Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women
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...
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| Published in | Diabetes care Vol. 37; no. 8; pp. 2268 - 2275 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Alexandria, VA
American Diabetes Association
2014
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0149-5992 1935-5548 1935-5548 |
| DOI | 10.2337/dc13-2936 |
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| Abstract | 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.
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.
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).
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. |
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| AbstractList | 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. 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. 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.OBJECTIVEThe 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.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.RESEARCH DESIGN AND METHODSWe 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.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).RESULTSThere 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).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.CONCLUSIONSFindings 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. 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. 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. 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). 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. 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. 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. 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). 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. 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 healthregisters, clinicalscreening, 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. |
| Author | Singh-Manoux, Archana Burr, Hermann Leineweber, Constanze Nielsen, Martin L. Pejtersen, Jan H. Goldberg, Marcel Kivimäki, Mika Kouvonen, Anne Pentti, Jaana Theorell, Töres Knutsson, Anders Virtanen, Marianna Salo, Paula Jokela, Markus Nordin, Maria Westerholm, Peter J.M. Dragano, Nico Koskenvuo, Markku Fransson, Eleonor I. Marmot, Michael G. Hamer, Mark Vahtera, Jussi Heikkilä, Katriina Nyberg, Solja T. Brunner, Eric J. Siegrist, Johannes Magnusson Hanson, Linda L. Väänänen, Ari Rugulies, Reiner Suominen, Sakari Koskinen, Aki Madsen, Ida E.H. Ahola, Kirsi Oksanen, Tuula Steptoe, Andrew Alfredsson, Lars Bjorner, Jakob B. Borritz, Marianne Westerlund, Hugo Batty, G. David Zins, Marie Ferrie, Jane E. |
| Author_xml | – sequence: 1 givenname: Solja T. surname: Nyberg fullname: Nyberg, Solja T. organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 2 givenname: Eleonor I. surname: Fransson fullname: Fransson, Eleonor I. organization: School of Health Sciences, Jönköping University, Jönköping, Sweden, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, Stress Research Institute, Stockholm University, Stockholm, Sweden – sequence: 3 givenname: Katriina surname: Heikkilä fullname: Heikkilä, Katriina organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 4 givenname: Kirsi surname: Ahola fullname: Ahola, Kirsi organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 5 givenname: Lars surname: Alfredsson fullname: Alfredsson, Lars organization: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden – sequence: 6 givenname: Jakob B. surname: Bjorner fullname: Bjorner, Jakob B. organization: National Research Centre for the Working Environment, Copenhagen, Denmark – sequence: 7 givenname: Marianne surname: Borritz fullname: Borritz, Marianne organization: Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark – sequence: 8 givenname: Hermann surname: Burr fullname: Burr, Hermann organization: Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany – sequence: 9 givenname: Nico surname: Dragano fullname: Dragano, Nico organization: Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany – sequence: 10 givenname: Marcel surname: Goldberg fullname: Goldberg, Marcel organization: Versailles-Saint Quentin University, Versailles, France, Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France – sequence: 11 givenname: Mark surname: Hamer fullname: Hamer, Mark organization: Department of Epidemiology and Public Health, University College London, London, U.K – sequence: 12 givenname: Markus surname: Jokela fullname: Jokela, Markus organization: Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland – sequence: 13 givenname: Anders surname: Knutsson fullname: Knutsson, Anders organization: Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden – sequence: 14 givenname: Markku surname: Koskenvuo fullname: Koskenvuo, Markku organization: Department of Public Health, University of Helsinki, Helsinki, Finland – sequence: 15 givenname: Aki surname: Koskinen fullname: Koskinen, Aki organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 16 givenname: Anne surname: Kouvonen fullname: Kouvonen, Anne organization: School 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 – sequence: 17 givenname: Constanze surname: Leineweber fullname: Leineweber, Constanze organization: Stress Research Institute, Stockholm University, Stockholm, Sweden – sequence: 18 givenname: Ida E.H. surname: Madsen fullname: Madsen, Ida E.H. organization: National Research Centre for the Working Environment, Copenhagen, Denmark – sequence: 19 givenname: Linda L. surname: Magnusson Hanson fullname: Magnusson Hanson, Linda L. organization: Stress Research Institute, Stockholm University, Stockholm, Sweden – sequence: 20 givenname: Michael G. surname: Marmot fullname: Marmot, Michael G. organization: Department of Epidemiology and Public Health, University College London, London, U.K – sequence: 21 givenname: Martin L. surname: Nielsen fullname: Nielsen, Martin L. organization: Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark – sequence: 22 givenname: Maria surname: Nordin fullname: Nordin, Maria organization: Department of Psychology, Umeå University, Umeå, Sweden – sequence: 23 givenname: Tuula surname: Oksanen fullname: Oksanen, Tuula organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 24 givenname: Jan H. surname: Pejtersen fullname: Pejtersen, Jan H. organization: The Danish National Centre for Social Research, Copenhagen, Denmark – sequence: 25 givenname: Jaana surname: Pentti fullname: Pentti, Jaana organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 26 givenname: Reiner surname: Rugulies fullname: Rugulies, Reiner organization: National Research Centre for the Working Environment, Copenhagen, Denmark, Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark – sequence: 27 givenname: Paula surname: Salo fullname: Salo, Paula organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland, Department of Psychology, University of Turku, Turku, Finland – sequence: 28 givenname: Johannes surname: Siegrist fullname: Siegrist, Johannes organization: Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany – sequence: 29 givenname: Andrew surname: Steptoe fullname: Steptoe, Andrew organization: Department of Epidemiology and Public Health, University College London, London, U.K – sequence: 30 givenname: Sakari surname: Suominen fullname: Suominen, Sakari organization: Folkhälsan Research Center, Helsinki, Finland, Nordic School of Public Health, Göteborg, Sweden, Department of Public Health, University of Turku, Turku, Finland – sequence: 31 givenname: Töres surname: Theorell fullname: Theorell, Töres organization: Stress Research Institute, Stockholm University, Stockholm, Sweden – sequence: 32 givenname: Ari surname: Väänänen fullname: Väänänen, Ari organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 33 givenname: Jussi surname: Vahtera fullname: Vahtera, Jussi organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland, Department of Public Health, University of Turku, Turku, Finland, Turku University Hospital, Turku, Finland – sequence: 34 givenname: Marianna surname: Virtanen fullname: Virtanen, Marianna organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland – sequence: 35 givenname: Peter J.M. surname: Westerholm fullname: Westerholm, Peter J.M. organization: Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden – sequence: 36 givenname: Hugo surname: Westerlund fullname: Westerlund, Hugo organization: Stress Research Institute, Stockholm University, Stockholm, Sweden – sequence: 37 givenname: Marie surname: Zins fullname: Zins, Marie organization: Versailles-Saint Quentin University, Versailles, France, Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France – sequence: 38 givenname: G. David surname: Batty fullname: Batty, G. David organization: Department of Epidemiology and Public Health, University College London, London, U.K., Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, U.K – sequence: 39 givenname: Eric J. surname: Brunner fullname: Brunner, Eric J. organization: Department of Epidemiology and Public Health, University College London, London, U.K – sequence: 40 givenname: Jane E. surname: Ferrie fullname: Ferrie, Jane E. organization: Department of Epidemiology and Public Health, University College London, London, U.K., School of Community and Social Medicine, University of Bristol, Bristol, U.K – sequence: 41 givenname: Archana surname: Singh-Manoux fullname: Singh-Manoux, Archana organization: Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France, Department of Epidemiology and Public Health, University College London, London, U.K – sequence: 42 givenname: Mika surname: Kivimäki fullname: Kivimäki, Mika organization: Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland, Department of Epidemiology and Public Health, University College London, London, U.K., Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, Finland |
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| Snippet | 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... 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... 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... |
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| SubjectTerms | Adult Biological and medical sciences Burnout, Professional - complications Burnout, Professional - epidemiology Cohort Studies Diabetes Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Epidemiology/Health Services Research Etiopathogenesis. Screening. Investigations. Target tissue resistance Europe - epidemiology Female Humans Incidence Life Style Male Medical sciences Men Metabolic diseases Middle Aged Obesity - complications Obesity - epidemiology Risk Factors Socioeconomic factors Stress, Psychological - complications Stress, Psychological - epidemiology Surveys and Questionnaires Women Work - psychology Work - statistics & numerical data |
| Title | Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women |
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