Job insecurity and risk of diabetes: a meta-analysis of individual participant data
Job insecurity and risk of diabetes: a meta-analysis of individual participant data
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DOI：
10.1503/cmaj.150942
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发表时间：
2016-12-06
影响因子：
14.6
通讯作者：
Kivimaki, Mika
中科院分区：
文献类型：
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作者：
Ferrie, Jane E.;Virtanen, Marianna;Kivimaki, Mika
背景：工作不安全感与某些健康结果有关。我们研究的作用，工作不安全感作为一个危险因素的事件diabetes.Methods：我们使用的个人参与者的数据，从8个队列研究中确定的2个开放访问的数据档案和11个队列研究参与的个人参与者数据荟萃分析工作人群联盟。我们计算了基线时报告的工作不安全感与随访期间发生的糖尿病之间关系的研究特定估计值。我们汇集了荟萃分析中的估计，以产生一个汇总的风险estimate.Results：19项研究涉及140 825名参与者来自澳大利亚，欧洲和美国，平均随访9.4年和3954例糖尿病事件。在调整年龄和性别的初步分析中，与低工作不安全感相比，高工作不安全感与糖尿病发病风险增加相关（调整后的比值比[OR] 1.19，95%置信区间[CI] 1.09-1.30）。在多变量校正分析中，仅限于15项研究，所有协变量（年龄，性别，社会经济地位，肥胖，体力活动，酒精和吸烟）的基线数据，相关性略有减弱（校正OR 1.12，95% CI 1.01-1.24）。研究间的异方差性为低至中度（年龄和性别校正模型：I-2 = 24%，p = 0.2;多变量校正模型：I-2 = 27%，p = 0.2）。在多变量校正分析中，仅限于高质量的研究，其中糖尿病的诊断是从电子病历或临床检查确定的，该协会是类似的主要分析（调整OR 1.19，95%CI 1.04-1.35）。解释：我们的研究结果表明，自我报告的工作不安全感与糖尿病事件的风险适度增加。卫生保健人员应该意识到这种关联的工人报告工作不安全。
Background: Job insecurity has been associated with certain health outcomes. We examined the role of job insecurity as a risk factor for incident diabetes.Methods: We used individual participant data from 8 cohort studies identified in 2 open-access data archives and 11 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary risk estimate.Results: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09-1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking), the association was slightly attenuated (adjusted OR 1.12, 95% CI 1.01-1.24). Heterogeneity between the studies was low to moderate (age- and sex-adjusted model: I-2 = 24%, p = 0.2; multivariable-adjusted model: I-2 = 27%, p = 0.2). In the multivariable-adjusted analysis restricted to high-quality studies, in which the diabetes diagnosis was ascertained from electronic medical records or clinical examination, the association was similar to that in the main analysis (adjusted OR 1.19, 95% CI 1.04-1.35).Interpretation: Our findings suggest that self-reported job insecurity is associated with a modest increased risk of incident diabetes. Health care personnel should be aware of this association among workers reporting job insecurity.