Kroenke Candyce H, Spiegelman Donna, Manson JoAnn, Schernhammer Eva S, Colditz Graham A, Kawachi Ichiro
Robert Wood Johnson Health and Society Scholars Program, University of California, San Francisco, CA 94118, USA.
Am J Epidemiol. 2007 Jan 15;165(2):175-83. doi: 10.1093/aje/kwj355. Epub 2006 Oct 27.
The authors prospectively investigated associations between potentially stressful work characteristics and type 2 diabetes incidence in 62,574 young and middle-aged women, aged 29-46 years at baseline in 1993, from the Nurses' Health Study II; 365 cases of type 2 diabetes accrued over 6 years of follow-up. Cox proportional hazards regression was used to simultaneously evaluate associations of hours per week in paid employment, years of rotating night-shift work, and job strain with incidence of type 2 diabetes. In multivariate-adjusted analyses, women working less than 20 hours per week had a lower risk of diabetes (relative risk = 0.80, 95% confidence interval: 0.50, 1.30), and those working overtime (> or =41 hours/week) had an elevated risk of diabetes (relative risk = 1.23, 95% confidence interval: 0.98, 1.55) compared with women working 21-40 hours/week (referent) in paid employment (p(trend) = 0.03). In subsequent analysis, the elevated association appeared stronger in unmarried women (p(interaction) = 0.02). A positive association between years in rotating night-shift work and diabetes was mediated entirely by body weight. Job strain was unrelated to risk of type 2 diabetes. In conclusion, working overtime predicted a slightly elevated risk of type 2 diabetes in young and middle-aged female nurses.
作者对护士健康研究II中62574名年龄在29至46岁之间的年轻及中年女性进行了前瞻性调查，研究潜在压力性工作特征与2型糖尿病发病率之间的关联。这些女性在1993年基线时参与研究；在6年的随访中，共出现365例2型糖尿病病例。采用Cox比例风险回归同时评估每周带薪工作时长、轮班夜班工作年限以及工作压力与2型糖尿病发病率之间的关联。在多变量调整分析中，每周工作少于20小时的女性患糖尿病的风险较低（相对风险=0.80，95%置信区间：0.50，1.30），而与每周带薪工作21至40小时（参照组）的女性相比，加班工作（≥41小时/周）的女性患糖尿病的风险升高（相对风险=1.23，95%置信区间：0.98，1.55）（趋势p值=0.03）。在后续分析中，这种升高的关联在未婚女性中似乎更强（交互作用p值=0.02）。轮班夜班工作年限与糖尿病之间的正相关完全由体重介导。工作压力与2型糖尿病风险无关。总之，加班工作预示着年轻及中年女性护士患2型糖尿病的风险略有升高。
