Rautio Nina, Varanka-Ruuska Tuulia, Vaaramo Eeva, Palaniswamy Saranya, Nedelec Rozenn, Miettunen Jouko, Karppinen Jaro, Auvinen Juha, Järvelin Marjo-Riitta, Keinänen-Kiukaanniemi Sirkka, Sebert Sylvain, Ala-Mursula Leena
Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, OYS, P.O. Box 20, 90029 Oulu, Finland.
Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Kallio Primary Health Care Unit, Kirkkotie 4, 84100 Ylivieska, Finland.
Prim Care Diabetes. 2017 Aug;11(4):365-372. doi: 10.1016/j.pcd.2017.03.010. Epub 2017 Apr 26.
We explored whether registered unemployment is associated with impaired glucose metabolism in general population.
Based on Northern Finland Birth Cohort 1966 at 46 years, we analyzed the oral glucose tolerance tests of 1970 men and 2544 women in relation to their preceding three-year employment records in three categories of unemployment exposure: no (employed), low (≤1-year) and high exposure (>1-year).
Among men, pre-diabetes was found in 19.2% of those with no unemployment, 23.0% with low and 27.0% with high exposure, the corresponding figures for screen-detected type 2 diabetes were 3.8%, 3.8% and 9.2% (p<0.01). Among women, analogous figures for pre-diabetes were 10.0%, 12.6% and 16.2% and for screen-detected type 2 diabetes 1.7%, 3.4% and 3.6% (p<0.01). Men with high exposure to unemployment had a higher risk for pre-diabetes (OR 1.61, CI 95% 1.03-2.51) and screen-detected type 2 diabetes (OR 2.58 95% CI 1.23-5.44) than employed men, after adjustment for education, smoking, alcohol intake, physical activity and body mass index. Among women, associations were attenuated in the adjusted models.
High exposure to unemployment may predispose to type 2 diabetes in middle-aged men. For clinicians, awareness of the patient's unemployment status may be helpful in recognizing undiagnosed cases.
我们探讨了登记失业是否与普通人群的糖代谢受损有关。
基于1966年出生的芬兰北部队列研究对象46岁时的情况，我们分析了1970名男性和2544名女性的口服葡萄糖耐量试验结果，并将其与他们之前三年在三类失业暴露情况下的就业记录相关联：无（就业）、低（≤1年）和高暴露（>1年）。
在男性中，无失业经历者的糖尿病前期患病率为19.2%，低暴露者为23.0%，高暴露者为27.0%；筛查发现的2型糖尿病相应患病率分别为3.8%、3.8%和9.2%（p<0.01）。在女性中，糖尿病前期的类似患病率分别为10.0%、12.6%和16.2%，筛查发现的2型糖尿病患病率分别为1.7%、3.4%和3.6%（p<0.01）。在对教育程度、吸烟、饮酒、身体活动和体重指数进行调整后，高暴露于失业的男性患糖尿病前期（比值比1.61，95%置信区间1.03 - 2.51）和筛查发现的2型糖尿病（比值比2.58，95%置信区间1.23 - 5.44）的风险高于就业男性。在女性中，调整后的模型中关联减弱。
高暴露于失业可能使中年男性易患2型糖尿病。对于临床医生来说，了解患者的失业状况可能有助于识别未确诊的病例。
