Job Strain as a Risk Factor for the Onset of Type 2 Diabetes Mellitus: Findings From the MONICA/KORA Augsburg Cohort Study
Job Strain as a Risk Factor for the Onset of Type 2 Diabetes Mellitus: Findings From the MONICA/KORA Augsburg Cohort Study
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DOI：
10.1097/psy.0000000000000084
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发表时间：
2014-09-01
影响因子：
3.3
通讯作者：
Ladwig, Karl-Heinz
中科院分区：
文献类型：
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作者：
Huth, Cornelia;Thorand, Barbara;Ladwig, Karl-Heinz
目的：在一项基于人群的男性和女性研究中，检查工作压力是否与随后发生2型糖尿病（T2 DM）的风险增加相关。方法：数据来自前瞻性MONICA/KORA Augsburg研究。我们调查了5337名年龄在29至66岁之间的工作参与者，他们在三次基线调查中没有糖尿病。工作压力的测量Karasek工作内容问卷。高工作压力是由象限方法定义的，高工作要求与低工作控制相结合被归类为高工作压力。连续工作压力（工作要求除以工作控制的商）作为敏感性分析进行了额外分析。使用多变量考克斯比例风险模型估计风险比（HR），并调整年龄、性别、调查、社会经济和生活方式变量、父母糖尿病史和体重指数。结果：在中位随访12.7年期间，观察到291例T2 DM事件。基线时工作压力高的参与者发生T2 DM的完全校正风险比工作压力低的参与者高45%（HR = 1.45 [95%置信区间= 1.00-2.10]，p = 0.048）。在连续量表上，1个标准差量级的更严重的工作压力对应于完全校正的T2 DM风险增加12%（HR = 1.12 [95%置信区间= 1.00-1.25]，p = 0.045）。结论：经历高工作压力的男性和女性发展为T2 DM的风险较高，独立于传统的危险因素。对抗全球日益增长的T2 DM流行病的预防策略应考虑到工作环境中高压力的不利影响。
Objective: To examine whether job strain is associated with an increased risk of subsequent Type 2 diabetes mellitus (T2DM) development in a population-based study of men and women. Methods: Data were derived from the prospective MONICA/KORA Augsburg study. We investigated 5337 working participants aged 29 to 66 years without diabetes at one of the three baseline surveys. Job strain was measured by the Karasek job content questionnaire. High job strain was defined by the quadrant approach, where high job demands combined with low job control were classified as high job strain. Continuous job strain (quotient of job demands divided by job control) was additionally analyzed as sensitivity analysis. Hazard ratios (HRs) were estimated using multivariable Cox proportional hazards models with adjustment for age, sex, survey, socioeconomic and life-style variables, parental history of diabetes, and body mass index. Results: During a median follow-up of 12.7 years, 291 incident cases of T2DM were observed. The participants with high job strain at baseline had a 45% higher fully adjusted risk to develop T2DM than did those with low job strain (HR = 1.45 [95% confidence interval = 1.00-2.10], p = .048). On the continuous scale, more severe job strain in the magnitude of 1 standard deviation corresponded to a 12% increased fully adjusted T2DM risk (HR = 1.12 [95% confidence interval = 1.00-1.25], p = .045). Conclusions: Men and women who experience high job strain are at higher risk for developing T2DM independently of traditional risk factors. Preventive strategies to combat the globally increasing T2DM epidemic should take into consideration the adverse effects of high strain in the work environment.