To the Editor The finding of an inverse relationship between melatonin level and risk for developing type 2 diabetes in the Nurses’ Health Study (NHS) cohort1 potentially provides additional evidence for the emerging recognition that disruption of circadian timing increases the risk for metabolic and cardiovascular disease.2
One of the unique factors of the NHS cohort is exposure to a significant amount of shift work. Previous analyses of the parent cohort found that women working rotating night shifts had an increased risk of developing type 2 diabetes that was cumulative, with the highest risk seen in individuals working rotating shifts for more than 20 years.3 Additional analysis of this same cohort has shown that cumulative exposure to shift work also increases the risk for stroke.4 These findings suggest that chronic circadian misalignment may be more detrimental to health than current exposure to shift work.
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