Chronic stress at work and the

metabolic syndrome: prospective study

BMJ 2006; 332 doi: http://dx.doi.org/10.1136/bmj.38693.435301.80 (Published 02
March 2006)Cite this as: BMJ 2006;332:521
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Tarani Chandola, senior lecturer (t.chandola@ucl.ac.uk)1,

Eric Brunner, reader1,
Michael Marmot, head of group and department 1
Objectives To investigate the association between stress at work and the
metabolic syndrome.

Table 4
Risk of having the metabolic syndrome by relative index of inequality of employment
grade. Multivariate multiple imputation logistic regression models: non-retired men and
women in the Whitehall II cohort at phase 5

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Design Prospective cohort study investigating the association between work stress
and the metabolic syndrome.
Participants 10 308 men and women, aged 35-55, employed in 20 London civil
service departments at baseline (the Whitehall II study); follow-up was an average of
14 years.
Main outcome measures Work stress based on the iso-strain model,
measured on four occasions (1985-99). Biological measures of the metabolic
syndrome, based on the National Cholesterol Education Program definition,
measured in 1997-9.
Results A dose-response relation was found between exposure to work stressors
over 14 years and risk of the metabolic syndrome, independent of other relevant risk
factors. Employees with chronic work stress (three or more exposures) were more

than twice as likely to have the syndrome than those without work stress (odds ratio
adjusted for age and employment grade 2.25, 95% confidence interval 1.31 to 3.85).
Conclusions Stress at work is an important risk factor for the metabolic syndrome.
The study provides evidence for the biological plausibility of the link between
psychosocial stressors from everyday life and heart disease.

Work Stress and Metabolic Syndrome in

Police Officers. A Prospective Study

Sergio Garbarino,
Nicola Magnavita

Published: December 7, 2015

http://dx.doi.org/10.1371/journal.pone.0144318

Abstract
Objective

The aim of this longitudinal study was to evaluate the association between occupational
stress and metabolic syndrome (MetS) in a rapid response police unit.
Method

Work-related stress was continuously monitored during the 5-year period with both the
Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models. Blood
pressure, body mass index (BMI), waist circumference, triglycerides, HDL-cholesterol,
and fasting blood glucose were measured at baseline in January 2009, and in January
2014. 234 out of 290 police officers (81%) completed the follow-up.
Results

The majority of police officers had high stress levels. At follow-up, police officers in the
highest quartile of stress had significantly higher mean levels of triglycerides, and lower

levels of HDL-cholesterol than their colleagues in the lowest quartile. Police officers with
high stress had an increased adjusted risk of developing MetS (aOR = 2.68; CI95% =
1.086.70), and hypertriglyceridemia (aOR = 7.86; CI95 = 1.2948.04). Demand and
Effort were significant predictors of MetS.
Conclusion

Our study supports the hypothesis that work-related stress induces MetS, particularly
through its effects on blood lipids. Future longitudinal studies with continuous monitoring
of stress levels will definitively confirm this hypothesis.