TitleJob strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women.
Publication TypeJournal Article
Year of Publication2014
AuthorsNyberg, ST, Fransson, EI, Heikkilä, K, Ahola, K, Alfredsson, L, Bjorner, JB, Borritz, M, Burr, H, Dragano, N, Goldberg, M, Hamer, M, Jokela, M, Knutsson, A, Koskenvuo, M, Koskinen, A, Kouvonen, A, Leineweber, C, Madsen, IEH, Hanson, LLMagnusso, Marmot, MG, Nielsen, ML, Nordin, M, Oksanen, T, Pejtersen, JH, Pentti, J, Rugulies, R, Salo, P, Siegrist, J, Steptoe, A, Suominen, S, Theorell, T, Väänänen, A, Vahtera, J, Virtanen, M, Westerholm, PJM, Westerlund, H, Zins, M, Batty, GD, Brunner, EJ, Ferrie, JE, Singh-Manoux, A, Kivimäki, M
Corporate AuthorsIPD-Work Consortium
JournalDiabetes Care
Volume37
Issue8
Pagination2268-75
Date Published2014 Aug
ISSN1935-5548
KeywordsAdult, Burnout, Professional, Cohort Studies, Diabetes Mellitus, Type 2, Europe, Female, Humans, Incidence, Life Style, Male, Middle Aged, Obesity, Risk Factors, Stress, Psychological, Surveys and Questionnaires, Work
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.

DOI10.2337/dc13-2936
Alternate JournalDiabetes Care
PubMed ID25061139
PubMed Central IDPMC4113178
Grant ListRG/13/2/30098 / / British Heart Foundation / United Kingdom
R01 HL036310 / HL / NHLBI NIH HHS / United States
G19/35 / / Medical Research Council / United Kingdom
G0100222 / / Medical Research Council / United Kingdom
MR/K023241/1 / / Medical Research Council / United Kingdom
K013351 / / Medical Research Council / United Kingdom
RG/10/005/28296 / / British Heart Foundation / United Kingdom
G8802774 / / Medical Research Council / United Kingdom
G0902037 / / Medical Research Council / United Kingdom
R01 AG034454 / AG / NIA NIH HHS / United States
MR/K026992/1 / / Medical Research Council / United Kingdom
G1000616 / / Medical Research Council / United Kingdom
G0701830 / / Medical Research Council / United Kingdom
MR/K013351/1 / / Medical Research Council / United Kingdom
R01-AG-034454 / AG / NIA NIH HHS / United States
G0601647 / / Medical Research Council / United Kingdom
R01-HL-036310 / HL / NHLBI NIH HHS / United States
RG/07/008/23674 / / British Heart Foundation / United Kingdom