Relationship between Job Stress and Hypo-high-density Lipoproteinemia of Chinese Workers in Shanghai: The Rosai Karoshi Study

Background: Karoshi, or death due to overwork, has now become a serious social problem in China. Worsening of cardiovascular risks by stress might initiate karoshi. Many studies have examined the relationship between job stress and obesity, hypertension, and type 2 diabetes mellitus, but less evidence exists for dyslipidemia like hypo-high-density lipoproteinemia (hypo-HDL). The aim of this study was to investigate the relationship between job stress and hypo-HDL of Chinese workers in Shanghai. Methods: We studied 2219 Chinese workers in Shanghai, who participated in the Japan-China cooperative study for the prevention of karoshi. A questionnaire was administered to examine the lifestyle characteristics, job category, weekly working hours, and job stress. Job demand and job control were quantified using the National Institute for Occupational Safety and Health questionnaire. Modified job strain measure was defined by the combination of low job control and high demand. Hypo-HDL was defined as plasma high-density lipoprotein cholesterol concentration of <1.04 mmol/L (40 mg/dl). Multivariate logistic regression analysis was performed for hypo-HDL as a dependent variable. Results: Modified job strain was not related to hypo-HDL either in men or women. In men, multivariate adjusted odds ratio (OR) for having hypo-HDL was significantly higher in the lowest job control tertile compared with the highest job control tertile (OR = 1.39, 95% confidence interval [CI] 1.03-1.87, P = 0.034). In the same model, a similar trend was observed for women, but it did not reach a statistically significant level (OR = 1.51, 95% CI, 0.88-2.56, P = 0.132). Conclusion: A low level of job control but not modified job strain was significantly related to higher prevalence of hypo-HDL of Chinese workers in Shanghai.