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肥胖工人代谢综合征的决定因素:使用人工神经网络识别出的与工作相关压力感知及心理特征方面的性别差异。

Determinants of metabolic syndrome in obese workers: gender differences in perceived job-related stress and in psychological characteristics identified using artificial neural networks.

作者信息

Vigna Luisella, Brunani Amelia, Brugnera Agostino, Grossi Enzo, Compare Angelo, Tirelli Amedea S, Conti Diana M, Agnelli Gianna M, Andersen Lars L, Buscema Massimo, Riboldi Luciano

机构信息

Department of Preventive Medicine, Occupational Health Unit, Clinica del Lavoro Luigi Devoto, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.

Rehabilitation Medicine, IRCCS Istituto Auxologico Italiano, S. Giuseppe Hospital, Verbania, Italy.

出版信息

Eat Weight Disord. 2019 Feb;24(1):73-81. doi: 10.1007/s40519-018-0536-8. Epub 2018 Jul 10.

Abstract

OBJECTIVE

The metabolic syndrome (MS) is a multifactorial disorder associated with a higher risk of developing cardiovascular diseases and type 2 diabetes. However, its pathophysiology and risk factors are still poorly understood. In this study, we investigated the associations among gender, psychosocial variables, job-related stress and the presence of MS in a cohort of obese Caucasian workers.

METHODS

A total of 210 outpatients (142 women, 68 men) from an occupational medicine service was enrolled in the study. Age, BMI, waist circumference, fasting glucose, blood pressure, triglycerides and HDL cholesterol were collected to define MS. In addition, we evaluated eating behaviors, depressive symptoms, and work-related stress. Data analyses were performed with an artificial neural network algorithm called Auto Semantic Connectivity Map (AutoCM), using all available variables.

RESULTS

MS was diagnosed in 54.4 and 33.1% of the men and women, respectively. AutoCM evidenced gender-specific clusters associated with the presence or absence of MS. Men with a moderate occupational physical activity, obesity, older age and higher levels of decision-making freedom at work were more likely to have a diagnosis of MS than women. Women with lower levels of decision-making freedom, and higher levels of psychological demands and social support at work had a lower incidence of MS but showed higher levels of binge eating and depressive symptomatology.

CONCLUSION

We found a complex gender-related association between MS, psychosocial risk factors and occupational determinants. The use of these information in surveillance workplace programs might prevent the onset of MS and decrease the chance of negative long-term outcomes.

LEVEL OF EVIDENCE

Level V, observational study.

摘要

目的

代谢综合征(MS)是一种多因素疾病,与心血管疾病和2型糖尿病的发生风险较高相关。然而,其病理生理学和危险因素仍知之甚少。在本研究中,我们调查了一组肥胖白种工人中性别、心理社会变量、工作相关压力与MS存在情况之间的关联。

方法

本研究纳入了来自职业医学服务机构的210名门诊患者(142名女性,68名男性)。收集年龄、体重指数、腰围、空腹血糖、血压、甘油三酯和高密度脂蛋白胆固醇以定义MS。此外,我们评估了饮食行为、抑郁症状和工作相关压力。使用一种名为自动语义连接图(AutoCM)的人工神经网络算法,对所有可用变量进行数据分析。

结果

男性和女性中MS的诊断率分别为54.4%和33.1%。AutoCM证明了与MS存在与否相关的性别特异性聚类。职业体力活动适中、肥胖、年龄较大且工作中决策自由度较高的男性比女性更有可能被诊断为MS。工作中决策自由度较低、心理需求和社会支持水平较高的女性MS发病率较低,但暴饮暴食和抑郁症状水平较高。

结论

我们发现MS、心理社会危险因素和职业决定因素之间存在复杂的性别相关关联。在工作场所监测项目中使用这些信息可能会预防MS的发生,并降低负面长期结果的可能性。

证据水平

V级,观察性研究。

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