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Shift Work, Genetic Factors, and the Risk of Heart Failure

A Prospective Study of the UK Biobank
  • Cheng Xu
    Affiliations
    State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China

    Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
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  • Zhenkun Weng
    Affiliations
    State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China

    Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
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  • Jingjia Liang
    Affiliations
    State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China

    Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
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  • Qian Liu
    Affiliations
    State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China

    Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
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  • Xin Zhang
    Affiliations
    State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China

    Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
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  • Jin Xu
    Affiliations
    State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China

    Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
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  • Qingguo Li
    Correspondence
    Correspondence: Address to Qingguo Li, PhD, Department of Cardiovascular Center, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, 210011, Nanjing, Jiangsu, China
    Affiliations
    Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Cardiovascular Surgery Department, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China
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  • Yong Zhou
    Correspondence
    Yong Zhou, PhD, CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200032, China
    Affiliations
    CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
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  • Aihua Gu
    Correspondence
    Aihua Gu, PhD, State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
    Affiliations
    State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China

    Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
    Search for articles by this author

      Abstract

      Objective

      To quantify the association of combined shift work and genetic factors with the incidence of heart failure (HF).

      Participants and Methods

      This study included 242,754 participants with complete shift work information in the UK Biobank. Participants were followed from baseline (2006 to 2010) through January 31, 2018. The association between shift work and HF incidence was investigated separately in males and females using a Cox proportional hazards model adjusted for covariates. In addition, we established a polygenic risk score and assessed whether shift work alters genetic susceptibility to HF.

      Results

      The results showed a significant association of permanent night shift work with incident HF among females (hazard ratio, 2.25; 95% CI, 1.34 to 3.76; P=.002) after adjusting for age, and the association was attenuated in the fully adjusted model. Among men, we did not detect an association between shift work and HF. In addition, we observed that the association between the risk of HF and shift work was strengthened by high genetic risk. Permanent night shift work paired with high genetic risk, compared with low genetic risk, was suggested to be associated with the risk of HF in females (hazard ratio, 2.89; 95% CI, 1.05 to 7.94) but not in males.

      Conclusion

      Shift work, particularly permanent night shift work, may increase the risk of HF in females, especially in those with high genetic risk.

      Graphical abstract

      Abbreviations and Acronyms:

      AP (attributable proportion), BMI (body mass index), CAD (coronary artery disease), CVD (cardiovascular disease), HF (heart failure), HR (hazard ratio), PRS (polygenic risk score), RERI (relative excess risk), SNP (single nucleotide polymorphism)
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