Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women

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

doi:10.2337/dc13-2936

Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women

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

Section of Social Medicine

129 Citations (Scopus)

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.

Original language	English
Journal	Diabetes Care
Volume	37
Issue number	8
Pages (from-to)	2268-2275
Number of pages	8
ISSN	0149-5992
DOIs	https://doi.org/10.2337/dc13-2936
Publication status	Published - Aug 2014

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Nyberg, S. T., Fransson, E. I., Heikkilä, K., Ahola, K., Alfredsson, L., Bjørner, J., Borritz, M., Burr, H., Dragano, N., Goldberg, M., Hamer, M., Jokela, M., Knutsson, A., Koskenvuo, M., Koskinen, A., Kouvonen, A., Leineweber, C., Madsen, I. E. H., Magnusson Hanson, L. L., ... IPD-Work Consortium (2014). Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women. Diabetes Care, 37(8), 2268-2275. https://doi.org/10.2337/dc13-2936

Nyberg, ST, Fransson, EI, Heikkilä, K, Ahola, K, Alfredsson, L, Bjørner, J, Borritz, M, Burr, H, Dragano, N, Goldberg, M, Hamer, M, Jokela, M, Knutsson, A, Koskenvuo, M, Koskinen, A, Kouvonen, A, Leineweber, C, Madsen, IEH, Magnusson Hanson, LL, 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 & IPD-Work Consortium 2014, 'Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women', Diabetes Care, vol. 37, no. 8, pp. 2268-2275. https://doi.org/10.2337/dc13-2936

@article{4b5fa4ff75e145b5ae4be1cb3653acef,

title = "Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women",

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.",

author = "Nyberg, {Solja T} and Fransson, {Eleonor I} and Katriina Heikkil{\"a} and Kirsi Ahola and Lars Alfredsson and Jakob Bj{\o}rner and Marianne Borritz and Hermann Burr and Nico Dragano and Marcel Goldberg and Mark Hamer and Markus Jokela and Anders Knutsson and Markku Koskenvuo and Aki Koskinen and Anne Kouvonen and Constanze Leineweber and Madsen, {Ida E H} and {Magnusson Hanson}, {Linda L} and Marmot, {Michael G} and Nielsen, {Martin L} and Maria Nordin and Tuula Oksanen and Pejtersen, {Jan H} and Jaana Pentti and Reiner Rugulies and Paula Salo and Johannes Siegrist and Andrew Steptoe and Sakari Suominen and T{\"o}res Theorell and Ari V{\"a}{\"a}n{\"a}nen and Jussi Vahtera and Marianna Virtanen and Westerholm, {Peter J M} and Hugo Westerlund and Marie Zins and Batty, {G David} and Brunner, {Eric J} and Ferrie, {Jane E} and Archana Singh-Manoux and Mika Kivim{\"a}ki and {IPD-Work Consortium}",

note = "{\textcopyright} 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.",

year = "2014",

month = aug,

doi = "10.2337/dc13-2936",

language = "English",

volume = "37",

pages = "2268--2275",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association",

number = "8",

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TY - JOUR

T1 - Job Strain as a Risk Factor for Type 2 Diabetes

T2 - A Pooled Analysis of 124,808 Men and Women

AU - Nyberg, Solja T

AU - Fransson, Eleonor I

AU - Heikkilä, Katriina

AU - Ahola, Kirsi

AU - Alfredsson, Lars

AU - Bjørner, Jakob

AU - Borritz, Marianne

AU - Burr, Hermann

AU - Dragano, Nico

AU - Goldberg, Marcel

AU - Hamer, Mark

AU - Jokela, Markus

AU - Knutsson, Anders

AU - Koskenvuo, Markku

AU - Koskinen, Aki

AU - Kouvonen, Anne

AU - Leineweber, Constanze

AU - Madsen, Ida E H

AU - Magnusson Hanson, Linda L

AU - Marmot, Michael G

AU - Nielsen, Martin L

AU - Nordin, Maria

AU - Oksanen, Tuula

AU - Pejtersen, Jan H

AU - Pentti, Jaana

AU - Rugulies, Reiner

AU - Salo, Paula

AU - Siegrist, Johannes

AU - Steptoe, Andrew

AU - Suominen, Sakari

AU - Theorell, Töres

AU - Väänänen, Ari

AU - Vahtera, Jussi

AU - Virtanen, Marianna

AU - Westerholm, Peter J M

AU - Westerlund, Hugo

AU - Zins, Marie

AU - Batty, G David

AU - Brunner, Eric J

AU - Ferrie, Jane E

AU - Singh-Manoux, Archana

AU - Kivimäki, Mika

AU - IPD-Work Consortium

PY - 2014/8

Y1 - 2014/8

N2 - 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.

AB - 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.

U2 - 10.2337/dc13-2936

DO - 10.2337/dc13-2936

M3 - Journal article

C2 - 25061139

SN - 0149-5992

VL - 37

SP - 2268

EP - 2275

JO - Diabetes Care

JF - Diabetes Care

IS - 8

ER -

Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women

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