title: Association between Work-Related Stress and Risk for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.
abstract: 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.
authors: Institute of Basic Research of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, P.R. China.
authors: Hua
authors: H
authors: Sui
authors: The Affiliated Hospital of Wuhan University of Science and Technology, Wuhan, P.R. China.
authors: Nijing
authors: N
authors: Sun
authors: College of Basic Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, P.R. China.
authors: Libin
authors: L
authors: Zhan
authors: Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, Liaoning, P.R. China.
authors: Xiaoguang
authors: X
authors: Lu
authors: Dalian Medical University, Dalian, Liaoning, P.R. China.
authors: Tuo
authors: T
authors: Chen
authors: Dalian Medical University, Dalian, Liaoning, P.R. China.
authors: Xinyong
authors: X
authors: Mao
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D009784:Occupational Diseases / Q000150:complications* / Q000523:psychology; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications*