Interactive effects of corticotropin-releasing hormone receptor 1 gene and work stress on burnout in medical professionals in a Chinese Han population
Interactive effects of corticotropin-releasing hormone receptor 1 gene and work stress on burnout in medical professionals in a Chinese Han population
复制标题
促肾上腺皮质激素释放激素受体1基因和工作压力对中国汉族医务人员职业倦怠的交互作用
DOI：
10.1016/j.jad.2019.03.084
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发表时间：
2019-06-01
影响因子：
6.6
通讯作者：
Zhang Xiang Yang
中科院分区：
文献类型：
--
作者：
He Shu-Chang;Wu Shuang;Zhang Xiang Yang
背景：职业倦怠是一种与工作相关的压力综合征，由长期暴露在压力环境中而引起。下丘脑-垂体-肾上腺(HPA)轴调节失调可能与应激和职业倦怠有关；对改变HPA活性的基因多态性的评估可能预测环境产生职业倦怠的可能性。方法：采用横断面设计，检验促肾上腺皮质激素释放激素受体1(CRHR1)基因多态性rs110402是否为职业倦怠的危险因素；进一步探讨应激x CRHR1基因的交互作用是否预测中国汉族医务人员的职业倦怠。采用House和Rizzo的工作压力量表、压力源量表和Maslach工作倦怠量表对北京某大型综合医院的712名受试者进行问卷调查。结果：压力源、工作压力与抑郁评分呈显著正相关(P均<0.001)。男性、低年龄和高教育水平与职业倦怠相关(均P<；0.05)。CRHR1 rs110402基因的存在与工作压力或职业倦怠无关。然而，我们发现CRHR1rs110402与工作压力在职业倦怠上存在显著的交互作用(p<；0.05)。在高应激组中，A等位基因纯合子个体的情绪衰竭程度显著高于G等位基因携带者。限制：样本仅选自医学专业，样本量相对较小。结论：CRHR1基因rs110402多态与职业倦怠密切相关，CRHR1rs110402多态A等位基因可能增强工作压力时的情绪衰竭感。
Background: Burnout is a worked-related stress syndrome caused by long-term exposure to a stressful environment. Dysregulation of the hypothalamic- pituitary- adrenal (HPA) axis may be involved in both stress and burnout; an evaluation of genetic polymorphisms which alter activity in the HPA may be predictive of how likely an environment is to produce burnout.Methods: Using a cross-sectional design, this study examined whether corticotrophin-releasing hormone receptor 1 (CRHR1) gene polymorphism rs110402 is a risk factor for burnout; further, it explores whether the interaction of stress x CRHR1 gene predicts burnout in the healthcare workers in a Chinese Han population. House and Rizzo's work stress scale, Sources of Pressure Scale and Maslach Burnout Inventory-General Survey were administered to 712 participants from a large general hospital in Beijing. The CRHR1 rs110402 polymorphism was genotyped in 376 participants.Results: Our results showed significant positive inter-correlations between stressor, work stress and depressive scores (all p < 0.001) with only one exception. Males, younger age and higher educational level were associated with burnout (all p < 0.05). The presence of the CRHR1 rs110402 genotype was not correlated with the presence of job stress or burnout. However, we found statistically significant interaction between CRHR1 rs110402 and job stress on burnout (p < 0.05). Individuals homozygous for the A allele reported significantly higher emotional exhaustion than G allele carriers in the high stress group.Limitations: The sample was only chosen from the medical professions, and the sample size was relatively small. Only one polymorphism in CRHR1 gene was analyzed, while only about half of the total individuals were genotyped.Conclusions: Our results suggest a close relationship between work-related stress and burnout and that the A allele of the CRHR1 rs110402 polymorphism may enhance feelings of emotional exhaustion when experiencing work-related stress.