Brunner Eric J, Chandola Tarani, Marmot Michael G
Department of Epidemiology and Public Health, Royal Free and University College London Medical School, London, England.
Am J Epidemiol. 2007 Apr 1;165(7):828-37. doi: 10.1093/aje/kwk058. Epub 2007 Jan 22.
Positive energy balance is the major cause of obesity, and chronic stress may be a contributory factor. The authors examined cumulative work stress, using the Job Strain Questionnaire on four occasions, as a predictor of obesity in a prospective 19-year study of 6,895 men and 3,413 women (aged 35-55 years) in the Whitehall II cohort in London, United Kingdom (baseline: 1985-1988). A dose-response relation was found between work stress and risk of general obesity (body mass index > or =30 kg/m(2)) and central obesity (waist circumference >102 cm in men, >88 cm in women) that was largely independent of covariates. The imputed odds ratios of body mass index obesity for one, two, and three or more reports of work stress adjusted for age, sex, and social position were 1.17, 1.24, and 1.73 (trend p < 0.01), respectively. For waist obesity, the corresponding findings were 1.17, 1.41, and 1.61 (trend p < 0.01). Work stress effect was modestly attenuated after exclusion of obese individuals at baseline and further adjustments for smoking; intakes of dietary fiber, fruits and vegetables, and alcohol; and levels of physical activity during follow-up. This study provides prospective, population-based evidence that chronic work stress predicts general and central obesity.
正能量平衡是肥胖的主要原因，而慢性压力可能是一个促成因素。在对英国伦敦白厅II队列中6895名男性和3413名女性（年龄在35 - 55岁之间）进行的一项为期19年的前瞻性研究中（基线：1985 - 1988年），作者使用工作压力问卷在四个时间点对累积工作压力进行了检测，以作为肥胖的预测指标。研究发现工作压力与一般肥胖（体重指数≥30 kg/m²）和中心性肥胖（男性腰围>102 cm，女性腰围>88 cm）风险之间存在剂量反应关系，且该关系在很大程度上独立于协变量。在对年龄、性别和社会地位进行调整后，工作压力报告一次、两次以及三次或更多次时体重指数肥胖的归因比值比分别为1.17、1.24和1.73（趋势p<0.01）。对于腰围肥胖，相应的结果分别为1.17、1.41和1.61（趋势p<0.01）。在排除基线时的肥胖个体并进一步对吸烟、膳食纤维、水果和蔬菜以及酒精的摄入量以及随访期间的身体活动水平进行调整后，工作压力的影响略有减弱。这项研究提供了基于人群的前瞻性证据，表明慢性工作压力可预测一般肥胖和中心性肥胖。
