The expansion of the gig economy has been marked by an increase in platform workers, including ride-hailing drivers, who typically work non-standard schedules, with night shifts being common. Although night shift work was known to disrupt circadian rhythms and elevate cardiovascular risks, the interplay between early alteration in cardiovascular biomarkers and gut microbiome remain unclear. To investigate these associations in the platform worker groups, we conducted a cross-sectional study comparing 66 night shift and 175 day shift ride-hailing drivers in Beijing, China. All participants underwent health examinations, provided blood tests for the assessment of four key cardiovascular biomarkers (hs-cTnI, ET-1, NT-pro-BNP, and FABP-3), and submitted fecal samples for gut microbiome profiling via 16S rDNA sequencing. Bioinformatics, linear regression, and mediation analyses were conducted to evaluate the associations between night shift work, biomarkers, and microbial taxa, with adjustments for key sociodemographic and lifestyle factors. Night shift drivers exhibited significantly higher levels of NT-pro-BNP (median 49.8 vs. 41.3 ng/L, P = 0.044), the association that remained significant after adjustment for covariates (β = 0.195, P = 0.004). Twenty differentially abundant taxa were identified, four of which were significantly associated with hs-cTnI. This study found that night shift work in ride-hailing drivers was significantly associated with adverse cardiovascular biomarker profiles and distinct gut microbiome alterations. Correlation analysis further suggested that gut microbial changes were linked to the observed cardiovascular risk. This study reported associations between night-shift work and alterations in early cardiovascular injury biomarkers as well as the gut microbiota, suggesting a potential link between gut microbiota and night-shift-related cardiovascular injury.
