Center for Life Course Health Research, University of Oulu, Oulu, Finland
Kallio Primary Health Care Unit, Ylivieska, Finland.
Occup Environ Med. 2020 May;77(5):324-332. doi: 10.1136/oemed-2019-106170. Epub 2020 Jan 20.
To evaluate how clinically measured glucose metabolism categories predict registered participation in working life.
In the 46-year follow-up of Northern Finland Birth Cohort 1966 (n=5328, 2342 men and 2986 women), we used oral glucose tolerance tests, surveys and glycated haemoglobin to determine glucose metabolism categorised as normal, pre-diabetes, screen-detected and previous type 2 diabetes (T2D). Consequent participation in working life during the 2-year follow-up period was measured as registered disability, unemployment and employment days, for which incidence rate ratios (IRRs) with 95% CIs were calculated using Poisson regression, adjusted for baseline employment and socioeconomic, health-related and behavioural factors.
In comparison to normal glucose, all categories of impaired glucose metabolism were associated with poorer participation in working life in the unadjusted models. After adjustments, the risks (IRR (95% CI)) of disability days remained heightened by both screen-detected and previous T2D among men (1.3 (1.3 to 1.4) and 1.5 (1.4 to 1.5), respectively), whereas among women the risks were lowered (0.9 (0.8 to 0.9) and 0.9 (0.9 to 1.0), respectively). The risks of unemployment were consistently higher in all categories of impaired glucose metabolism, and were the highest among women with previous T2D (1.6 (1.5 to 1.6)). Correspondingly, the rates of total employment days were lower in relation to screen-detected T2D among men and women (5% and 6%, respectively), and previous T2D (6% and 3%).
Overall, impaired glucose metabolism associated with deteriorated working life participation already in middle age. The high prevalence of impaired glucose metabolism emphasises the need for actions to support sustainable working careers.
评估临床测量的葡萄糖代谢类别如何预测登记参与工作生活。
在芬兰北部出生队列 1966 年的 46 年随访中（n=5328，2342 名男性和 2986 名女性），我们使用口服葡萄糖耐量试验、调查和糖化血红蛋白来确定葡萄糖代谢分类为正常、糖尿病前期、筛查发现和既往 2 型糖尿病（T2D）。在 2 年的随访期间，通过注册残疾、失业和就业天数来衡量随后的工作生活参与情况，使用泊松回归计算发病率比（IRR）及其 95%置信区间，调整了基线就业以及社会经济、健康相关和行为因素。
与正常葡萄糖相比，所有葡萄糖代谢受损类别在未调整模型中与较差的工作生活参与相关。调整后，在男性中，筛查发现和既往 T2D 的残疾天数风险（IRR（95%CI））仍然升高（分别为 1.3（1.3 至 1.4）和 1.5（1.4 至 1.5）），而在女性中，风险降低（分别为 0.9（0.8 至 0.9）和 0.9（0.9 至 1.0））。所有葡萄糖代谢受损类别的失业风险始终较高，既往 T2D 的女性风险最高（1.6（1.5 至 1.6））。相应地，男性和女性中与筛查发现的 T2D 相关的总就业天数（分别为 5%和 6%）以及与既往 T2D 相关的总就业天数（分别为 6%和 3%）均较低。
总体而言，葡萄糖代谢受损与中年时工作生活参与度下降相关。葡萄糖代谢受损的高患病率强调需要采取行动支持可持续的职业发展。
