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

Solja T Nyberg 1, * Eleonor I Fransson 2, 3 Katriina Heikkilä 1 Kirsi Ahola 1 Lars Alfredsson 4, 5 Jakob B Bjorner 6 Marianne Borritz 7 Hermann Burr 8 Nico Dragano 9 Marcel Goldberg 10 Mark Hamer 11 Markus Jokela 12, 13 Anders Knutsson 14 Markku Koskenvuo 15 Aki Koskinen 1 Anne Kouvonen 16, 17 Constanze Leineweber 18 Ida E H Madsen 6 Linda L Magnusson Hanson 18 Michael G Marmot 19 Martin L Nielsen 7 Maria Nordin 15 Tuula Oksanen 1 Jan H Pejtersen 20 Jaana Pentti 1 Reiner Rugulies 21, 6 Paula Salo 1, 22 Johannes Siegrist 9 Andrew Steptoe 19 Sakari Suominen 23, 24, 25 Töres Theorell 18 Ari Väänänen 1 Jussi Vahtera 1, 26, 27, 28 Marianna Virtanen 1 Peter J M Westerholm 29 Hugo Westerlund 18 Marie Zins 10 G David Batty 11, 30 Eric J Brunner 19 Jane E Ferrie 31, 32 Archana Singh-Manoux 10, 11 Mika Kivimäki 1, 19, 33, * 
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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Solja T Nyberg, Eleonor I Fransson, Katriina Heikkilä, Kirsi Ahola, Lars Alfredsson, et al.. Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women.: Job Strain and Incident Type 2 Diabetes. Diabetes Care, American Diabetes Association, 2014, 37 (8), pp.2268-75. ⟨10.2337/dc13-2936⟩. ⟨inserm-01153173⟩



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