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This study aims to explore the association between the triglyceride-glucose (TyG) index and the risk of carotid atherosclerosis (CAS) among Chinese steelworkers. This is a cross-sectional study involving a total of 4,203 Chinese steelworkers. The TyG index was calculated using the formula: TyG = Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]. The association between the TyG index and CAS was analyzed using multivariable logistic regression and restricted cubic spline (RCS) models. The association between TyG and CAS was evaluated across different subgroups, including sex, age, lifestyle, medical history, and the state of occupational exposure. In addition, the TyG index was used to perform calibration and risk reclassification analyses on the fully adjusted model. Feature importance and predictive models were generated using LASSO regression and machine learning methods. In the fully adjusted model, compared to the lowest quartile group, the odds ratios ( OR , 95% CI ) for CAS, increased CIMT, and plaque in the highest quartile group of the TyG index were 3.199 (2.423 ~ 4.223), 2.877 (2.149 ~ 3.851), and 3.738 (2.700 ~ 5.177), respectively. Steelworkers exposed to occupational hazards had a higher risk of CAS compared to those not exposed. There was a nonlinear positive correlation between the TyG index and CAS ( P  < 0.05), and the risk of CAS increased when TyG > 8.72. Additionally, the TyG index demonstrated additional predictive capability beyond existing risk factors, significantly improving discriminatory performance ( P  < 0.05). In LASSO regression, TyG index and other covariables are screened as important feature variables to be incorporated into the development of machine learning models. The TyG index is associated with an increased risk of CAS among steelworkers, underscoring its potential as a reliable and practical predictive tool for assessing CAS risk in this population. Steelworkers with a TyG index>8.72 should receive additional CAS screening and health interventions. In addition, attention should be paid to those exposed to occupational hazards. The TyG index may serve as a simple, rapid, and reliable assessment tool for identifying high-risk individuals with CAS among steelworkers.

OBJECTIVE: Hyperuricemia has become the second most common metabolic disease in China after diabetes, and the disease burden is not optimistic. METHODS: We used the method of retrospective cohort studies, a baseline survey completed from January to September 2017, and a follow-up survey completed from March to September 2019. A group of 2992 steelworkers was used as the study population. Three models of Logistic regression, CNN, and XG Boost were established to predict HUA incidence in steelworkers, respectively. The predictive effects of the three models were evaluated in terms of discrimination, calibration, and clinical applicability. RESULTS: The training set results show that the accuracy of the Logistic regression, CNN, and XG Boost models was 84.4, 86.8, and 86.6, sensitivity was 68.4, 72.3, and 81.5, specificity was 82.0, 85.7, and 86.8, the area under the ROC curve was 0.734, 0.724, and 0.806, and Brier score was 0.121, 0.194, and 0.095, respectively. The XG Boost model effect evaluation index was better than the other two models, and similar results were obtained in the validation set. In terms of clinical applicability, the XG Boost model had higher clinical applicability than the Logistic regression and CNN models. CONCLUSION: The prediction effect of the XG Boost model was better than the CNN and Logistic regression models and was suitable for the prediction of HUA onset risk in steelworkers.

Background Occupational exposure may be associated with an increased risk of developing hyperuricemia. This study sheds lights on the association between occupational exposure and hyperuricemia in steelworkers. Method A nested case–control study was conducted within a cohort of workers in steel companies to explore the association between occupational exposure and hyperuricemia. The case group consisted of a total of 641 cases of hyperuricemia identified during the study period, while 641 non-hyperuricemia subjects with the same age and gender distribution were randomly selected from the cohort as the control group. Results The incidence rate of hyperuricemia among workers in the steel company was 17.30%, with an incidence density of 81.32/1,000 person-years. In comparison to the reference group, the risks of developing hyperuricemia for steelworkers undergoing ever shifts, current shifts, heat exposure, and dust exposure were 2.18 times, 1.81 times, 1.58 times and 1.34 times higher respectively. The odds ratios (ORs) and 95% confidence intervals ( CIs ) were 1.87(1.12–3.13) and 2.02(1.21–3.37) for the cumulative number of days of night work at 0–1,972.80 and ≥ 1,972.80 (days), respectively. Compared to the group with the cumulative heat exposure of 0 (°C/year), the ORs (95% CI ) for the risk of developing hyperuricemia in the groups with the cumulative heat exposure of 0–567.83 and ≥ 567.83 (°C/year) were 1.50(1.02–2.22) and 1.64(1.11–2.43), respectively. The OR (95% CI ) for the risk of developing hyperuricemia was 1.56(1.05–2.32) at the cumulative dust exposure of ≥ 30.02 (mg/m 3 /year) compared to that at the cumulative dust exposure of 0 (mg/m 3 /year). Furthermore, there was a multiplicative interaction between heat exposure and dust exposure in the development of hyperuricemia. Conclusion Shift work, heat, and dust are independent risk factors for the development of hyperuricemia in steelworkers. Additionally, there is a multiplicative interaction between heat exposure and dust exposure in the development of hyperuricemia. Interventions for shift work, heat and dust may help to reduce the incidence rate of hyperuricemia and improve the health of steelworkers.

Objectives To investigate the relationships between abnormal bone mineral density (BMD) and exposure to single or combined occupational hazards in steelworkers by analyzing the correlations between various occupational hazards (night-shift work, high temperature, dust and noise) and abnormal BMD with both a single-risk score model (SRSM) and a hybrid-risk score model (HRSM). Methods Participants were selected from a cross-sectional study called “Cohort Study on the Health Effects of the Occupational Population in the Beijing–Tianjin–Hebei Region”. A total of 6816 participants were recruited for this study. Night-shift work and high temperature, dust and noise exposure were considered occupational hazards and were analyzed separately and in combination (coexposure). The health risk factor score and partial regression coefficient were used to establish an SRSM and an HRSM. Results The rate of abnormal BMD in steelworkers was 27.6% (28.0% in males and 23.3% in females). Logistic regression revealed that, compared with that of individuals with 0 cumulative days of night-shift work, the risk of abnormal BMD for individuals with various amounts of night-shift work was as follows: ~927.20 days (OR = 1.40, 95% CI: 1.15 ~ 1.72), ~ 1772.02 days (OR = 1.45, 95% CI: 1.19 ~ 1.77), and ≥ 2573.50 days (OR = 1.55, 95% CI: 1.27 ~ 1.89). Compared with that of the cumulative exposure to high temperatures in the 0 °C·y group, the risk of abnormal BMD in the other groups was as follows: 667.49~°C·y (OR = 1.34, 95% CI: 1.06 ~ 1.71) and ≥ 790.30 °C·y (OR = 1.32, 95% CI: 1.03 ~ 1.69). Compared with that of the cumulative amount of dust exposure in the 0 mg/m 3 ·y group, the risk of abnormal BMD for the other groups was as follows: 30.42 ~ mg/m³·y (OR = 1.23, 95% CI: 1.02 ~ 1.49) and ≥ 40.17 mg/m³·y (OR = 1.37, 95% CI: 1.14 ~ 1.65). Compared with that of the cumulative amount of noise exposure in the 0 dB(A)·y group, the risk of abnormal BMD for the other groups was as follows: ≥1707.47 dB(A)·y (OR = 1.17, 95% CI: 1.00 ~ 1.40). When an SRSM was used, compared with that in the control group (score < 0.42), the risk of abnormal BMD in the other groups was as follows: ~0.42 (OR = 1.24, 95% CI: 1.03 ~ 1.19), ~ 0.72 (OR = 1.51, 95% CI: 1.24 ~ 1.83), and ≥ 0.97 (OR = 2.11, 95% CI: 1.71 ~ 2.60). When an HRSM was used, compared with that of the reference group (score < 0.360), the risk of abnormal BMD for the other groups was as follows: ~0.360 (OR = 1.26, 95% CI: 1.05 ~ 1.52), ~ 0.576 (OR = 1.43, 95% CI: 1.18 ~ 1.74), and ≥ 0.779 (OR = 2.08, 95% CI: 1.70 ~ 2.55). Conclusions (1) Night-shift work and high temperature and dust exposure may contribute to abnormal BMD in steelworkers. (2) The higher the corresponding risk score of occupational hazard coexposure is, the greater the risk of abnormal BMD in steelworkers. When workers are exposed to multiple occupational hazards at the same time, coexposure models could reveal the relationships between occupational hazard exposure and abnormal BMD in steelworkers more accurately.

This study aimed to examine the association between rotating night shift work and carotid atherosclerosis in Chinese steelworkers. A total of 3582 subjects were included in this study. Different exposure metrics of night shifts, including current shift status, duration of night shifts (years), the cumulative number of night shifts (nights), cumulative length of night shifts (hours) and average frequency of night shifts (nights/month), were used to examine the relationship between night shift work and carotid atherosclerosis, including carotid plaque and carotid plaque scores. The prevalence of carotid plaque was 29.9% in the study population. Compared with day workers, significantly increased odds of carotid plaque were observed among shift workers in each quartile of the duration of night shifts after adjusting for potential confounders, especially in the third and fourth quartiles: odds ratio (OR) = 1.91, 95% confidence interval (CI): 1.46 to 2.49, in the third quartiles; OR = 1.69, 95% CI: 1.30 to 2.20, in the fourth quartiles. Positive associations of different exposure metrics of night shifts (continuous) with the odds of carotid plaque and the carotid plaque score were observed in the restricted cubic spline (RCS) models. No significant association was found in female workers between night shift work and carotid plaque. Rotating night shift work is associated with elevated odds of carotid atherosclerosis in male steelworkers.

The Chinese Visceral Adiposity Index (CVAI) is an indicator of visceral adiposity dysfunction used to evaluate the metabolic health of the Chinese population. Steelworkers are more likely to be obese due to their exposure to special occupational factors, and have a higher prevalence of carotid atherosclerosis (CAS). This study aimed to analyze the special relationship between CVAI and CAS among steelworkers. A total of 4075 subjects from a northern steel company were involved in the cross-sectional study. Four logistic regression models were developed to analyze the correlation between CVAI and CAS. In addition, the restricted cubic spline was applied to fit the dose–response association between CVAI and CAS risk. In the study, the prevalence of CAS was approximately 25.94%. After adjustment for potential confounders, we observed a positive correlation between CVAI and CAS risk. Compared to the first CVAI quartile, the effect value odds ratio (OR) and 95% CI in the second, third, and fourth CVAI quartile were 1.523 (1.159–2.000), 2.708 (2.076–3.533), and 4.101 (3.131–5.372), respectively. Additionally, this positive correlation was stable in all subgroups except for female. Furthermore, we also found a non-linear relationship between CVAI and CAS risk (p nonlinear < 0.05). Notably, CVAI could increase the risk of CAS when higher than 106. In conclusion, our study showed that CVAI might be a reliable indicator to identify high-risk populations of CAS among steelworkers.

Background Obesity is increasingly recognized as a grave public health concern globally. It is associated with prevalent diseases including coronary heart disease, fatty liver, type 2 diabetes, and dyslipidemia. Prior research has identified demographic, socioeconomic, lifestyle, and genetic factors as contributors to obesity. Nevertheless, the influence of occupational risk factors on obesity among workers remains under-explored. Investigating risk factors specific to steelworkers is crucial for early detection, prediction, and effective intervention, thereby safeguarding their health. Methods This research utilized a cohort study examining health impacts on workers in an iron and steel company in Hebei Province, China. The study involved 5469 participants. By univariate analysis, multifactor analysis, and review of relevant literature, predictor variables were found. Three predictive models—XG Boost, Support Vector Machine (SVM), and Random Forest (RF)—were employed. Results Univariate analysis and cox proportional hazard regression modeling identified age, gender, smoking and drinking habits, dietary score, physical activity, shift work, exposure to high temperatures, occupational stress, and carbon monoxide exposure as key factors in the development of obesity in steelworkers. Test results indicated accuracies of 0.819, 0.868, and 0.872 for XG Boost, SVM, and RF respectively. Precision rates were 0.571, 0.696, and 0.765, while recall rates were 0.333, 0.592, and 0.481. The models achieved AUCs of 0.849, 0.908, and 0.912, with Brier scores of 0.128, 0.105, and 0.104, log losses of 0.409, 0.349, and 0.345, and calibration-in-the-large of 0.058, 0.054, and 0.051, respectively. Among these, the Random Forest model demonstrated superior performance. Conclusions The research indicates that obesity in steelworkers results from a combination of occupational and lifestyle factors. Of the models tested, the Random Forest model exhibited superior predictive ability, highlighting its significant practical application.

Background/Objectives: Steelworkers are more likely to have a higher prevalence of hyperuricemia due to their exposure to special occupational factors and dietary habits. The interrelationships of visceral adiposity index (VAI), hyperuricemia, and drinking tea remain uncertain. This study aimed to assess the association between VAI and hyperuricemia among steelworkers, and if drinking tea modified this association. Methods: A total of 9928 steelworkers from Hunan Hualing Xiangtan Iron and Steel Company participated in this cross-sectional study. All participants completed a questionnaire, received anthropometric measurements, and provided blood samples for biochemical testing. Three logistic regression models were used to analyze the association between VAI and hyperuricemia. Results: In this study, the prevalence of hyperuricemia was approximately 23.74% (males: 24.41%; females: 20.63%), and a positive correlation between VAI and hyperuricemia risk was observed. In multivariate logistic regression analysis, the risk of hyperuricemia increased 1.76 times (95% CI: 1.64–1.89) and 2.13 times (95% CI: 1.76–2.57) with the increase of ln VAI in males and females, respectively. For males, compared to quartile 1, the risk of hyperuricemia in the second, third, and fourth quartile of VAI were 1.75 (95% CI: 1.11–2.71), 2.56 (95% CI: 1.67–3.93) and 4.89 (95% CI: 3.22–7.43). For females, compared to quartile 1, the risk of hyperuricemia in the second, third, and fourth quartile of VAI were 1.99 (95% CI: 1.40–2.82), 2.92 (95% CI: 1.96–4.34) and 4.51 (95% CI: 2.89–7.02). Additionally, our study found that, compared with not consuming tea, drinking tea could reduce uric acid levels by 0.014 in male steelworkers (t = −2.051, p = 0.040), 0.020 in workers consuming smoked food (t = −2.569, p = 0.010), and 0.022 in workers consuming pickled food (t = −2.764, p = 0.006). Conclusions: In conclusion, VAI is positively correlated with hyperuricemia in steelworkers. Drinking tea may lower uric acid levels in male steelworkers and steelworkers who prefer smoked and pickled foods.

Objectives: Nonalcoholic fatty liver disease (NAFLD) has been associated with an increased risks of corrected QT (QTc) prolongation and left ventricular hypertrophy (LVH), both of which are associated with the development of cardiovascular disease. Rotating night shift work and a higher risk of incident NAFLD have been reported in male steelworkers. This study aimed to investigate the association of the severity of NAFLD with a prolonged QTc interval and LVH in a large cohort of Chinese male steelworkers. Methods: We examined baseline data of 2998 male steel workers aged 26 to 71 years at two plants. All workers at both plants received regular health assessments, including 12-lead ECG and echocardiography. Abdominal ultrasonography was performed to evaluate the severity of NAFLD. QTc prolongation was defined as follows: normal ≤ 430 ms, borderline 431–450 ms, and abnormal ≥ 451 ms. LVH was defined as a left ventricular mass index (LVMI) >131 g/m2. Associations of NAFLD with an abnormal QTc interval and LVH were examined using univariate and multivariate analyses. Results: The QTc interval and the LVMI were significantly correlated with the NAFLD fibrosis score, and the severity of NAFLD was correlated with an abnormal QTc interval and LVH (p for trend < 0.05). Multivariate analysis showed that in comparison to the workers without NAFLD, the odds ratios of having an abnormal QTc interval and LVH were 2.54 (95% CI: 1.22–5.39, p = 0.013) times and 2.23 (95% CI: 1.02–5.01, p = 0.044) times higher in the workers with moderate/severe NAFLD. Conclusions: NAFLD may be closely associated with the risks of an abnormal QTc interval and LVH, suggesting that regular electrocardiogram and echocardiogram monitoring could be used to evaluate the risk of arrhythmia and LVH in male steelworkers with NAFLD.

The purpose of this study was to determine whether neck circumference (NC) is associated with subclinical atherosclerosis among Chinese steelworkers in North China. A cross-sectional survey was conducted among steelworkers in northern China (n = 3467). Carotid intima-media thickness (CIMT) was measured at the distal wall of the common carotid artery proximal to the bifurcation point along a plaque-free segment 10 mm long on each side by B-ultrasound. The mean of the common CIMT was used bilaterally in this study. In the cross-sectional analysis, large NC was associated with the presence of abnormal CIMT. Logistic regression analysis was used to assess the relationship between NC tertiles and CIMT. The multivariable-adjusted odds ratio was 1.76 (95% CI: 1.40 to 2.22; p for trend <0.001) for the highest tertile versus the lowest tertile and was 1.07 (95% CI: 1.04 to 1.10; p < 0.001) per 1 standard deviation increment in NC. Among steelworkers in North China, relatively large NC level is associated with elevated odds of subclinical atherosclerosis.