Association between Job Stress and Newly Detected Combined Dyslipidemia among Chinese Workers: Findings from the SHISO Study

Abstract

Previous studies examining the association between job stress and blood lipids have produced mixed findings. We sought to investigate the association between job stress and blood lipids among Chinese workers. Methods: A total of 544 subjects (367 men and 177 women) without known diseases from the Stress and Health in Shenzhen Workers (SHISO) cross-sectional study were analyzed. Job stress was evaluated by the effort-reward imbalance (ERI) model. The associations between job stress and blood lipids, such as for total cholesterol (TCHO), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), were explored by multiple linear regression. The association between job stress and combined dyslipidemia was examined by multiple logistic regression. Results: Compared with their corresponding low level groups, groups with high levels of effort, overcommitment and ERI had a significantly increased risk of combined dyslipidemia with adjusted odd ratios (ORs) of 3.5 (95% CI 1.8-6.7), 4.2 (95% CI 2.3-7.7) and 2.7 (95% CI 1.5-5.1), respectively, whereas high rewards significantly reduced the risk of combined dyslipidemia (adjusted OR 0.3, 95% CI 0.2-0.6) compared with low rewards. Effort, overcommitment and ERI were significantly positively related to TG and LDL-C, while rewards were inversely related to them. No significant associations were observed between job stress and TCHO and HDL-C. The results were similar for men and women. Conclusions: Effort, overcommitment, low reward and ERI increased the risk of dyslipidemia among Chinese workers, and they were significantly associated with TG and LDL-C rather than TCHO or HDL-C. Increasing blood lipids may be the possible link between job stress and coronary heart disease. (J Occup Health 2011; 53: 334-342)

High‐sensitivity CRP: Possible link between job stress and atherosclerosis

“…However, in our study, the pattern of results was similar in women and men. Therefore, we do not expect that the effect of smoking as a potential confounder would be powerful enough to substantially change the results, as described previously [Xu et al, 2010a[Xu et al, , 2011a. (iv), In this study, job stress was assessed only one time, which may result in misclassification of chronic exposure and bias results towards the null value [Kivimaki et al, 2006].…”

“…ERI is associated with increased risk of coronary heart disease [Xu et al, 2009;Xu et al, 2010b], and risk of recurrent acute myocardial infarction [Aboa-Eboule et al, 2011]. Previous studies have also documented that ERI is associated with subclinical atherosclerosis [Xu et al, 2010a] and risk factors of CVD, such as hypertension [Xu et al, 2013], dyslipidemia [Xu et al, 2011a], and diabetes mellitus .Recently, studies reveal that the immune system plays important roles in the pathway from chronic psychosocial stress to disease [Nakata, 2012]. There is growing evidence demonstrating the role of inflammation in the immune system during the development of CVD.…”

“…The procedures were fully explained to the participants before the survey, and written informed consent was obtained. SHISO study details have been described in previous papers [Xu et al, 2010a[Xu et al, , 2011a[Xu et al, , 2012a. …”

Stress and A1c Among People with Diabetes Across the Lifespan

“…Foundational research in this area reported higher A1c among adult male workers without diabetes exposed to workplace stress (i.e., noise, rotating shifts, overwork) compared to peers not exposed to those chronic job stressors [56]. In a more recent study of Chinese workers without diabetes or impaired glucose tolerance, Xu and colleagues [57] reported a relationship between A1c and job stress in women, but not men. Chronic financial strain over a 10-year period has also been associated with high A1c levels in African-American women without diabetes [58].…”

Effort–reward imbalance is associated with the metabolic syndrome — Findings from the Mannheim Industrial Cohort Study (MICS)

“…ERI has been shown to predict poor health in numerous studies [14] and has been linked to CVD incidence and mortality [14][15][16][17]. Indeed, some research has linked ERI to individual MetS components, i.e., hypertension [18], dyslipidemia [19] and (pre-)diabetes [20].…”