Previous work suggested no or inconsistent associations between components of work-related stress and type 2 diabetes risk, but suggested sex-specific differences should be further investigated, as women potentially had higher risks.
We analyzed data from 73 517 women, mostly teachers, from the E3N cohort study followed for 22 years (1992–2014), to study the association between mentally tiring work, used as a proxy of job demands, and type 2 diabetes risk. Univariate and multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals.
A total of 4187 incident cases of type 2 diabetes cases were observed. There was a higher type 2 diabetes risk for women with a ‘Very mentally tiring work’ when compared to women with ‘Little or not mentally tiring work’ (HR = 1.21 (1.09–1.35)). This association was independent of unhealthy lifestyle and traditional metabolic factors. An interaction between mentally tiring work and BMI was detected (P < 0.0001), with a stronger association being observed in non-overweight women, HR = 1.26 (1.08–1.47) vs HR = 1.14 (0.98, 1.32), in overweight women.
We observed an increased risk of type 2 diabetes associated with mentally tiring work, used as a proxy of job demands. These observational results suggest the importance of taking into consideration the potential long-term metabolic impact of work-related stress for women working in a demanding environment. Increased support for such women should be investigated in intervention studies.
KarasekRBakerDMarxerFAhlbomATheorellT.Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. American Journal of Public Health198171694–705. (https://doi.org/10.2105/AJPH.71.7.694)
FishtaABackéEM.Psychosocial stress at work and cardiovascular diseases: an overview of systematic reviews. International Archives of Occupational and Environmental Health201588997–1014. (https://doi.org/10.1007/s00420-015-1019-0)
KivimäkiMNybergSTFranssonEIHeikkiläKAlfredssonLCasiniAClaysEDe BacquerDDraganoNFerrieJEet al. Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data. CMAJ2013185763–769. (https://doi.org/10.1503/cmaj.121735)
WatanabeKSakurayaAKawakamiNImamuraKAndoEAsaiYEguchiHKobayashiYNishidaNArimaHet al. Work-related psychosocial factors and metabolic syndrome onset among workers: a systematic review and meta-analysis. Obesity Reviews2018191557–1568. (https://doi.org/10.1111/obr.12725).
SuiHSunNZhanLLuXChenTMaoX.Association between work-related stress and risk for Type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. PLOS ONE201611e0159978. (https://doi.org/10.1371/journal.pone.0159978)
RyuHMoonJJungJ.Influence of health behaviors and occupational stress on prediabetic state among male office workers. International Journal of Environmental Research and Public Health201815 E1264. (https://doi.org/10.3390/ijerph15061264).
Van LaethemMBeckersDGJKompierMAJKecklundGvan den BosscheSNGeurtsSAE.Bidirectional relations between work-related stress, sleep quality and perseverative cognition. Journal of Psychosomatic Research201579391–398. (https://doi.org/10.1016/j.jpsychores.2015.08.011)
DescathaAHansonLLMMadsenIEHRuguliesRPeristeraPWesterlundH.Accuracy of a single item on mentally tiring work as proxy measure of job demands and efforts in the Gazel cohort. Journal of Occupational and Environmental Medicine201759e156–e158. (https://doi.org/10.1097/JOM.0000000000001093)
FagherazziGGustoGBalkauBBoutron-RuaultMCClavel-ChapelonFBonnetF.Functional gastrointestinal disorders and incidence of type 2 diabetes: evidence from the E3N–EPIC cohort study. Diabetes and Metabolism201642178–183. (https://doi.org/10.1016/j.diabet.2015.11.006)
KengneAPBeulensJWJPeelenLMMoonsKGMvan der SchouwYTSchulzeMBSpijkermanAMWGriffinSJGrobbeeDEPallaLet al. Non-invasive risk scores for prediction of type 2 diabetes (EPIC-InterAct): a validation of existing models. Lancet Diabetes and Endocrinology2014219–29. (https://doi.org/10.1016/S2213-8587(13)70103-7)
ManciniFRDowCAffretARajaobelinaKDartoisLBalkauBBonnetFBoutron-RuaultMCFagherazziG.Micronutrient dietary patterns associated with type 2 diabetes mellitus among women of the E3N-EPIC (Etude Epidémiologique auprès de femmes de l’Education Nationale) cohort study. Journal of Diabetes201810665–674. (https://doi.org/10.1111/1753-0407.12654).
CottetVTouvierMFournierATouillaudMSLafayLClavel-ChapelonFBoutron-RuaultMC.Postmenopausal breast cancer risk and dietary patterns in the E3N-EPIC prospective cohort study. American Journal of Epidemiology20091701257–1267. (https://doi.org/10.1093/aje/kwp257)
WiernikENabiHThomasFPannierBHanonOSimonTSimonJMDanchinNLimosinFCzernichowSet al. Association between current perceived stress and incident diabetes is dependent on occupational status: evidence from the IPC cohort study. Diabetes and Metabolism201642328–335. (https://doi.org/10.1016/j.diabet.2016.01.004)
BonnetFIrvingKTerraJLNonyPBerthezèneFMoulinP.Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis2005178339–344. (https://doi.org/10.1016/j.atherosclerosis.2004.08.035)
RodNHGrønbaekMSchnohrPPrescottEKristensenTS.Perceived stress as a risk factor for changes in health behaviour and cardiac risk profile: a longitudinal study. Journal of Internal Medicine2009266467–475. (https://doi.org/10.1111/j.1365-2796.2009.02124.x)
HeraclidesAChandolaTWitteDRBrunnerEJ. Psychosocial stress at work doubles the risk of type 2 diabetes in middle-aged women: evidence from the Whitehall II study. Diabetes Care2009322230–2235. (https://doi.org/10.2337/dbib9-0132)
ErikssonAKvan den DonkMHildingAÖstensonCG.Work stress, sense of coherence, and risk of Type 2 diabetes in a prospective study of middle-aged Swedish men and women. Diabetes Care2013362683–2689. (https://doi.org/10.2337/dc12-1738)
BerntssonLLundbergUKrantzG.Gender differences in work-home interplay and symptom perception among Swedish white-collar employees. Journal of Epidemiology and Community Health2006601070–1076. (https://doi.org/10.1136/jech.2005.042192)
Kunz-EbrechtSRMohamed-AliVFeldmanPJKirschbaumCSteptoeA.Cortisol responses to mild psychological stress are inversely associated with proinflammatory cytokines. Brain Behavior and Immunity200317373–383. (https://doi.org/10.1016/S0889-1591(03)00029-1)
SchulzPKirschbaumCPrüßnerJHellhammerD. Increased free cortisol secretion after awakening in chronically stressed individuals due to work overload. Stress Medicine19981491–97. (https://doi.org/10.1002/(SICI)1099-1700(199804)14:2<91::AID-SMI765>3.0.CO;2-S)
Rivera-TorresPAraque-PadillaRAMontero-SimóMJ.Job stress across gender: the importance of emotional and intellectual demands and social support in women. International Journal of Environmental Research and Public Health201310375–389. (https://doi.org/10.3390/ijerph10010375)