Structural equation modeling of associations between night work and glycemic levels

Arch Endocrinol Metab. 2019 Jun 27;63(5):487-494. doi: 10.20945/2359-3997000000147. eCollection 2019.


Objective: Different pathways may lead from night work to metabolic diseases, including type 2 diabetes. This study aimed to explore the direct and indirect pathways from night work to glycemic levels, considering the role of physical activity, waist circumference and snacking using data from ELSA-Brasil.

Materials and methods: A structural equation model was used to confirm the pathways from night work to glycemic levels. The latent variable, "glycemic levels", included fasting glucose, glycated hemoglobin and 2-hour plasma glucose.

Results: A total of 10.396 participants were included in the analyses. The final model showed that among women, night work was associated with increased glycemic levels. A statistical significant association between night work and glycemic levels mediated by waist circumference was observed among women and men.

Conclusions: The association between night shift and glycemic levels can be interpreted as an important step toward understanding the pathways that could explain night work as a risk factor for diabetes using epidemiological data.

MeSH terms

  • Adult
  • Blood Glucose / analysis*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / etiology*
  • Female
  • Glycated Hemoglobin / analysis*
  • Humans
  • Latent Class Analysis*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Shift Work Schedule / adverse effects*
  • Shift Work Schedule / statistics & numerical data
  • Waist Circumference


  • Blood Glucose
  • Glycated Hemoglobin A

Grants and funding

Funding: the ELSA-Brasil baseline study was supported by Brazil’s Ministry of Health (Department of Science and Technology) and Ministry of Science and Technology (Study and Project Funding agency – FINEP and National Research Council-CNPq) (grants 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, and 01 06 0071.00 RJ). ASC was a CNPq post-doctoral research fellow (150551/2015-0).