The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS).
BACKGROUND:Work stress is associated with an increased risk of pre-diabetes, Type 2 diabetes, and inflammation, as well as decreased autonomic nervous system function as measured, for example, via heart rate variability. We investigated the extent to which the association between work stress and gly...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4988666?pdf=render |
| _version_ | 1819064666992672768 |
|---|---|
| author | Marc N Jarczok Julian Koenig Jian Li Daniel Mauss Kristina Hoffmann Burkhard Schmidt Joachim E Fischer Julian F Thayer |
| author_facet | Marc N Jarczok Julian Koenig Jian Li Daniel Mauss Kristina Hoffmann Burkhard Schmidt Joachim E Fischer Julian F Thayer |
| author_sort | Marc N Jarczok |
| collection | DOAJ |
| description | BACKGROUND:Work stress is associated with an increased risk of pre-diabetes, Type 2 diabetes, and inflammation, as well as decreased autonomic nervous system function as measured, for example, via heart rate variability. We investigated the extent to which the association between work stress and glycemic status is mediated by vagally-mediated heart rate variability (vmHRV) and/or inflammation. METHODS:Cross-sectional data from the Mannheim Industrial Cohort Study (MICS) with 9,937 participants were analyzed. The root mean squared successive differences (RMSSD) from long-term heart rate monitoring during work and night time periods was used to index vmHRV. Fasting plasma glucose and glycosylated hemoglobin were assessed to determine glycemic status. High sensitive C-reactive protein levels were observed as a measure of systemic inflammation and the Effort-Reward-Imbalance scale was used to evaluate work stress. Mediation models were adjusted for age, sex, and occupational status, and estimations were bootstrapped (5,000 replications). RESULTS:Effort-Reward-Imbalance was significantly negatively associated with RMSSD and both glycosylated hemoglobin and fasting plasma glucose during both work and night time periods. Effort-Reward-Imbalance was observed to have a significant direct effect on glycosylated hemoglobin and significant indirect effects, through RMSSD, on both glycemic measures during both time periods. Introducing C-reactive protein as a further mediator to the model did not alter the indirect effects observed. C-reactive protein, as an exclusive mediator, was observed to have smaller direct and indirect effects on the glycemic measures as compared to when Effort-Reward-Imbalance was included in the model. CONCLUSIONS:Our results suggest that the association between work stress and glycemic status is partially mediated through vmHRV independent of systemic inflammation as measured by C-reactive protein. We conclude that work stress may be an additional factor that promotes development of hyperglycemic-metabolic states. If supported by prospective evidence, these results may lead to new approaches for primary prevention of hyperglycemia in the workplace. |
| first_indexed | 2024-12-21T15:34:12Z |
| format | Article |
| id | doaj.art-444f8b6f1497429dbd49d8f397fe7977 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T15:34:12Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-444f8b6f1497429dbd49d8f397fe79772022-12-21T18:58:41ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01118e016074310.1371/journal.pone.0160743The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS).Marc N JarczokJulian KoenigJian LiDaniel MaussKristina HoffmannBurkhard SchmidtJoachim E FischerJulian F ThayerBACKGROUND:Work stress is associated with an increased risk of pre-diabetes, Type 2 diabetes, and inflammation, as well as decreased autonomic nervous system function as measured, for example, via heart rate variability. We investigated the extent to which the association between work stress and glycemic status is mediated by vagally-mediated heart rate variability (vmHRV) and/or inflammation. METHODS:Cross-sectional data from the Mannheim Industrial Cohort Study (MICS) with 9,937 participants were analyzed. The root mean squared successive differences (RMSSD) from long-term heart rate monitoring during work and night time periods was used to index vmHRV. Fasting plasma glucose and glycosylated hemoglobin were assessed to determine glycemic status. High sensitive C-reactive protein levels were observed as a measure of systemic inflammation and the Effort-Reward-Imbalance scale was used to evaluate work stress. Mediation models were adjusted for age, sex, and occupational status, and estimations were bootstrapped (5,000 replications). RESULTS:Effort-Reward-Imbalance was significantly negatively associated with RMSSD and both glycosylated hemoglobin and fasting plasma glucose during both work and night time periods. Effort-Reward-Imbalance was observed to have a significant direct effect on glycosylated hemoglobin and significant indirect effects, through RMSSD, on both glycemic measures during both time periods. Introducing C-reactive protein as a further mediator to the model did not alter the indirect effects observed. C-reactive protein, as an exclusive mediator, was observed to have smaller direct and indirect effects on the glycemic measures as compared to when Effort-Reward-Imbalance was included in the model. CONCLUSIONS:Our results suggest that the association between work stress and glycemic status is partially mediated through vmHRV independent of systemic inflammation as measured by C-reactive protein. We conclude that work stress may be an additional factor that promotes development of hyperglycemic-metabolic states. If supported by prospective evidence, these results may lead to new approaches for primary prevention of hyperglycemia in the workplace.http://europepmc.org/articles/PMC4988666?pdf=render |
| spellingShingle | Marc N Jarczok Julian Koenig Jian Li Daniel Mauss Kristina Hoffmann Burkhard Schmidt Joachim E Fischer Julian F Thayer The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS). PLoS ONE |
| title | The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS). |
| title_full | The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS). |
| title_fullStr | The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS). |
| title_full_unstemmed | The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS). |
| title_short | The Association of Work Stress and Glycemic Status Is Partially Mediated by Autonomic Nervous System Function: Cross-Sectional Results from the Mannheim Industrial Cohort Study (MICS). |
| title_sort | association of work stress and glycemic status is partially mediated by autonomic nervous system function cross sectional results from the mannheim industrial cohort study mics |
| url | http://europepmc.org/articles/PMC4988666?pdf=render |
| work_keys_str_mv | AT marcnjarczok theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT juliankoenig theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT jianli theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT danielmauss theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT kristinahoffmann theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT burkhardschmidt theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT joachimefischer theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT julianfthayer theassociationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT marcnjarczok associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT juliankoenig associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT jianli associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT danielmauss associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT kristinahoffmann associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT burkhardschmidt associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT joachimefischer associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics AT julianfthayer associationofworkstressandglycemicstatusispartiallymediatedbyautonomicnervoussystemfunctioncrosssectionalresultsfromthemannheimindustrialcohortstudymics |