228 ADEQUATE SOCIAL SUPPORT IS ASSOCIATED WITH LOWER RISK OF DIABETES INDEPENDENT OF OBESITY IN URBAN WORKERS

Abstract

Background: Work-related cardiovascular death, or Karoshi is now a social problem in Asia. It has been shown that work stress increases the risk of hypertension and diabetes. It is unknown, however, that what component of work stress is most closely related to the risk of hypertension or diabetes. Methods: We studied work-related stress on decision latitude, social support, job-demand, skill underutilization and job strength by means of NIOSH stress questionnaire in 3092 workers living in Shanghai,China (2994 Chinese and 98 Japanese, mean age 45 yrs, 59% men). Demographyc data, supine blood pressure by means of oscillometric method (form PWV/ABI, Japan) and fasting blood were examined. The relationship between hypertension (treatment or ≧140/90 mmHg) or diabetes (treatment or ≧HbA1c 6.1%) and work stress was examined by logistic regression analysis. Results: Each work stress was graded into four levels according to the scores. In univariate analysis, lowest decision latitude was associated with higher OR for diabetes (1.62; 95%CI;1.21-2.14) compared with highest decision latitude group. Second highest social support was associated with significantly lower OR for diabetes (0.63:95%CI;0.47–0.84). Multiple logistic regression analysis after adjusting for age, sex, BMI, smoking, drinking, exercise habits and kind of work, second highest social support still showed a significantly lower OR for diabetes (0.59; 95%CI;0.40-0.85). In univariate analysis, lowest decision latitude and lowest skill use showed higher OR for hypertension compared their highest counterpart but those relationships became insignificant after multivariate adjustments. Conclusions: Adequate social support may reduce the risk of diabetes in urban workers, suggesting a good strategy for the prevention of Karoshi.