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© 2003 by the American Diabetes Association, Inc.
Epidemiology/Health Services/Psychosocial Research |
Work Stress and Low Sense of Coherence Is Associated With Type 2 Diabetes in Middle-Aged Swedish Women
1 Department of Molecular Medicine, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Sweden
2 Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3 Department of Epidemiology, Stockholm Center of Public Health, Stockholm, Sweden
4 Department of Public Health Science, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden
OBJECTIVE—The risk of type 2 diabetes is suggested to be increased for individuals exposed to stress. We analyzed the association of work stress by high demands, low decision latitude, and job strain (combination of high demands and low decision latitude) with type 2 diabetes. We also studied low sense of coherence (SOC) (a factor for successful coping with stressors) in association with type 2 diabetes. Finally, we investigated the combination of SOC and demands or SOC and decision latitude in association with the disease.
RESEARCH DESIGN AND METHODS—This cross-sectional study recruited 4,821 healthy Swedish women (aged 35–56 years) residing in five municipalities in the Stockholm area. An oral glucose tolerance test identified 52 women with type 2 diabetes. Relative risks (RRs) with 95% CIs were estimated in a logistic multiple regression analysis.
RESULTS—No association was found between high demands and type 2 diabetes (RR 1.1 [CI 0.5–2.2]). Low decision latitude was associated with type 2 diabetes with a RR of 2.2 (1.0–4.8). The RR of type 2 diabetes with low SOC was 3.7 (1.2–11.2). The combination of low SOC and low decision latitude was associated with type 2 diabetes with a RR of 2.6 (1.2–5.7). Homeostasis model assessment revealed an association of 4.2 (1.2–15.0) between low SOC and insulin resistance.
CONCLUSIONS—This study provided new evidence that stress factors such as low decision latitude at work and low SOC were associated with type 2 diabetes in middle-aged Swedish women.
Abbreviations: FHD, family history of diabetes • HOMA, homeostasis model assessment • HPA, hypothalamo-pituitary-adrenal • IGT, impaired glucose tolerance • OGTT, oral glucose tolerance test • RR, relative risk • SOC, sense of coherence • WHR, waist-to-hip ratio
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