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上海中国工人工作压力与低高密度脂蛋白血症的关系:罗赛“过劳死”研究

Relationship between Job Stress and Hypo-high-density Lipoproteinemia of Chinese Workers in Shanghai: The Rosai Karoshi Study.

作者信息

Muratsubaki Tomohiko, Hattori Tomomi, Li Jue, Fukudo Shin, Munakata Masanori

机构信息

Department of Behavioural Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.

Research Centre for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai 981-8563, Japan.

出版信息

Chin Med J (Engl). 2016 Oct 20;129(20):2409-2415. doi: 10.4103/0366-6999.191750.

Abstract

BACKGROUND

Karoshi, or death due to overwork, has now become a serious social problem in China. Worsening of cardiovascular risks by stress might initiate karoshi. Many studies have examined the relationship between job stress and obesity, hypertension, and type 2 diabetes mellitus, but less evidence exists for dyslipidemia like hypo-high-density lipoproteinemia (hypo-HDL). The aim of this study was to investigate the relationship between job stress and hypo-HDL of Chinese workers in Shanghai.

METHODS

We studied 2219 Chinese workers in Shanghai, who participated in the Japan-China cooperative study for the prevention of karoshi. A questionnaire was administered to examine the lifestyle characteristics, job category, weekly working hours, and job stress. Job demand and job control were quantified using the National Institute for Occupational Safety and Health questionnaire. Modified job strain measure was defined by the combination of low job control and high demand. Hypo-HDL was defined as plasma high-density lipoprotein cholesterol concentration of <1.04 mmol/L (40 mg/dl). Multivariate logistic regression analysis was performed for hypo-HDL as a dependent variable.

RESULTS

Modified job strain was not related to hypo-HDL either in men or women. In men, multivariate adjusted odds ratio (OR) for having hypo-HDL was significantly higher in the lowest job control tertile compared with the highest job control tertile (OR = 1.39, 95% confidence interval [CI] 1.03-1.87, P = 0.034). In the same model, a similar trend was observed for women, but it did not reach a statistically significant level (OR = 1.51, 95% CI, 0.88-2.56, P = 0.132).

CONCLUSION

A low level of job control but not modified job strain was significantly related to higher prevalence of hypo-HDL of Chinese workers in Shanghai.

摘要

背景

过劳死,即因过度劳累导致的死亡,如今已成为中国一个严重的社会问题。压力导致心血管风险恶化可能引发过劳死。许多研究探讨了工作压力与肥胖、高血压及2型糖尿病之间的关系,但关于血脂异常如低高密度脂蛋白血症(低HDL)的证据较少。本研究旨在调查上海中国工人的工作压力与低HDL之间的关系。

方法

我们对2219名参与日中过劳死预防合作研究的上海中国工人进行了研究。通过问卷调查来了解生活方式特征、工作类别、每周工作时长及工作压力。使用美国国家职业安全与健康研究所的问卷对工作需求和工作控制进行量化。改良的工作紧张度测量指标由低工作控制和高需求组合定义。低HDL定义为血浆高密度脂蛋白胆固醇浓度<1.04 mmol/L(40 mg/dl)。以低HDL为因变量进行多因素逻辑回归分析。

结果

改良的工作紧张度在男性和女性中均与低HDL无关。在男性中,与工作控制最高三分位数相比,工作控制最低三分位数的男性患低HDL的多因素调整优势比(OR)显著更高(OR = 1.39,95%置信区间[CI] 1.03 - 1.87,P = 0.034)。在同一模型中,女性也观察到类似趋势,但未达到统计学显著水平(OR = 1.51,95% CI,0.88 - 2.56,P = 0.132)。

结论

工作控制水平低而非改良的工作紧张度与上海中国工人中低HDL的较高患病率显著相关。

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