Comment on “Relationship between components of the

Authors: Eva Backé Ute Latza

Publish Date: 2013/04/14

Volume: 86, Issue: 6, Pages: 727-727

PDF Link

Abstract

We thank Tomoyuki Kawada for his interest in the systematic review on the effect of occupational stress on the risk of the development of cardiovascular disease and his comments We agree that possible associations of occupational stress with components of the metabolic syndrome as well as with type 2 diabetes are in discussionThere is evidence that the association of work stress is mediated through indirect effects on health behaviours as well as direct effects on neuroendocrine stress pathways Chandola et al 2008 According to results of the Whitehall study around 32  of the effect of work stress on CHD seems to be attributable to its effect on health behaviours and the metabolic syndrome In the Whitehall II study there also appeared to be a difference in the risk of type 2 diabetes in women exposed to a combination of job strain and low social support Heraclides et al 2009 A recent publication on data of the Whitehall study Heraclides et al 2012 indicates that gender as well as body weight status play a critical role in determining the direction of the association between psychosocial stress and type 2 diabetesHowever overall observational epidemiological studies investigating the association between workrelated psychosocial stress the metabolic syndrome and type 2 diabetes still provide an inconsistent picture A systematic review and metaanalysis based on crosssectional studies case–control studies as well as cohort studies of the evidence evaluating whether workrelated psychosocial stress is associated with the risk of type 2 diabetes did not support an association Cosgrove et al 2012 Reasons for the inconsistent findings may be heterogeneity between studies as well as methodological weaknesses of studies as highlighted in this review Thus further research is required to confirm the findingIn this context the crosssectional study by Kawada et al adds some evidence to support an association between work stress and fasting glucose However the crosssectional design is limiting the significance of the investigation In addition there is no information how the applied instrument BJSQ to assess work stress is comparable to the job content questionnaire Karasek et al 1998 which is used in most of the other studies on occupational stress

Keywords: