title: Interaction between serotonin transporter gene-linked polymorphic region (5-HTTLPR) and job-related stress in insomnia: a cross-sectional study in Sichuan, China.
abstract: OBJECTIVE
  Insomnia, a widely occurring sleep disorder in modern society, has a large impact on life quality and work safety. A cross-sectional study was conducted to explore the possible link between serotonin transporter-linked polymorphic region (5-HTTLPR), job-related stress, and insomnia in West China.
  
  
  METHODS
  Of the total 462 workers recruited, 177 had insomnia according to the Athens Insomnia Scale (AIS-5). The 5-HTTLPR genotypes were determined by polymerase chain reaction. Job-related stress was assessed for each participant by the General Job Stress Questionnaire.
  
  
  RESULTS
  Unconditional logistic regression models showed that the 5-HTTLPR genotype was significantly associated with insomnia, and >80% increased risk per S allele was observed. High job-related stress had a higher risk for insomnia than low job-related stress (odds ratio [OR], 6.14; 95% confidence interval [CI], 3.94-9.59). Crossover analysis found significant job-related stress × 5-HTTLPR interaction. Compared to individuals with both low job-related stress and SL/LL genotype, those with both higher job-related stress and SS genotype had a higher risk of insomnia (OR, 5.16; 95% CI, 3.13-8.54), whereas those with both low job-related stress and SS genotype showed a lower risk of insomnia (OR, 0.26; 95% CI, 0.08-0.74). The interaction remained statistically significant after adjusting for potential confounding factors.
  
  
  CONCLUSIONS
  The findings indicated that 5-HTTLPR could modify the effect of job-related stress on employees' insomnia, suggesting that a work environment-based personalized intervention may be applied to prevent employees' insomnia by alleviating job-related stress in the workplace.
authors.affiliation: Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China; Department of Occupational and Environmental Health, Sichuan Science and Technology Staff University, Chengdu, Sichuan, China.
authors.forename: Chan
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China; Department of Occupational and Environmental Health, Sichuan Science and Technology Staff University, Chengdu, Sichuan, China.
authors.forename: Ju
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, School of Medicine, Yale University, New Haven, CT, USA.
authors.forename: Lingeng
authors.initials: L
authors.lastname: Lu
authors.affiliation: Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Ren
authors.affiliation: Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yongru
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China; Department of Occupational Health, No. 4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: lanyajia@sina.com.
authors.forename: Yajia
authors.initials: Y
authors.lastname: Lan
authors.affiliation: Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China; Department of Occupational Health, No. 4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yongwei
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000328:Adult; D000483:Alleles; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics / Q000502:physiology; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics* / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology / Q000235:genetics*; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins
keywords: 5-HTTLPR; Employee; Environment–gene interaction; Genotype; Insomnia; Job-related stress; Susceptibility; Workplace