Liu Herong, Song Hui, Tian Rulong, Chen Lijun, Zhang Wei, Qiang Yan
School of Public Health, Ningxia Medical University, Yinchuan 750004, China.
E-mail:
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2015 Feb;33(2):88-92.
To investigate the association between occupational psychological stress and metabolic syndrome (MS) in Hui and Han populations in Ningxia, China.
A 1:1 matched case-control study was performed. A total of 600 unrelated patients aged from 20 to 60 years who were clearly diagnosed with MS in General Hospital of Ningxia Medical University and Wuzhong People's Hospital from October 2011 to October 2012 were collected as the case group (MS group). A total of 600 healthy people who underwent a regular health examination in the same hospital during the same period were selected as the control group with matched gender, nationality, and age (≤ ± 3 years). The self-designed questionnaire was used to investigate the general situations and do the physical examination, and the fasting venous blood samples were collected for laboratory biochemical blood tests. The Occupational Stress Inventory (OSI) was used to investigate the subjects' occupational stress factors and stress levels.
With the increase in stress levels, the levels of WC, FPG, TG, AST, and UA were increased, WHR, SBP, and DBP first increased and then decreased, and the level of HDL-C increased. There were statistically significant differences in these parameters between the two groups (P < 0.05 or 0.01). The occupational psychological stress test results showed that the total score of stress factors (t = 6.676, P < 0.05), workload (t = 10.269, P < 0.05), interpersonal relationship (t = 6.569, P < 0.05), family/work balance (t = 2.028, P < 0.05), cognitive load (t = 8.714, P < 0.05), and other scores (t = 2.838, P < 0.05) in the MS group were all significantly higher than those in the control group, but there were no significant differences in the scores of management role, work responsibilities, and organizational climate between the MS group and the control group (P>0.05). There were no significant differences in the total score of stress factors and the score of each factor between Hui and Han groups (P>0.05). The relative risks of MS in the people with moderate stress exposure were 2.325 and 2.331 times those in the people with mild stress exposure before and after adjustment for age, gender, education level, marriage status, smoking, and drinking, and the relative risks for MS in the people with severe stress exposure were 3.000 and 3.126 times those in the people with mild stress exposure. There were significant differences in the detection rates of abdominal obesity, high TG, low HDL-C, hypertension, hyperglycemia, and diabetes between the sub-groups with different stress levels in the MS group (χ² = 17.636, 8.514, 14.640, 14.280, and 33.323, P < 0.01). The results of multivariate conditional logistic regression analysis showed that the risk factors for MS were SBP, TG, LDL-C, UA, BMI, fasting blood glucose, family history of hypertension, family history of diabetes, and the level of psychological stress in Ningxia, and the protective factor for MS was HDL-C.
The occupational psychological stress is closely associated with MS, and it is an environmental risk factor for MS. With the increase in the stress level, the detection rates of MS components and the relative risk for MS are significantly increased. And there is no significant difference in the level of occupational psychological stress between the Hui and Han nationality groups.
探讨中国宁夏回族和汉族人群职业心理压力与代谢综合征(MS)之间的关联。
进行1:1匹配的病例对照研究。收集2011年10月至2012年10月在宁夏医科大学总医院和吴忠市人民医院明确诊断为MS的600例20至60岁无亲属关系的患者作为病例组(MS组)。同期在同一家医院进行定期健康体检的600例健康人作为对照组,匹配性别、民族和年龄(≤±3岁)。采用自行设计的问卷调查一般情况并进行体格检查,采集空腹静脉血样本进行实验室生化血液检测。使用职业压力量表(OSI)调查受试者的职业压力因素和压力水平。
随着压力水平的升高,腰围、空腹血糖、甘油三酯、谷草转氨酶和尿酸水平升高,腰臀比、收缩压和舒张压先升高后降低,高密度脂蛋白胆固醇水平升高。两组这些参数差异有统计学意义(P<0.05或0.01)。职业心理压力测试结果显示,MS组的压力因素总分(t=6.676,P<0.05)、工作量(t=10.269,P<0.05)、人际关系(t=6.569,P<0.05)、家庭/工作平衡(t=2.028,P<0.05)、认知负荷(t=8.7,14,P<0.05)及其他得分(t=2.838,P<0.05)均显著高于对照组,但MS组与对照组在管理角色、工作职责和组织氛围得分方面差异无统计学意义(P>0.05)。回族和汉族组在压力因素总分及各因素得分方面差异无统计学意义(P>0.05)。在调整年龄、性别、教育程度、婚姻状况、吸烟和饮酒因素前后,中度压力暴露人群患MS的相对风险分别是轻度压力暴露人群的2.325倍和2.331倍,重度压力暴露人群患MS的相对风险分别是轻度压力暴露人群的3.000倍和3.126倍。MS组不同压力水平亚组间腹型肥胖、高甘油三酯、低高密度脂蛋白胆固醇、高血压、高血糖和糖尿病的检出率差异有统计学意义(χ²=17.636、8.514、14.640、14.280和33.323,P<0.01)。多因素条件logistic回归分析结果显示,宁夏MS的危险因素为收缩压、甘油三酯、低密度脂蛋白胆固醇、尿酸、体重指数、空腹血糖、高血压家族史、糖尿病家族史及心理压力水平,MS的保护因素为高密度脂蛋白胆固醇。
职业心理压力与MS密切相关,是MS的一个环境危险因素。随着压力水平的升高,MS各组分的检出率及患MS的相对风险显著增加。回族和汉族人群职业心理压力水平差异无统计学意义。