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

Solja Nyberg; Eleonor Fransson; Katriina Heikkilä; Kirsi Ahola; Lars Alfredsson; Jakob Bjorner; Marianne Borritz; Hermann Burr; Nico Dragano; Marcel Goldberg; Mark Hamer; Markus Jokela; Anders Knutsson; Markku Koskenvuo; Aki Koskinen; Anne Kouvonen; Constanze Leineweber; Ida Madsen; Linda Magnusson Hanson; Michael Marmot; Martin Nielsen; Maria Nordin; Tuula Oksanen; Jan Pejtersen; Jaana Pentti; Reiner Rugulies; Paula Salo; Johannes Siegrist; Andrew Steptoe; Sakari Suominen; Töres Theorell; Ari Väänänen; Jussi Vahtera; Marianna Virtanen; Peter Westerholm; Hugo Westerlund; Marie Zins; G David Batty; Eric Brunner; Jane Ferrie; Archana Singh-Manoux; Mika Kivimäki

doi:10.2337/dc13-2936

Journal articles

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 Nyberg ^{1, *} Eleonor Fransson ^{2, 3} Katriina Heikkilä ¹ Kirsi Ahola ¹ Lars Alfredsson ^{4, 5} Jakob 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 Madsen ⁶ Linda Magnusson Hanson ¹⁸ Michael Marmot ¹⁹ Martin Nielsen ⁷ Maria Nordin ¹⁵ Tuula Oksanen ¹ Jan 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 Westerholm ²⁹ Hugo Westerlund ¹⁸ Marie Zins ¹⁰ G David Batty ^{11, 30} Eric Brunner ¹⁹ Jane Ferrie ^{31, 32} Archana Singh-Manoux ^{10, 11} Mika Kivimäki ^{1, 19, 33, *}

* Corresponding author

1 Finnish Institute of Occupational Health

2 Institute of Environmental Medicine

3 School of Health Sciences

4 Institute of Environmental Medicine

5 Centre for Occupational and Environmental Medicine

6 National Research Centre for the Working Environment

7 Department of Occupational and Environmental Medicine

8 BAuA - Federal Institute for Occupational Safety and Health

9 Institute for Medical Sociology

10 CESP - Centre de recherche en épidémiologie et santé des populations

11 Department of Epidemiology and Public Health

12 Finnish Institute of Occupational Health and Institute of Behavioral Sciences

13 IBS - Institute of Behavioural Sciences [Helsinki]

14 Department of Health Sciences

15 Department of Public Health

16 School of Sociology, Social Policy, & Social Work

17 UKCRC Centre of Excellence for Public Health (NI)

18 Stress Research Institute

19 Department of Epidemiology and Public Health

20 The Danish National Centre for Social Research

21 Department of Public Health [Copenhagen]

22 Department of Psychology

23 Folkhälsan Research Center

24 Department of Public Health

25 Nordic School of Public Health

26 Department of Public Health

27 Finnisth Institute of Occupational Health

28 Turku University Hospital

29 Occupational and Environmental Medicine

30 Centre for Cognitive Ageing and Cognitive Epidemiology

31 Department of Epidemiology and Public Health

32 School of Community and Social Medicine

33 Department of Public Health [Helsinki]

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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Journal articles

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Life Sciences [q-bio] / Santé publique et épidémiologie

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