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Diabetes Care. 2014 Aug;37(8):2268-75. doi: 10.2337/dc13-2936.

Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women.

Author information

  • 1Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland solja.nyberg@ttl.fi m.kivimaki@ucl.ac.uk.
  • 2School of Health Sciences, Jönköping University, Jönköping, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenStress Research Institute, Stockholm University, Stockholm, Sweden.
  • 3Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland.
  • 4Institute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenCentre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
  • 5National Research Centre for the Working Environment, Copenhagen, Denmark.
  • 6Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
  • 7Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
  • 8Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
  • 9Versailles-Saint Quentin University, Versailles, FranceInserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
  • 10Department of Epidemiology and Public Health, University College London, London, U.K.
  • 11Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
  • 12Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
  • 13Department of Public Health, University of Helsinki, Helsinki, Finland.
  • 14School of Sociology, Social Policy & Social Work, Queen's University Belfast, Belfast, U.K.UKCRC Centre of Excellence for Public Health Northern Ireland, Queen's University Belfast, Belfast, U.K.
  • 15Stress Research Institute, Stockholm University, Stockholm, Sweden.
  • 16Department of Psychology, Umeå University, Umeå, Sweden.
  • 17The Danish National Centre for Social Research, Copenhagen, Denmark.
  • 18National Research Centre for the Working Environment, Copenhagen, DenmarkDepartment of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
  • 19Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, FinlandDepartment of Psychology, University of Turku, Turku, Finland.
  • 20Folkhälsan Research Center, Helsinki, FinlandNordic School of Public Health, Göteborg, SwedenDepartment of Public Health, University of Turku, Turku, Finland.
  • 21Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, FinlandDepartment of Public Health, University of Turku, Turku, FinlandTurku University Hospital, Turku, Finland.
  • 22Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
  • 23Department of Epidemiology and Public Health, University College London, London, U.K.Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, U.K.
  • 24Department of Epidemiology and Public Health, University College London, London, U.K.School of Community and Social Medicine, University of Bristol, Bristol, U.K.
  • 25Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, FranceDepartment of Epidemiology and Public Health, University College London, London, U.K.
  • 26Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, FinlandDepartment of Epidemiology and Public Health, University College London, London, U.K.Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, Finland solja.nyberg@ttl.fi m.kivimaki@ucl.ac.uk.

Abstract

OBJECTIVE:

The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors.

RESEARCH DESIGN AND METHODS:

We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses.

RESULTS:

There were 3,703 cases of incident diabetes during a mean follow-up of 10.3 years. After adjustment for age, sex, and socioeconomic status (SES), the hazard ratio (HR) for job strain compared with no job strain was 1.15 (95% CI 1.06-1.25) with no difference between men and women (1.19 [1.06-1.34] and 1.13 [1.00-1.28], respectively). In stratified analyses, job strain was associated with an increased risk of diabetes among those with healthy and unhealthy lifestyle habits. In a multivariable model adjusted for age, sex, SES, and lifestyle habits, the HR was 1.11 (1.00-1.23).

CONCLUSIONS:

Findings from a large pan-European dataset suggest that job strain is a risk factor for type 2 diabetes in men and women independent of lifestyle factors.

© 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

PMID:
25061139
[PubMed - indexed for MEDLINE]
PMCID:
PMC4113178
Free PMC Article
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