Diabetes Care：工作压力增加妇女T2DM发病风险

为了研究工作压力对2 型糖尿病(T2D)的预期影响，来自瑞士斯德哥尔摩卡罗琳斯卡医学院医学系和临床流行病学组的Anna-Karin Eriksson博士等人进行了一项研究，研究发现，工作压力和轮班工作促进妇女T2D的发生。而在男性中，工作要求高、工作紧张度高以及积极的工作能够降低T2D风险。研究结果在线发表于2013年5月1日的美国《糖尿病治疗》(Diabetes Care)杂志上。

这是一项基于人口的前瞻性队列研究，研究对象为3,205名女性和2,227男性，年龄35-56岁，口服葡糖糖耐量试验测定基线糖耐量正常。随访8-10年后，60名女性和111名男性被诊断为T2D。研究主要评价工作压力因素(如工作要求、决策自由度、工作紧张度、轮班工作、加班和心理一致感，采用问卷调查法进行调查)与T2D的相关性。经年龄、教育、BMI、体力活动、吸烟、糖尿病家族史和心理困扰校正后，计算危险比(ORs)和95%可信限(CIs)。

结果显示，在妇女中，校正所有可能的潜在混杂因素后，决策自由度低与T2D有关(OR 2.4[95% CI 1.1-5.2]，决策自由度低与工作要求高相结合(即工作紧张度)也与T2D有关(OR 4.2 [2.0-8.7]。并且，经年龄、教育和心理困扰校正后，轮班工作也能增加妇女T2D风险(OR 2.2[1.0-4.7]，虽然这种风险经多因素校正后会有所降低(OR 1.9[0.8-4.4])。在男性中，工作要求和工作紧张度高能降低T2D风险(OR 0.5[0.3-0.9])，积极的工作也一样(工作要求高和决策自由度高，OR 0.4 [0.2-0.9])。

研究表明，工作压力和轮班工作促进妇女T2D的发生。在男性中，工作要求高、工作紧张度高以及积极的工作能够降低T2D风险。

Work Stress, Sense of Coherence, and Risk of Type 2 Diabetes in a Prospective Study of Middle-Aged Swedish Men and Women.
Abstract
OBJECTIVETo investigate the prospective influence of work stress on type 2 diabetes (T2D).RESEARCH DESIGN AND METHODSThis population-based cohort included 3,205 women and 2,227 men, aged 35-56 years, with baseline normal glucose tolerance measured with oral glucose tolerance test. At follow-up 8-10 years later, T2D was diagnosed in 60 women and 111 men. Work stress factors evaluated by questionnaire (i.e., demands, decision latitude, job strain, shift work, overtime work, and also sense of coherence) were studied in association with T2D. Odds ratios (ORs) and 95% CIs adjusted for age, education, BMI, physical activity, smoking, family history of diabetes, and psychological distress were calculated.RESULTSIn women, low decision latitude was associated with T2D on its own (OR 2.4 [95% CI 1.1-5.2]) and combined with high demands: job strain (OR 4.2 [2.0-8.7]), adjusted for all available potential confounders. Also, shift work increased the risk of T2D in women (OR 2.2 [1.0-4.7]) when adjusted for age, education, and psychological distress, although this risk was diluted after multifactor adjustment (OR 1.9 [0.8-4.4]). In men, high work demands and high strain decreased the risk of T2D (OR 0.5 [0.3-0.9]) for both measures, as did an active job (high demands and high decision latitude, OR 0.4 [0.2-0.9]).CONCLUSIONSWork stress and shift work may contribute to the development of T2D in women. In men, the risk was decreased by high work demands, high strain, and an active job.