Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
Diabetes Care. 2013 Sep;36(9):2683-9. doi: 10.2337/dc12-1738. Epub 2013 May 1.
To investigate the prospective influence of work stress on type 2 diabetes (T2D).
This population-based cohort included 3,205 women and 2,227 men, aged 35-56 years, with baseline normal glucose tolerance measured with oral glucose tolerance test. At follow-up 8-10 years later, T2D was diagnosed in 60 women and 111 men. Work stress factors evaluated by questionnaire (i.e., demands, decision latitude, job strain, shift work, overtime work, and also sense of coherence) were studied in association with T2D. Odds ratios (ORs) and 95% CIs adjusted for age, education, BMI, physical activity, smoking, family history of diabetes, and psychological distress were calculated.
In women, low decision latitude was associated with T2D on its own (OR 2.4 [95% CI 1.1-5.2]) and combined with high demands: job strain (OR 4.2 [2.0-8.7]), adjusted for all available potential confounders. Also, shift work increased the risk of T2D in women (OR 2.2 [1.0-4.7]) when adjusted for age, education, and psychological distress, although this risk was diluted after multifactor adjustment (OR 1.9 [0.8-4.4]). In men, high work demands and high strain decreased the risk of T2D (OR 0.5 [0.3-0.9]) for both measures, as did an active job (high demands and high decision latitude, OR 0.4 [0.2-0.9]).
Work stress and shift work may contribute to the development of T2D in women. In men, the risk was decreased by high work demands, high strain, and an active job.
研究工作压力对 2 型糖尿病（T2D）的前瞻性影响。
本研究基于人群的队列纳入了 3205 名女性和 2227 名男性，年龄在 35-56 岁之间，基线时通过口服葡萄糖耐量试验测量空腹血糖正常。8-10 年后的随访中，60 名女性和 111 名男性被诊断为 T2D。通过问卷调查评估工作压力因素（即需求、决策自由度、工作压力、轮班工作、加班工作以及心理一致感）与 T2D 的关系。计算调整年龄、教育程度、BMI、体力活动、吸烟、糖尿病家族史和心理困扰等因素后，比值比（OR）及其 95%置信区间（CI）。
在女性中，低决策自由度与 T2D 本身（OR 2.4 [95%CI 1.1-5.2]）以及与高需求相结合（工作压力：OR 4.2 [2.0-8.7]）相关，调整了所有可用的潜在混杂因素。同样，轮班工作增加了女性 T2D 的风险（OR 2.2 [1.0-4.7]），调整了年龄、教育程度和心理困扰，但在多因素调整后（OR 1.9 [0.8-4.4]）风险降低。在男性中，高工作需求和高压力降低了 T2D 的风险（两种措施的 OR 0.5 [0.3-0.9]），而积极的工作（高需求和高决策自由度，OR 0.4 [0.2-0.9]）也是如此。
工作压力和轮班工作可能导致女性 T2D 的发生。在男性中，高工作需求、高压力和积极的工作降低了风险。
