Norberg M, Stenlund H, Lindahl B, Andersson C, Eriksson J W, Weinehall L
Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University Umeå, Sweden.
Diabetes Res Clin Pract. 2007 Jun;76(3):368-77. doi: 10.1016/j.diabres.2006.09.002. Epub 2006 Oct 10.
A case-referent study nested within a population-based health survey investigated the associations between psychosocial stress, such as work stress and low emotional support, and future development of type 2 diabetes among occupationally working middle-aged men and women. All participants in a health survey conducted during 1989-2000 (n=33,336) in Umeå in northern Sweden, were included. We identified 191 cases, who were not diabetic initially but were diagnosed with type 2 diabetes after 5.4+/-2.6 years. Two age- and sex-matched referents were selected for each case. Multivariate logistic regression analyses and interaction effects between variables were evaluated. In women, passive or tense working situations were associated with future type 2 diabetes with odds ratios 3.6 (95% confidence interval 1.1-11.7) and 3.6 (1.0-13.3), respectively, and also low emotional support 3.0 (1.3-7.0). These associations were not seen in men. In women, they remained after adjustment for BMI, civil status and educational level, and there were also tendencies for interactions between work stress and low emotional support. In conclusion, work stress and low emotional support may increase the risk of type 2 diabetes in women, but not in men. These findings contribute to our understanding of psychosocial stress as potential risk factors for type 2 diabetes in a Swedish population.
一项基于人群健康调查的病例对照研究,调查了心理社会压力(如工作压力和低情感支持)与职业工作的中年男性和女性未来患2型糖尿病之间的关联。纳入了1989年至2000年期间在瑞典北部于默奥进行的一项健康调查中的所有参与者(n = 33336)。我们确定了191例病例,他们最初并非糖尿病患者,但在5.4±2.6年后被诊断为2型糖尿病。为每个病例选择了两名年龄和性别匹配的对照。评估了多变量逻辑回归分析和变量之间的交互作用。在女性中,被动或紧张的工作环境分别与未来患2型糖尿病相关,优势比为3.6(95%置信区间1.1 - 11.7)和3.6(1.0 - 13.3),低情感支持的优势比为3.0(1.3 - 7.0)。在男性中未观察到这些关联。在女性中,调整体重指数、婚姻状况和教育水平后这些关联依然存在,并且工作压力和低情感支持之间也存在交互作用的趋势。总之,工作压力和低情感支持可能会增加女性患2型糖尿病的风险,但不会增加男性的风险。这些发现有助于我们理解心理社会压力作为瑞典人群中2型糖尿病潜在风险因素的情况。