轮班工作与更年期延迟有关

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Shift work linked to delayed onset of menopause

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It's no secret that working nontraditional shifts can wreak havoc on lifestyle and sleep habits. Shift work has also been known to have a negative effect on workers' health. A new study suggests it also may delay the onset of natural menopause, possibly because of disruptions in circadian rhythms. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).

Shift work has increased globally in recent years, with an estimated 20% of the economically active population in North America and Europe working some type of nontraditional or alternating shifts. Although shift work has become an economic necessity to keep up with the increased demand for goods and services, it is not without health risks. Previous studies have linked shift work with an increased risk of coronary events, with the highest risk being associated with night shifts. Other related health problems include peptic ulcers, type 2 diabetes, and cancers such as prostate, colorectal, and breast.

Although previous studies have shown the various adverse health effects of shift work on working adults, there has been little research on the effect of shift work on middle-aged and older adults. Age at natural menopause is a matter of concern for middle-aged and older women, because both early or late menopause may be a significant risk marker for subsequent morbidity and mortality. Environmental factors such as smoking, parity, and socioeconomic status have previously been identified to be strongly associated with variations in age at natural menopause.

Researchers have hypothesized that a factor that may affect age at menopause is shift work, as previous studies have suggested a possible effect of circadian rhythm disruption on ovulation and fertility. In addition, excessive exposure to artificial light during dark hours has been documented to cause melatonin suppression that, in turn, leads to disruption of ovarian activity. To date, little has been documented regarding the relationship between shift work and age at natural menopause.

This new study, based on secondary data analyses of nearly 3,700 premenopausal women, aimed to investigate the association between shift work exposure and variations in age at natural menopause in adult Canadian workers. Based on study results, a significant relationship has been shown between rotating shifts and delayed onset of menopause. The researchers speculate that disruptive circadian rhythms may play a role, although further investigation is necessary.

Study results are published in the article "The association between shift work exposure and the variations in age at natural menopause among adult Canadian workers: results from the Canadian Longitudinal Study on Aging (CLSA)."

This study shows a potential influence of circadian regulation on age at natural menopause, with current rotating shift work linked to later age at menopause and current night shift work linked to earlier age at menopause. Whether these differences in age at menopause are directly related to the effect of circadian rhythm changes on underlying hypothalamic regulation or are because of other sociodemographic factors such as chronic stress, economic insecurity, and substance use or abuse requires further study."

Dr. Stephanie Faubion, NAMS medical director

全文翻译（仅供参考）

       非传统轮班工作会对生活方式和睡眠习惯造成严重破坏，这已不是什么秘密。众所周知，轮班工作会对工人的健康产生负面影响。一项新的研究表明，它也可能延迟自然绝经的开始，可能是由于昼夜节律的中断。研究结果在线发表在北美更年期协会 (NAMS) 杂志《更年期》上。

       近年来，全球轮班工作有所增加，北美和欧洲估计有 20% 的经济活动人口从事某种非传统或交替轮班工作。尽管轮班工作已成为满足对商品和服务不断增长的需求的经济必需品，但它并非没有健康风险。先前的研究已将轮班工作与冠状动脉事件风险增加联系起来，其中最高风险与夜班有关。其他相关的健康问题包括消化性溃疡、2 型糖尿病以及前列腺癌、结肠直肠癌和乳腺癌等癌症。

       尽管之前的研究已经表明轮班工作对在职成年人的各种不利健康影响，但关于轮班工作对中老年人的影响的研究很少。自然绝经的年龄是中年和老年妇女关注的问题，因为提前或晚期绝经可能是随后发病率和死亡率的重要风险标志。以前已经确定环境因素，如吸烟、生育情况和社会经济地位与自然绝经时的年龄变化密切相关。

       研究人员假设可能影响更年期年龄的一个因素是轮班工作，因为以前的研究表明昼夜节律紊乱可能对排卵和生育能力产生影响。此外，已证明在黑暗时间过度暴露于人造光会导致褪黑激素抑制，进而导致卵巢活动中断。迄今为止，关于轮班工作与自然绝经年龄之间的关系的文献很少。

       这项新研究基于对近 3,700 名绝经前妇女的二手数据分析，旨在调查轮班工作暴露与加拿大成年工人自然绝经年龄变化之间的关系。根据研究结果，已显示轮班与更年期延迟之间存在显着关系。研究人员推测，破坏性的昼夜节律可能发挥了作用，尽管还需要进一步调查。

       研究结果发表在“加拿大成年工人轮班工作暴露与自然绝经年龄变化之间的关联：加拿大老龄化纵向研究 (CLSA) 的结果”一文中。

       这项研究显示了昼夜节律调节对自然绝经年龄的潜在影响，当前轮班工作与绝经年龄较晚有关，而当前夜班工作与绝经年龄较早有关。这些绝经年龄差异是否与昼夜节律变化对潜在下丘脑调节的影响直接相关，或者是由于其他社会人口因素，如慢性压力、经济不安全以及物质使用或滥用，需要进一步研究。”

NAMS 医学主任 Stephanie Faubion 博士

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