One pathway was measured, not a network of them
The question asks about pathways, plural, but the evidence supports a single measured route. In a cohort of rotating night shift workers, researchers measured two inflammatory signalling molecules, IL-1β and IL-6, and examined how they related to carotid intimal medial thickness (cIMT) — a ultrasound measure of how thick the innermost layers of the neck artery have become, used as a marker of early atherosclerosis [2]. The study describes this IL-1β/IL-6 axis as significantly associated with carotid atherosclerosis and treats it as a marker of disturbed circadian rhythm [2].
That is a meaningful result, but it is one axis in one occupational cohort. No other biochemical pathway — for example, lipid metabolism, blood-pressure regulation, or oxidative stress — is quantified in the evidence here. The systematic review of vascular function in night shift workers, which includes radiographers, reports associations between night shift work and vascular outcomes but does not quantify biochemical pathways at all [1]. So the count of quantified pathways is one, not several.
Why inflammation is the link researchers chose to test
The logic is intuitive once you separate the pieces. Shift work scrambles the body's daily timing, and the study treats IL-1β/IL-6 as a readout of that disturbance [2]. Carotid wall thickness is a structural sign that atherosclerosis is developing. If the inflammatory signal rises with disrupted timing and the artery wall thickens alongside it, that is a coherent chain from schedule to biology to vessel. The study's framing is that this axis is a marker of disturbed circadian rhythm associated with carotid atherosclerosis [2].
It is worth being precise about what that establishes. The finding is an association between the inflammatory markers and artery thickness in shift workers [2]. It does not show that circadian disruption causes atherosclerosis through inflammation, and the abstract does not report a mediation analysis. The pathway is a plausible and measured correlate, not a proven causal mechanism.
Consistency can't be judged from one pathway
The consistency question has a short answer: there is nothing to compare. Consistency of effect sizes is a property of multiple studies measuring the same thing, and here only one study quantifies a biochemical pathway [2]. The review that could have provided a broader picture explicitly notes inconsistency in effect sizes across vascular outcomes, but those are vascular function parameters, not biochemical pathway effect sizes [1].
That distinction matters for anyone reading headlines about shift work and heart disease. A review finding inconsistent vascular results [1] and a single cohort finding an inflammatory association [2] are not in conflict — they are measuring different things at different levels. The inconsistency in the review concerns how strongly night shift work relates to vessel function across studies; it says nothing about whether the IL-1β/IL-6 result would replicate.
What this means if you work nights
The practical takeaway is modest. There is evidence that rotating night shift work is associated with thicker carotid artery walls, and that this tracks with an inflammatory signal in the same workers [2]. That is consistent with the general idea that disrupted circadian rhythm has a biological footprint, but it is a single cohort and the abstract does not report how large the effect was or how many workers were studied in the relevant analysis.
The broader review supports the idea that night shift work is linked to vascular outcomes while cautioning that the strength of those links varies across studies [1]. For a general reader, the fair summary is: the inflammation-to-artery link is real enough to study further, but the field has not yet measured enough pathways, in enough cohorts, to say which biochemical route matters most or how reliably its effect size holds up.
Sources used in this answer
Night Shift Work and Vascular Function Parameters: A Systematic Review of Occupational and Healthcare Evidence with Implications for Radiographers
A systematic review of night shift workers, including radiographers, found associations between night shift work and vascular function parameters but inconsistent effect sizes, and did not quantify biochemical pathways linking circadian disruption to atherosclerosis.
Carotid intimal medial thickness in rotating night shift is related to IL1β/IL6 axis
In an occupational cohort of rotating night shift workers, an IL-1β/IL-6 inflammatory axis was significantly associated with carotid intimal medial thickness, a marker of carotid atherosclerosis, and was treated as a marker of disturbed circadian rhythm.