title: Association between effort-reward imbalance and glycosylated hemoglobin (HbA1c) among Chinese workers: results from SHISO study.
abstract: OBJECTIVE
  The studies focusing on effort-reward imbalance and diabetes mellitus (DM)/glycosylated hemoglobin (HbA1c) are rare. We sought to examine the association between job stress evaluated by effort-reward imbalance (ERI) model and HbA1c in a Chinese population.
  
  
  METHODS
  We analyzed 680 subjects (465 men and 215 women) without DM or impaired glucose tolerance from the stress and health in Shenzhen workers (SHISO) study. Job stress was evaluated by effort-reward imbalance (ERI) model. HbA1c was measured by an automatic analyzer by means of high-performance liquid chromatography. The association between job stress and HbA1c was explored by variance analysis, partial correlations and multiple linear regression analysis.
  
  
  RESULTS
  For women, effort, and ERI were positively associated with HbA1c (r = 0.22, p = 0,003; r = 0.21, p = 0.006, respectively), in contrast, reward was negatively associated with HbA1c (r = -0.17, p = 0.021), after controlling age, BMI and physical exercise in the partial correlation analysis; the similar results were confirmed in the multiple linear regression. No significant correlations between job stress and HbA1c were found for men.
  
  
  CONCLUSIONS
  Effort and ERI are positively associated with HbA1c, and reward is inversely related to HbA1c among Chinese women. The association is not accounted for by age, BMI, and physical exercise. More efforts should be made to improve the job stress status of Chinese working women for the purpose of DM prevention.
authors.affiliation: Department of Cardiology, Peking University Third Hospital and Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
authors.forename: Weixian
authors.initials: W
authors.lastname: Xu
authors.forename: Juan
authors.initials: J
authors.lastname: Hang
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.forename: Yiming
authors.initials: Y
authors.lastname: Zhao
authors.forename: Weihong
authors.initials: W
authors.lastname: Li
authors.forename: Xinyu
authors.initials: X
authors.lastname: Wang
authors.forename: Zhaoping
authors.initials: Z
authors.lastname: Li
authors.forename: Lijun
authors.initials: L
authors.lastname: Guo
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D044466:Asian People; D002681:China; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D012201:Reward; D012737:Sex Factors; D013315:Stress, Psychological / Q000097:blood*; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology*
chemical_list: D006442:Glycated Hemoglobin