Huth Cornelia, Thorand Barbara, Baumert Jens, Kruse Johannes, Emeny Rebecca Thwing, Schneider Andrea, Meisinger Christa, Ladwig Karl-Heinz
From the Institute of Epidemiology II (C.H., B.T., J.B., R.T.E., A.S., C.M., K.-H.L), Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD) (C.H., B.T., A.S., C.M.), Neuherberg, Germany; Department of Psychosomatic Medicine and Psychotherapy (J.K.), University of Gießen, Gießen, Germany; Department of Psychosomatic Medicine and Psychotherapy (J.K.), University of Marburg, Marburg, Germany; MONICA/KORA Myocardial Infarction Registry (C.M.), Central Hospital of Augsburg, Augsburg, Germany; and Department of Psychosomatic Medicine and Psychotherapy (K.-H.L.), Klinikum Rechts der Isar, Technische Universität München (TUM), Munich, Germany.
Psychosom Med. 2014 Sep;76(7):562-8. doi: 10.1097/PSY.0000000000000084.
To examine whether job strain is associated with an increased risk of subsequent Type 2 diabetes mellitus (T2DM) development in a population-based study of men and women.
Data were derived from the prospective MONICA/KORA Augsburg study. We investigated 5337 working participants aged 29 to 66 years without diabetes at one of the three baseline surveys. Job strain was measured by the Karasek job content questionnaire. High job strain was defined by the quadrant approach, where high job demands combined with low job control were classified as high job strain. Continuous job strain (quotient of job demands divided by job control) was additionally analyzed as sensitivity analysis. Hazard ratios (HRs) were estimated using multivariable Cox proportional hazards models with adjustment for age, sex, survey, socioeconomic and life-style variables, parental history of diabetes, and body mass index.
During a median follow-up of 12.7 years, 291 incident cases of T2DM were observed. The participants with high job strain at baseline had a 45% higher fully adjusted risk to develop T2DM than did those with low job strain (HR = 1.45 [95% confidence interval = 1.00-2.10], p = .048). On the continuous scale, more severe job strain in the magnitude of 1 standard deviation corresponded to a 12% increased fully adjusted T2DM risk (HR = 1.12 [95% confidence interval = 1.00-1.25], p = .045).
Men and women who experience high job strain are at higher risk for developing T2DM independently of traditional risk factors. Preventive strategies to combat the globally increasing T2DM epidemic should take into consideration the adverse effects of high strain in the work environment.
在一项基于人群的男性和女性研究中，探讨工作压力是否与后续发生2型糖尿病（T2DM）的风险增加相关。
数据来源于前瞻性的奥格斯堡地区动脉粥样硬化风险因素监测/合作健康研究（MONICA/KORA）。我们在三次基线调查中的一次调查了5337名年龄在29至66岁之间且无糖尿病的在职参与者。工作压力通过Karasek工作内容问卷进行测量。高工作压力采用象限法定义，即高工作要求与低工作控制相结合被归类为高工作压力。作为敏感性分析，还额外分析了连续工作压力（工作要求与工作控制的商数）。使用多变量Cox比例风险模型估计风险比（HRs），并对年龄、性别、调查、社会经济和生活方式变量、糖尿病家族史以及体重指数进行了调整。
在中位随访12.7年期间，观察到291例T2DM新发病例。基线时工作压力高的参与者发生T2DM的完全调整风险比工作压力低的参与者高45%（HR = 1.45 [95%置信区间 = 1.00 - 2.10]，p = 0.048）。在连续量表上，工作压力每增加1个标准差，完全调整后的T2DM风险增加12%（HR = 1.12 [95%置信区间 = 1.
