To investigate the effects of shift work and remnant cholesterol (RC) on renal impairment among steel workers and to analyze the mediating role of RC in this association.
A cohort study was conducted involving 4 113 workers from a steel enterprise in Tangshan. Participants were enrolled in 2017 and followed up until 2023 to record incident cases of renal impairment. Shift work status was assessed to calculate the Weighted Shift Index (WSI), and RC levels were determined based on fasting lipid profiles. Cox regression was used to analyze risk associations, the Bootstrap method was employed to examine the mediating effect of RC, and sensitivity analyses were conducted to evaluate the robustness of the findings.
A total of 626 participants (15.2%) developed renal impairment. Compared with those who never worked shifts, former and current shift workers had a 3.267-fold (95%CI: 2.399-4.449) and 2.910-fold (95%CI: 2.163-3.914) increased risk of renal impairment, respectively. Each IQR increase in WSI was associated with a 29.4% increase in risk. Participants in the high RC group (≥ 0.71 mmol/L) had a 1.762-fold (1.364-2.277) higher risk compared to those in the low RC group (<0.34 mmol/L). Mediation analysis revealed that RC partially mediated the association between shift work and renal impairment, accounting for 12.4% (former shift work), 10.6% (current shift work), and 6.1% (WSI) of the effect, respectively.
Higher shift work load and elevated RC levels were both significantly associated with an increased risk of renal impairment, with RC playing a partial mediating role in this relationship.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |