ntawm kev siv Kev kuaj ntshav yoo mov nrog Jaffe tus nqi-blanked thiab them nyiaj (Hitachi Automatic Analyzer 7600–210; Hitachi / Nyiv, CREA, Rosche / Lub Tebchaws Yelemees). Cov neeg koom nrog eGFR ntawm<60 mL/min/1.73 m2 were considered to have significant loss of renal function and were classified into the CKD group.29,31

Lwm Covariates

Cov ntaub ntawv hais txog cov yam ntxwv ntawm pej xeem thiab cov yam ntxwv ntawm kev noj qab haus huv thiab kev ua neej nyob tau txais los ntawm kev siv cov lus nug txog kev sib tham txog kev noj qab haus huv. Cov ntaub ntawv soj ntsuam kev noj qab haus huv, suav nrog kev ntsuas anthropometric, qib ntshav siab, thiab kuaj cov txiaj ntsig, tau sau los ntawm cov kws kho mob uas tau kawm thiab siv cov cuab yeej ntsuas ntsuas raws sijhawm.25 Cov neeg koom nrog tau muab faib ua pawg raws li hnub nyoog (40–49, 50–59, 60–69, thiab 70 xyoo), kev kawm ntawv (tsev kawm theem pib, tsev kawm theem nrab, tsev kawm theem siab, lossis tsev kawm qib siab), thiab tsev neeg cov nyiaj tau los. Lawv kuj tau muab faib ua cov neeg ua haujlwm hauv phau ntawv (cov neeg ua haujlwm txawj ua haujlwm hauv kev ua liaj ua teb, hav zoov, thiab nuv ntses; khoom siv tes ua thiab cov neeg ua haujlwm cuam tshuam; cov neeg ua haujlwm tshuab thiab sib dhos; lossis cov neeg ua haujlwm phau ntawv yooj yim), cov neeg ua haujlwm tsis siv neeg (cov thawj coj, cov kws tshaj lij thiab cov neeg ua haujlwm cuam tshuam, cov neeg ua haujlwm, cov neeg ua haujlwm pabcuam, thiab cov neeg muag khoom), thiab lwm tus (cov neeg ua haujlwm hauv tsev, cov tub ntxhais kawm) raws li qhov kev ua haujlwm ntawm lub cev (cov tub rog raug cais tawm). Cov sijhawm ua haujlwm tau muab faib ua cov haujlwm ua haujlwm ib hnub thiab ua haujlwm ua haujlwm: cov neeg koom ua haujlwm nruab hnub (06:00–18:00) tau txhais tias yog cov neeg ua haujlwm nruab hnub, thiab lwm qhov ntxiv (14:{{ 14}}– 24:00, 21:00–08:00, ua haujlwm nruab hnub- hmo ntuj, 24-h ua haujlwm, faib ua haujlwm, ua haujlwm tsis tu ncua ua haujlwm) tau txhais tias yog cov neeg ua haujlwm hloov haujlwm.

Cov xwm txheej cuam tshuam txog kev noj qab haus huv ntawm cov neeg koom kuj raug soj ntsuam. Lub cev ua haujlwm tau txhais tias ua tau yam tsawg kawg 150 min ntawm kev siv lub cev nruab nrab 75 min ntawm kev ua kom lub cev muaj zog, lossis sib npaug ntawm kev tawm dag zog lub cev hauv ib lub lis piam.32 Txog kev haus luam yeeb, cov neeg koom nrog tau muab faib ua cov neeg tsis haus luam yeeb, cov neeg haus luam yeeb yav dhau los, thiab cov neeg haus luam yeeb tam sim no. Teeb meem haus cawv tau txhais tias haus 6 units ntawm cawv ob lossis ntau zaus hauv ib lub lis piam hauv cov txiv neej thiab 4 units ntawm cawv ob lossis ntau zaus hauv ib lub lis piam hauv cov poj niam. Lub cev qhov ntsuas qhov ntsuas (BMI) tau siv los txiav txim qhov kev rog rog: BMI<18.5 kg/m2 was defined as underweight, 18.5 kg/m2 BMI< 25 kg/m2 was defined as normal weight, and BMI 25 kg/m2 was defined as obesity.33 Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured thrice and the mean of the second and third measurements was used to determine the hypertensive status. Hypertension was defined as SBP 140 mm Hg, DBP 90 mm Hg, or the use of antihypertensive medications.

Diabetes-related factors were also assessed. The duration of diabetes was measured using the age at the diagnosis of diabetes. If diabetes was not yet diagnosed by a doctor, the duration of diabetes was considered 0. The participants were grouped according to DM duration as follows: 0, 1 to 10, 11 to 20, 21 to 30, and >30 xyoo. Kev tswj glycemic tau soj ntsuam siv qib HbA1c, thiab cov neeg koom nrog ntshav qab zib tau muab faib ua peb pawg: HbA1c<7%, 7% to 9%, and >9%.34

Kev txheeb cais

Nyob rau hauv txoj kev tshawb no, kev soj ntsuam tau ua los ntawm kev txiav txim siab cov qauv qauv tsim, uas suav nrog ntau theem kev sib koom ua ke thiab kev sib cais los sawv cev rau South Kauslim cov pej xeem. Cov yam ntxwv hauv paus yog nthuav tawm raws li cov zaus thiab qhov hnyav feem pua. Qhov kev xeem Rao-Scott x2 tau siv los sib piv cov yam ntxwv dav dav ntawm pawg DM thiab tsis yog DM raws li cov sijhawm ua haujlwm. Ntau lub logistic regression tau ua los xam qhov sib txawv ntawm qhov sib txawv (ORs) thiab 95% kev ntseeg siab ib ntus (CIs). Kev sib koom ua ke ntawm cov sij hawm ua hauj lwm thiab CKD raws li kev mob ntshav qab zib tau raug tshuaj xyuas ua ntej thiab tom qab kho covariates. SAS (version 9.4M6; SAS Institute Inc, Cary, NC) tau siv rau txhua qhov kev txheeb xyuas txheeb cais. Ob sab P-tus nqi tau siv los ntsuas qhov tseem ceeb ntawm kev txheeb cais. Kev txheeb xyuas qhov tseem ceeb tau teeb tsa ntawm P < 0.05.

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