Metabolic syndrome and carotid plaque in Chinese taxi drivers: a cross-sectional study of 5,999 participants.

BACKGROUND

Taxi drivers face occupational exposures that are associated with cardiovascular disease (CVD) risk, including prolonged sedentary behavior, irregular meal patterns, and psychosocial stress. However, comprehensive assessments of metabolic health in this population, particularly with standardized comparisons to the general population, are limited.

METHODS

This cross-sectional study analyzed data from 5,999 Beijing taxi drivers undergoing annual health examinations (2022-2023). Metabolic risk factors were assessed and metabolic syndrome (MetS) was defined using the 2009 harmonized criteria. Carotid ultrasound was performed in 4,582 participants (76.37%) to detect subclinical atherosclerosis. Age-standardized prevalence ratios (SPRs) were calculated by comparing taxi drivers with the Beijing general population. A parallel occupational health survey (n = 5,922) from the same population characterized work conditions and lifestyle factors.

RESULTS

Compared with the Beijing general population, male taxi drivers exhibited significantly elevated metabolic risk: hypertension (SPR = 2.25, 95% CI: 2.16-2.33), obesity (SPR = 2.19, 95% CI: 2.10-2.28), carotid plaque (SPR = 2.00, 95% CI: 1.91-2.10), and fatty liver disease (SPR = 1.76, 95% CI: 1.71-1.82; all p < 0.001). Occupational survey data showed substantial adverse work exposures: 62.25% had worked ≥20 years as taxi drivers, 36.31% reported insufficient rest (<4 days/month), 58.17% reported difficulty accessing restrooms, and 53.31% reported meal-related difficulties during work. Among those with carotid ultrasound data, 40.77% had carotid plaque. MetS (≥3 of 5 components) was independently associated with carotid plaque (adjusted OR = 1.28, 95% CI: 1.11-1.48, p < 0.001). The association remained robust in inverse probability weighting (OR = 1.27, 95% CI: 1.10-1.47), modified Poisson regression (PR = 1.12, 95% CI: 1.05-1.19), and analyses using alternative central obesity definitions.

CONCLUSION

Chinese taxi drivers bear a substantially elevated burden of metabolic disorders compared with the general population. The high prevalence of adverse occupational exposures provides important context for understanding these findings. Targeted occupational health interventions addressing lifestyle and work conditions in this population may be warranted.