Kittel F, Leynen F, Stam M, Dramaix M, de Smet P, Mak R, De Backer G, Kornitzer M
Epidemiology and Health Promotion Department, Health Psychology Unit, School of Public Health, Université Libre Bruxelles, Erasmus Campus CP 596, route de Lennik, 808-1070 Brussels, Belgium.
Eur Heart J. 2002 Dec;23(23):1841-8. doi: 10.1053/euhj.2002.3258.
To investigate the relationship between fibrinogen and stressful work conditions, where perceived strain is defined by the simultaneous presence of high psychological demands and low control, according to Karasek's Demand/Control/(Social Support) model.
A cross-sectional study was realized between 1994 and 1998 in 24 Belgian enterprises, on 16335 male and 5084 female middle-aged workers of different Belgian companies participating in the Belstress study. This study confirmed the well-documented bivariate relationship between plasma fibrinogen levels and gender, age, educational level, smoking, obesity, physical activity, alcohol consumption, total cholesterol, HDL-cholesterol, arterial hypertension and diabetes. No independent multivariate relationship was observed between job control, psychological job demands or social support at work and plasma fibrinogen, but after stratification a positive association (P< or =0.05) was observed between psychological job demands and plasma fibrinogen for males in the lowest educational level. Moreover a positive statistically significant association between job strain and plasma fibrinogen was observed in males but not in females. After stratification for educational level this association remained significant for males especially in the lowest educational level (P< or =0.001) and became significant for females in the middle educational level. CONCLUSIONS; As suggested in our study and others, plasma fibrinogen could be one of the potential mediators explaining the relationship between job stress and coronary heart disease.
根据Karasek的需求/控制/（社会支持）模型，研究纤维蛋白原与压力工作条件之间的关系，其中感知到的压力由高心理需求和低控制的同时存在来定义。
1994年至1998年期间，在24家比利时企业中对参与Belstress研究的不同比利时公司的16335名男性和5084名女性中年工人进行了横断面研究。该研究证实了血浆纤维蛋白原水平与性别、年龄、教育水平、吸烟、肥胖、身体活动、饮酒、总胆固醇、高密度脂蛋白胆固醇、动脉高血压和糖尿病之间已得到充分记录的双变量关系。未观察到工作控制、心理工作需求或工作中的社会支持与血浆纤维蛋白原之间存在独立的多变量关系，但分层后，在教育水平最低的男性中，观察到心理工作需求与血浆纤维蛋白原之间存在正相关（P≤0.05）。此外，在男性中观察到工作压力与血浆纤维蛋白原之间存在统计学上显著的正相关，而在女性中未观察到。按教育水平分层后，这种相关性在男性中仍然显著，尤其是在教育水平最低的男性中（P≤0.001），在教育水平中等的女性中也变得显著。结论：正如我们的研究和其他研究所表明的，血浆纤维蛋白原可能是解释工作压力与冠心病之间关系的潜在中介因素之一。
