Abstract
Objective
The studies focusing on effort–reward imbalance and diabetes mellitus (DM)/glycosylated hemoglobin (HbA1c) are rare. We sought to examine the association between job tress evaluated by effort–reward imbalance (ERI) model and HbA1c in a Chinese population.
Methods
We analyzed 680 subjects (465 men and 215 women) without DM or impaired glucose tolerance from the stress and health in Shenzhen workers (SHISO) study. Job stress was evaluated by effort–reward imbalance (ERI) model. HbA1c was measured by an automatic analyzer by means of high-performance liquid chromatography. The association between job stress and HbA1c was explored by variance analysis, partial correlations and multiple linear regression analysis.
Results
For women, effort, and ERI were positively associated with HbA1c (r = 0.22, p = 0,003; r = 0.21, p = 0.006, respectively), in contrast, reward was negatively associated with HbA1c (r = −0.17, p = 0.021), after controlling age, BMI and physical exercise in the partial correlation analysis; the similar results were confirmed in the multiple linear regression. No significant correlations between job stress and HbA1c were found for men.
Conclusion
Effort and ERI are positively associated with HbA1c, and reward is inversely related to HbA1c among Chinese women. The association is not accounted for by age, BMI, and physical exercise. More efforts should be made to improve the job stress status of Chinese working women for the purpose of DM prevention.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Agardh EE, Ahlbom A, Andersson T, Efendic S, Grill V, Hallqvist J et al (2003) Work stress and low sense of coherence is associated with type 2 diabetes in middle-aged Swedish women. Diabetes Care 26(3):719–724
Berliner HS, Ginzberg E (2002) Why this hospital nursing shortage is different. JAMA 288(21):2742–2744
Cesana G, Panza G, Ferrario M, Zanettini R, Arnoldi M, Grieco A (1985) Can glycosylated hemoglobin be a job stress parameter? J Occup Med 27(5):357–360
Chandola T, Kuper H, Singh-Manoux A, Bartley M, Marmot M (2004) The effect of control at home on CHD events in the whitehall II study: gender differences in psychosocial domestic pathways to social inequalities in CHD. Soc Sci Med 58(8):1501–1509
Feldman PJ, Steptoe A (2003) Psychosocial and socioeconomic factors associated with glycated hemoglobin in nondiabetic middle-aged men and women. Health Psychol 22(4):398–405
Grossi G, Perski A, Evengard B, Blomkvist V, Orth-Gomer K (2003) Physiological correlates of burnout among women. J Psychosom Res 55(4):309–316
Hansen AM, Kaergaard A, Andersen JH, Netterstrom B (2003) Association between repetitive work and endocrinological indicators of stress. Work Stress 17:264–276
Hansen AM, Larsen AD, Rugulies R, Garde AH, Knudsen LE (2009) A review of the effect of the psychosocial working environment on physiological changes in blood and urine. Basic Clin Pharmacol Toxicol 105(2):73–83
Hayashino Y, Yamazaki S, Nakayama T, Sokejima S, Fukuhara S (2010) The association between socioeconomic status and prevalence of diabetes mellitus in rural Japan. Arch Environ Occup Health 65(4):224–229
Heraclides A, Chandola T, Witte DR, Brunner EJ (2009) Psychosocial stress at work doubles the risk of type 2 diabetes in middle-aged women: evidence from the Whitehall II study. Diabetes Care 32(12):2230–2235
Kawakami N, Araki S, Hayashi T, Masumoto T (1989) Relationship between perceived job-stress and glycosylated hemoglobin in white-collar workers. Ind Health 27(4):149–154
Kawakami N, Akachi K, Shimizu H, Haratani T, Kobayashi F, Ishizaki M et al (2000) Job strain, social support in the workplace, and haemoglobin A1c in Japanese men. Occup Environ Med 57(12):805–809
Kroenke CH, Spiegelman D, Manson J, Schernhammer ES, Colditz GA, Kawachi I (2007) Work characteristics and incidence of type 2 diabetes in women. Am J Epidemiol 165(2):175–183
Kumari M, Head J, Marmot M (2004) Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. Arch Intern Med 164(17):1873–1880
Lee S, Colditz GA, Berkman LF, Kawachi I (2003) Caregiving and risk of coronary heart disease in U.S. women: a prospective study. Am J Prev Med 24(2):113–119
Leynen F, Moreau M, Pelfrene E, Clays E, De Backer G, Kornitzer M (2003) Job stress and prevalence of diabetes: results from the Belstress study. Arch Public Health 61:75–90
Li J, Yang W, Cheng Y, Siegrist J, Cho SI (2005) Effort-reward imbalance at work and job dissatisfaction in Chinese healthcare workers: a validation study. Int Arch Occup Environ Health 78(3):198–204
Li J, Yang W, Cho SI (2006) Gender differences in job strain, effort-reward imbalance, and health functioning among Chinese physicians. Soc Sci Med 62(5):1066–1077
Li L, Chen Q, Jia R, Cui X (2008) The smoking pattern and disease burden of tobacco use in China. Chin Health Econ 27:26–30
Lippi G, Targher G (2010) Glycated hemoglobin (HbA1c): old dogmas, a new perspective? Clin Chem Lab Med 48(5):609–614
Matsushita K, Blecker S, Pazin-Filho A, Bertoni A, Chang PP, Coresh J et al (2010) The association of hemoglobin a1c with incident heart failure among people without diabetes: the atherosclerosis risk in communities study. Diabetes 59(8):2020–2026
Norberg M, Stenlund H, Lindahl B, Andersson C, Eriksson JW, Weinehall L (2007) Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women. Diabetes Res Clin Pract 76(3):368–377
Ostry AS, Hershler R, Chen L, Hertzman C (2004) A longitudinal study comparing the effort-reward imbalance and demand-control models using objective measures of physician utilization. Scand J Public Health 32(6):456–463
Rivera JJ, Choi EK, Yoon YE, Chun EJ, Choi SI, Nasir K et al (2010) Association between increasing levels of hemoglobin A1c and coronary atherosclerosis in asymptomatic individuals without diabetes mellitus. Coron Artery Dis 21(3):157–163
Safraj S, Anish T, Vijayakumar K, Kutty VR, Soman CR (2010) Socioeconomic position and prevalence of self-reported diabetes in rural Kerala, India: results from the PROLIFE study. Asia Pac J Public Health [Epub ahead of print]
Shaw JE, Sicree RA, Zimmet PZ (2010) Global estimates of the prevalence of diabetes for 2010, and 2030. Diabetes Res Clin Pract 87(1):4–14
Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol 1(1):27–41
Xu L, Siegrist J, Cao W, Li L, Tomlinson B, Chan J (2004) Measuring job stress and family stress in Chinese working women: a validation study focusing on blood pressure and psychosomatic symptoms. Women Health 39(2):31–46
Xu W, Zhao Y, Guo L, Guo Y, Gao W (2009) Job stress and coronary heart disease: a case-control study using a Chinese population. J Occup Health 51(2):107–113
Xu W, Hang J, Cao T, Shi R, Zeng W, Deng Y et al (2010a) Job stress and carotid intima-media thickness in Chinese workers. J Occup Health 52(5):257–262
Xu W, Zhao Y, Guo L, Guo Y, Gao W (2010b) The association between effort-reward imbalance and coronary atherosclerosis in a Chinese sample. Am J Ind Med 53(7):655–661
Acknowledgments
The authors thank Jian Li, Paul Landsbergis, Peter Schnall, Haiou Yang, Tingting Cao, Rong Shi, Wenshuang Zeng, and Yuanfei Deng for their help. The study was supported by Major National Basic Research Program of the PR China (No. 2007CB512107 to W. G.).
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Xu, W., Hang, J., Gao, W. et al. Association between effort–reward imbalance and glycosylated hemoglobin (HbA1c) among Chinese workers: results from SHISO study. Int Arch Occup Environ Health 85, 215–220 (2012). https://doi.org/10.1007/s00420-011-0650-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-011-0650-7