Association between Work-Related Stress and Risk for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

PLoS One. 2016 Aug 11;11(8):e0159978. doi: 10.1371/journal.pone.0159978. eCollection 2016.

Abstract

Background/objective: The prevalence of type 2 diabetes is increasing rapidly around the world. Work-related stress is thought to be a major risk factor for type 2 diabetes; however, this association has not been widely studied, and the findings that have been reported are inconsistent. Therefore, we conducted a meta-analysis of prospective cohort studies to explore the association between work-related stress and risk for type 2 diabetes.

Methods: A systematic literature search and manual search limited to articles published in English were performed to select the prospective cohort studies evaluated the association between work-related stress and risk for type 2 diabetes up to September 2014 from four electronic databases including PubMed, EMBASE, the Cochrane Library and Web of Science. A random-effects model was used to estimate the overall risk.

Results: No significant association was found between work-related stress and risk for type 2 diabetes based on meta-analysis of seven prospective cohort studies involving 214,086 participants and 5,511 cases (job demands: relative risk 0.94 [95% confidence interval 0.72-1.23]; decision latitude: relative risk 1.16 [0.85-1.58]; job strain: relative risk 1.12 [.0.95-1.32]). However, an association between work-related stress and risk for type 2 diabetes was observed in women (job strain: relative risk 1.22 [1.01-1.46]) (P = 0.04). A sensitivity analysis conducted by excluding one study in each turn yielded similar results. No publication bias was detected with a funnel plot despite the limited number of studies included in the analysis.

Conclusions: The results of this meta-analysis did not confirm a direct association between work-related stress and risk for type 2 diabetes. In subgroup analyses we found job strain was a risk factor for type 2 diabetes in women.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Diabetes Mellitus, Type 2 / etiology*
  • Diabetes Mellitus, Type 2 / psychology
  • Humans
  • Mental Disorders / complications*
  • Mental Disorders / psychology
  • Occupational Diseases / complications*
  • Occupational Diseases / psychology
  • Prospective Studies
  • Stress, Psychological / complications*

Grants and funding

This work was financially supported by The Key Project of National Natural Science Foundation of China (No. 81230084), and by the Specialized Research Fund for the Doctoral Program of Higher Education of China (20132105130001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.