油田作业人员职业紧张状况调查及心理障碍的影响因素分析

目的:调查油田作业人员职业紧张状况,并分析心理障碍的影响因素。方法:通过分层整群抽样法纳入600例油田作业人员作为研究对象,采用职业紧张量表(OSI-R)以及症状自评量表(SCL-90)对油田作业人员的职业紧张程度以及心理障碍状况进行评估,并按照SCL-90评分将其分为研究组(SCL-90评分160分)214例与对照组(SCL-90评分≤160分)386例,采用多因素Logistic回归分析油田作业人员心理障碍的影响因素。结果:研究组年龄45岁、受教育程度为本科及以上、工龄20年人数占比均高于对照组(均P0.05)。研究组职业任务问卷(ORQ)、个体紧张反应(PSQ)评分均高于对照组(均P0.05)。研究组重度职业紧张程度人数占比高于对照组(P0.05)。经多因素Logistic回归分析发现:年龄45岁、受教育程度本科及以上、工龄20年、重度职业紧张均是油田作业人员心理障碍的独立危险因素(均P0.05)。结论:油田作业人员职业紧张状况不容乐观,重度职业紧张、年龄较小、工龄较短及受教育程度较高的油田工作人员发生心理障碍的风险往往较大。临床工作中可通过降低油田作业人员的职业紧张程度,继而达到降低心理障碍发生几率的目的。     

油田野外作业工人慢性疾病调查及职业紧张与神经递质的相关性研究

目的:调查油田野外作业工人慢性疾病患病情况,分析职业紧张与神经递质的相关性。方法:通过整群抽样的方式选取油田野外作业工人2000例作为研究对象,采用自制的慢性非传染性疾病调查量表对所有工人的慢性疾病情况予以调查,采用职业紧张量表对所有工人的职业紧张情况予以调查。采用酶联免疫吸附法检测所有工人血清五羟色胺、去甲肾上腺素以及神经肽Y水平,并采用偏相关分析油田野外作业工人职业紧张与神经递质的相关性。结果:2000例油田野外作业工人慢性疾病发病率最高的前三种疾病分别为颈腰部疾病、高血压、高血脂,占比分别为20.60%、15.35%、11.20%。油田野外作业工人中男性职业任务、个体应对资源评分高于女性,而锻炼工人的个体紧张反应评分低于不锻炼工人(P0.05)。油田野外作业工人中饮酒工人神经肽Y水平低于不饮酒工人,锻炼工人的去甲肾上腺素水平高于不锻炼工人(P0.05)。经偏相关分析可得:油田野外作业工人的职业任务评分与五羟色胺、去甲肾上腺素水平呈正相关(P0.05),个体紧张反应评分与神经肽Y水平呈负相关(P0.05)。结论:油田野外作业工人慢性疾病患病情况不容乐观,且其职业紧张与神经递质存在密切相关,在临床工作中可通过改善油田野外作业工人的职业紧张,从而达到改善其神经递质水平的目的。     

长期住院老年精神疾病患者营养状况与认知功能的相关性研究

目的:了解长期住院老年精神疾病患者营养状况及与认知功能的相关性,为临床提供指导。方法:对住院3个月及以上的123例老年精神疾病患者采用简易精神状态检查量表(MMSE)评估认知功能,采用简易微型营养评定精简版(MNA-SF)评估营养状况,并采集一般资料、相关营养生化指标,应用Pearson相关分析MNA-SF评分与MMSE评分的相关性。结果:123例患者中,营养不良风险者67例(54.47%),营养不良者37例(30.08%),营养正常者19例(15.44%)。有认知障碍患者的营养不良发生率显著高于无认知障碍患者营养不良发生率(P<0.05),重度认知障碍者营养不良发生率显著高于轻、中度认知障碍者(P<0.05)。与无认知障碍者比较,中度、重度认知障碍者MNA-SF评分显著降低(P<0.05);与轻度、中度认知障碍者比较,重度认知障碍者MNA-SF评分显著降低(P<0.05)。营养不良者MMSE 6个认知领域评分和认知总评分均显著低于营养不良风险/正常者(P<0.05),Pearson相关分析显示:长期住院老年精神疾病患者MNA-SF评分与MMSE评分呈正相关(r=0.486, P=0.023<0.05)。结论:长期住院老年精神疾病患者营养不良发生率高,且与认知功能密切相关。临床部门需加强老年精神疾病患者,特别是有认知损害老人的营养关切。     

肺通气功能程度与慢性阻塞性肺疾病患者夜间低氧发生的相关性分析

目的:研究肺通气功能程度与慢性阻塞性肺疾病患者夜间低氧发生的相关性。方法:选取2012年1月至2013年6月我院治疗的60例稳定期慢性阻塞性肺疾病患者,按肺通气功能分为轻度、中度、重度、极重度4组,每组15例,监测记录研究对象肺通气功能指标及夜间血氧指标,比较各组监测指标的差异,并分析其相关性。结果:不同病情程度COPD患者FEV1/FVC、FEV1、FVC、PEF、RV、RV/TLC、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);极重度和重度比较FEV1/FVC、FEV1、RV、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);极重度和中度比较FEV1/FVC、FEV1、FVC、PEF、RV、RV/TLC、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);极重度和轻度比较FEV1/FVC、FEV1、FVC、PEF、RV、RV/TLC、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);重度和中度比较FEV1/FVC、FEV1、FVC、PEF、RV/TLC、MsaO2有差异(P0.05);重度和轻度比较FEV1/FVC、FEV1、FVC、PEF、RV/TLC、MsaO2、ODI、LsaO2有差异(P0.05);中度和轻度比较FEV1/FVC、FEV1、FVC、PEF、ODI有差异(P0.05)。COPD患者的肺通气功能FEV1与MsaO2呈正相关(r=0.683,P0.05)。结论:肺通气功能程度与慢性阻塞性肺疾病患者夜间低氧发生具有相关性。     

广西急诊儿科医生心理健康状况调查分析

目的探讨广西急诊儿科医生的心理健康状况及其影响因素。方法 2011年1~12月选择广西10所设置有儿科急诊的大型综合性医院和妇女儿童专科医院的89名儿科医生为研究对象,纳入儿科医生组(n=89),采用症状自评量表(SCL-90)对其进行调查;同时选择SCL-90全国历年正常普通人员样本常模纳入常模组(n=1388)。比较两组SCL-90评分结果。结果广西10所医院的急诊儿科医生组与全国常模组SCL-90评分及其平均分进行比较,89名急诊儿科医生SCL-90测评结果中有8项症状因子分均高于全国成人常模(P0.05)。结论急诊室紧张的工作特点和工作环境使儿科医生形成较大精神压力,急诊儿科医生心理健康水平显著低于普通人群,易引发心理问题。     

饮酒、吸烟与冠状动脉病变程度的相关性研究

目的:探讨饮酒、吸烟与冠状动脉病变程度的相关性。方法:抽取行冠脉造影的男性患者(343例),排除患有高血压病、糖尿病、肝肾功能等异常的患者,根据患者是否吸烟、饮酒将其分为四组,吸烟+饮酒组(86例),吸烟+非饮酒组(135例),饮酒+非吸烟饮酒组(16例),非吸烟+非饮酒组(106例)。通过Gensini积分系统评价和比较各组冠脉病变的情况,分析评估冠心病的风险因素以及饮酒、吸烟与冠心病的关系。结果:吸烟+非饮酒组Gensini评分最高(33.89±31.14)分别与另外三组有统计学意义(P0.05)。饮酒+非吸烟组最低(9.31±10.88),分别与另外三组有统计学意义(P0.05)。单因素分析结果显示年龄、饮酒、TG、HDL-C是发生冠心病的危险因素,logistic回归分析结果显示饮酒是发生冠心病的保护因素,年龄与TG是发生冠心病的危险因素。结论:吸烟为冠状动脉病变高危因素,饮酒是发生冠心病的保护因素。     

油田工作人员高尿酸血症患病率调查及其影响因素分析

目的:了解油田工作人员高尿酸血症(HUA)患病率并分析其影响因素。方法:于2018年1月至2018年12月通过随机抽样法选取300例华北油田的工作人员。统计所有油田工作人员的HUA患病率,并根据HUA发生与否分成HUA组41例与非HUA组259例。采用单因素分析及多因素Logistic回归分析HUA的影响因素。结果:300例油田工作人员HUA患病率为13.67%(41/300),其中男性油田工作人员血清尿酸水平及HUA患病率均高于女性(均P0.05)。HUA组肥胖、饮酒、高血压、高血糖、高血脂症人数占比高于非HUA组(均P0.05)。HUA组尿素氮(BUN)、血肌酐(Scr)水平均高于非HUA组,而肾小球滤过率(eGFR)水平低于非HUA组(均P0.05)。多因素Logistic回归分析显示,男性、肥胖、饮酒、高血压、高血糖、高血脂症及BUN5.0 mmol/L、Scr130.0μmol/L、eGFR130.0 m L/(min·1.73m2)均是油田工作人员HUA的独立危险因素(均P0.05)。结论:油田工作人员HUA患病率较高,应予以重视。男性、肥胖、饮酒、高血压、高血糖、高血脂症、BUN、Scr水平较高以及eGFR较低的人群HUA发生的风险较高,可通过针对上述因素予以干预,继而降低HUA的发生风险。     

不同病情妊娠高血压综合征患者凝血指标及血小板参数检测的临床价值及其妊娠结局研究

目的:研究不同病情妊娠高血压综合征患者凝血指标及血小板参数检测的临床价值及其妊娠结局。方法:2017年2月～2018年12月期间,我院收治的120例妊娠高血压综合征患者作为研究对象,将其按照疾病严重程度的不同分为轻度组45例、中度组40例以及重度组35例。分别比较三组患者的各项凝血指标、血小板参数、产妇不良妊娠结局以及新生儿不良妊娠结局。结果:重度组部分凝血活酶时间(APTT)、凝血酶时间(TT)较轻度组和中度组缩短,而纤维蛋白原(FIB)较轻度组和中度组升高(P0.05),且中度组FIB高于轻度组(P0.05)。重度组血小板数量(PLT)低于轻度组和中度组,而平均血小板体积(MPV)高于轻度组和中度组(P0.05),中度组PLT低于轻度组,而MPV高于轻度组(P0.05)。重度组胎盘早剥、剖腹产、产后出血的发生率高于中度组和轻度组,且中度组高于轻度组(P0.05)。重度组新生儿窒息、早产、呼吸窘迫的发生率高于中度组、轻度组,且中度组高于轻度组(P0.05)。结论:临床工作中可通过联合检测凝血指标及血小板参数,从而有利于评估妊娠高血压综合征患者的病情严重程度,同时有助于预测妊娠结局。     

慢性牙周炎与原发性肝硬化的相关性分析

目的:探究慢性牙周炎与原发性肝硬化之间的相关性。方法:选择2017年1月至2019年1月于我院接受治疗的60例原发性肝硬化患者为研究组,选择同期于我院接受体格检查的100例健康个体为对照组,对两组患者分别实施牙周检查,对比两组患者牙周炎发生率,分析吸烟、饮酒对牙周炎发生率影响,按照Child-改良分级法对肝硬化患者进行评分并分级,对比各级原发性肝硬化患者慢性牙周亚发生率,并就慢性牙周炎与肝硬化相关性进行分析。结果:(1)对照组慢性牙周炎发生率显著低于研究组慢性牙周炎发病率(44.00%vs. 71.67%,P0.05);(2)研究组和对照组中吸烟者的慢性牙周炎患病率显著高于不吸烟者(P0.05),研究组中吸烟者发生慢性牙周炎患病率高于对照组,对比无统计学意义(P0.05);研究组和对照组饮酒者的慢性牙周炎患病率显著高于不饮酒者(P0.05),研究组中饮酒者发生慢性牙周炎患病率显著高于对照组(P0.05);(3)随着原发性肝硬化患者评分的升高,患者牙周炎患病率也随之上升,牙周附着丧失程度也出现加剧(P0.05)。结论:原发性肝硬化患者慢性牙周炎患病率高于健康个体,随着肝硬化患者病情的加剧,患者慢性牙周炎发生率也随之上升;另外,吸烟及饮酒会增加健康个体慢性牙周炎患病率。     

慢性牙周炎患者牙龈卟啉单胞菌感染与血清HMGB1、IL-1β、IL-6以及牙周临床指标的相关性研究

摘要 目的：研究慢性牙周炎患者牙龈卟啉单胞菌（Pg）感染与血清高迁移率族蛋白1（HMGB1）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）以及牙周临床指标的相关性。方法：将2019年1月～2020年12月在长沙市第三医院口腔科接受诊治的300例慢性牙周炎患者纳入研究,按照慢性牙周炎严重程度分成轻度组169例、中度组92例、重度组39例。对所有受试者进行Pg检测,同时检测血清HMGB1、IL-1β、IL-6水平和牙周临床指标水平。比较各组上述各项指标的差异,并以Pearson相关性分析慢性牙周炎患者Pg感染与血清HMGB1、IL-1β、IL-6水平以及牙周临床指标的相关性。结果：重度组和中度组的Pg感染阳性率、Pg感染浓度均高于轻度组,且重度组上述指标高于中度组（P＜0.05）。重度组和中度组的血清HMGB1、IL-1β、IL-6水平均高于轻度组,且重度组上述指标高于中度组（P＜0.05）。重度组和中度组的探诊深度（PD）、龈沟出血指数（SBI）以及附着丧失（AL）均高于轻度组,且重度组上述指标高于中度组（P＜0.05）。Pearson相关性分析显示：慢性牙周炎患者的Pg感染浓度与血清HMGB1、IL-1β、IL-6水平以及PD、SBI、AL均呈正相关（P＜0.05)。结论：慢性牙周炎患者的Pg感染浓度与血清HMGB1、IL-1β、IL-6水平及牙周健康状况密切相关,早期明确Pg感染浓度以及检测上述血清学指标水平,可能对抑制病程进展以及提高治疗效果具有指导意义。     

Increased lymphocyte DNA strand breaks in rubber workers

OBJECTIVE: To study the effect of occupational exposure to rubber processing, smoking, and alcohol drinking on lymphocyte DNA damage. SUBJECTS AND METHODS: Of 371 employees (197 men and 174 women) from a rubber factory in Guangzhou, 281 were rubber processing workers from five production sections and 90 were managerial workers. Information on occupational exposure, smoking, and drinking was collected by interviews. Blood samples were taken in the morning by venipuncture. DNA damages were measured by the Comet assay. Possible DNA-protein crosslinks were broken down by proteinase K. Tail moment, measured by Komet 4.0 image analysis software, was the measure of DNA damage. RESULTS: The rubber processing workers had larger tail moment than the managerial workers (Geometric mean, 95%CI) [1. 77microm (1.64-1.90) versus 1.52microm (1.36-1.71), P=0.04]. Both smoking [1.93microm (1.74-2.13) versus 1.59microm (1.47-1.71), P=0. 003] and alcohol drinking [2.21microm (1.87-2.62) versus 1.63microm (1.53-1.74), P<0.001] increased tail moment. Tail moment differed significantly among job categories (F=3.21, P=0.008), the largest was observed in mixers. In the non-smoking and non-drinking workers, rubber processing workers had larger tail moment than managerial workers after adjusting for age (P=0.033). General linear model analysis showed that after adjusting for each other, occupational exposure (P=0.027), smoking (P=0.012), and alcohol drinking (P=0. 013) was associated with larger tail moment, whereas age and gender had no effect. CONCLUSIONS: Occupational exposure to rubber processing, smoking, and alcohol drinking can cause DNA damage.     

Increased lymphocyte DNA strand breaks in rubber workers

Objective: To study the effect of occupational exposure to rubber processing, smoking, and alcohol drinking on lymphocyte DNA damage. Subjects and Methods: Of 371 employees (197 men and 174 women) from a rubber factory in Guangzhou, 281 were rubber processing workers from five production sections and 90 were managerial workers. Information on occupational exposure, smoking, and drinking was collected by interviews. Blood samples were taken in the morning by venipuncture. DNA damages were measured by the Comet assay. Possible DNA-protein crosslinks were broken down by proteinase K. Tail moment, measured by Komet 4.0 image analysis software, was the measure of DNA damage. Results: The rubber processing workers had larger tail moment than the managerial workers (Geometric mean, 95%CI) [1.77 μm (1.64–1.90) versus 1.52 μm (1.36–1.71), P=0.04]. Both smoking [1.93 μm (1.74–2.13) versus 1.59 μm (1.47–1.71), P=0.003] and alcohol drinking [2.21 μm (1.87–2.62) versus 1.63 μm (1.53–1.74), P<0.001] increased tail moment. Tail moment differed significantly among job categories (F=3.21, P=0.008), the largest was observed in mixers. In the non-smoking and non-drinking workers, rubber processing workers had larger tail moment than managerial workers after adjusting for age (P=0.033). General linear model analysis showed that after adjusting for each other, occupational exposure (P=0.027), smoking (P=0.012), and alcohol drinking (P=0.013) was associated with larger tail moment, whereas age and gender had no effect. Conclusions: Occupational exposure to rubber processing, smoking, and alcohol drinking can cause DNA damage.     

Smoking and drinking by middle-aged British men: effects of social class and town of residence.

In 7735 men aged 40-59, selected at random from general practices in 24 towns throughout Britain, pronounced differences were noted in the prevalences of smoking and drinking between the social classes. Social class differences also existed for frequency and quantity of drinking, type of beverage, and several aspects of smoking behaviour. Increasing amounts of smoking were associated with higher prevalences of moderate to heavy drinking, particularly in daily rather than weekend drinkers. Between drinking groups, however, the relation with smoking was more U-shaped, with light and heavy drinkers smoking more than moderate drinkers. The lowest rates of moderate to heavy smoking were observed in frequent light drinkers, particularly in the nonmanual workers. The proportion of moderate to heavy drinkers was no higher among ex-cigarette smokers than among current smokers. When the data were examined by town of residence social class differences persisted. Controlling for social class still showed pronounced differences between towns in both smoking and drinking behaviour. These data confirm that town of residence and social class have independent effects on smoking and drinking. The established regional and social class differences in cardiovascular disease may be due in part to the independent influences of town and social class on smoking and drinking behaviour.     

The remote effects of chronic exposure to ionizing radiation and electromagnetic fields with respect to hygienic standardization

A variety and rate of non-cancer diseases occurred in humans as a result of chronic exposure to ionizing radiation or to electromagnetic radiation (EMR) of high and superhigh frequency have been compared. The intensity of EMR was slightly higher than a sanitary standard for population. A risk of health impairments in workers having occupational exposure to EMR was assessed on the basis of Selie's concept of development of non-specific reaction of the body to chronic stress factors (general adaptation syndrome), models of changes in the body compensatory reserves and calculations of radiation risk after severe and chronic exposure to ionizing radiation.     

Lymphocyte DNA damage in elevator manufacturing workers in Guangzhou, China

AIMS: To study the effect of smoking, passive smoking, alcohol drinking, and occupational exposure to low level of benzene on DNA strand breaks in elevator manufacturing workers in Guangzhou, China. METHODS: Three hundred and fifty-nine workers (252 men and 107 women) of a modern elevator manufacturing factory, 205 were from production departments and 154 from managerial department. Information on the workers' health conditions, smoking, passive smoking, alcohol consumption and occupational exposure history was collected by personal interview. Lymphocyte DNA damage was measured by the Comet assay. RESULTS: None of the women smoked and 20.6% of the men were daily smokers. In non-smokers, the prevalence of passive smoking at work was 25% for men and 11.2% for women, and at home, 37.8 and 48.6%, respectively. Smoking significantly increased tail moment (P<0.001). Daily smokers had the largest tail moment (geometric mean, 95% CI) (0.93 microm (0.81-0.94)), followed by occasional smokers (0.76 microm (0.59-0.95)), ex-smokers (0.70 microm (0.58-0.85)), and never smokers (0.56 microm (0.53-0.60)). Tail moment increased significantly with daily tobacco consumption (cigarettes per day) (r=0.26, P<0.001) after adjusting for age, gender, occupational exposure, passive smoking, and drinking. Analysis of covariance (ANCOVA) showed that smoking (P<0.001), passive smoking at home (P=0.026), occupational exposure (P<0.001), male gender (P<0.001), and age (P=0.001) had independent effects on tail moment, whereas passive smoking at work and alcohol drinking had no significant effect. CONCLUSIONS: Smoking, passive smoking at home, male gender, age and occupational exposure independently increased lymphocyte DNA strand breaks. The presence of excess DNA damage under low level of occupational exposure to benzene or other solvents suggest that the current allowance concentrations may not be safe to prevent genotoxicity.     

Perceived psychological stress and serum leptin concentrations in Japanese men

Objective: To examine epidemiologically whether subjects with higher stress perception levels have higher leptin concentrations. Research Methods and Procedures: In this cross‐sectional study, the study population comprised 1062 male workers at local government offices in central Japan. Self‐administered questionnaires were distributed in 1997. Awareness of stress was assessed by the question: “Do you have much stress in your life?” and participants were asked to select from four possible responses: “very much,” “much,” “ordinary,” or “little.” Blood samples were also collected after fasting 12 hours overnight to determine serum leptin concentrations. Results: The mean (standard deviation) age and BMI were 50.2 (6.4) years and 23.3 (2.6) kg/m², respectively. Crude leptin concentrations according to stress categories were 2.86, 3.26, 3.32, and 3.54 ng/mL, respectively, and leptin concentrations adjusted for age, BMI, physical activity, drinking and smoking habits, overtime work, shift work, sleep duration, and availability of confidants were 2.96, 3.24, 3.34, and 3.43 ng/mL for “little,” “ordinary,” “much,” and “very much,” respectively (p = 0.03 by one‐way analysis of covariance; p < 0.01 by test of linear trend). Significant associations were also observed among the level of perceived psychological stress and work‐related stressors, variables related to sleep, and other psychological variables. Discussion: This study showed that subjects who perceived psychological stress had high leptin levels, which provides epidemiological evidence that psychological stress may have the potential effect of increasing blood levels of the pleiotropic peptide, leptin.     

Alcohol abstinence and mortality in a general population sample of adults in Germany: A cohort study

BackgroundEvidence suggests that people who abstain from alcohol have a higher mortality rate than those who drink low to moderate amounts. However, little is known about factors that might be causal for this finding. The objective was to analyze former alcohol or drug use disorders, risky drinking, tobacco smoking, and fair to poor health among persons who reported abstinence from alcohol drinking in the last 12 months before baseline in relation to total, cardiovascular, and cancer mortality 20 years later.Methods and findingsA sample of residents aged 18 to 64 years had been drawn at random among the general population in northern Germany and a standardized interview conducted in the years 1996 to 1997. The baseline assessment included 4,093 persons (70.2% of those who had been eligible). Vital status and death certificate data were retrieved in the years 2017 and 2018.We found that among the alcohol-abstinent study participants at baseline (447), there were 405 (90.60%) former alcohol consumers. Of the abstainers, 322 (72.04%) had met one or more criteria for former alcohol or drug dependence or abuse, alcohol risky drinking, or had tried to cut down or to stop drinking, were daily smokers, or self-rated their health as fair to poor. Among the abstainers with one or more of these risk factors, 114 (35.40%) had an alcohol use disorder or risky alcohol consumption in their history. Another 161 (50.00%) did not have such an alcohol-related risk but were daily smokers. The 322 alcohol-abstinent study participants with one or more of the risk factors had a shorter time to death than those with low to moderate alcohol consumption. The Cox proportional hazard ratio (HR) was 2.44 (95% confidence interval (CI), 1.68 to 3.56) for persons who had one or more criteria for an alcohol or drug use disorder fulfilled in their history and after adjustment for age and sex. The 125 alcohol-abstinent persons without these risk factors (27.96% of the abstainers) did not show a statistically significant difference from low to moderate alcohol consumers in total, cardiovascular, and cancer mortality. Those who had stayed alcohol abstinent throughout their life before (42; 9.40% of the alcohol-abstinent study participants at baseline) had an HR 1.64 (CI 0.72 to 3.77) compared to low to moderate alcohol consumers after adjustment for age, sex, and tobacco smoking. Main limitations of this study include its reliance on self-reported data at baseline and the fact that only tobacco smoking was analyzed as a risky behavior alongside alcohol consumption.ConclusionsThe majority of the alcohol abstainers at baseline were former alcohol consumers and had risk factors that increased the likelihood of early death. Former alcohol use disorders, risky alcohol drinking, ever having smoked tobacco daily, and fair to poor health were associated with early death among alcohol abstainers. Those without an obvious history of these risk factors had a life expectancy similar to that of low to moderate alcohol consumers. The findings speak against recommendations to drink alcohol for health reasons.

In this cohort study conducted over 20 years, Ulrich John and colleagues examine the relationship between alcohol abstinence and mortality in a German adult population.     

Psychosocial Predictors of Metabolic Syndrome among Latino Groups in the Multi-Ethnic Study of Atherosclerosis (MESA)

Objective

We sought to determine the contribution of psychological variables to risk for metabolic syndrome (MetS) among Latinos enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA), and to investigate whether social support moderates these associations, and whether inflammatory markers mediate the association between psychological variables and MetS.

Research design and methods

Cross-sectional analyses at study baseline were conducted with a national Latino cohort (n = 1,388) that included Mexican Americans, Dominican Americans, Puerto Rican Americans and Central/South Americans. Hierarchical logistic regression analyses were conducted to test the effects of psychosocial variables (chronic stress, depressive symptoms, and social support) on MetS. In addition, separate subgroup-specific models, controlling for nationality, age, gender, socioeconomic position, language spoken at home, exercise, smoking and drinking status, and testing for the effects of chronic stress, depressive symptoms and inflammation (IL-6, CRP, fibrinogen) in predicting risk for MetS were conducted.

Results

In the overall sample, high chronic stress independently predicted risk for MetS, however this association was found to be significant only in Mexican Americans and Puerto Rican Americans. Social support did not moderate the associations between chronic stress and MetS for any group. Chronic stress was not associated with inflammatory markers in either the overall sample or in each group.

Conclusions

Our results suggest a differential contribution of chronic stress to the prevalence of MetS by national groups.     

Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men

ObjectivesTo examine the association between self perceived psychological stress and cardiovascular disease in a population where stress was not associated with social disadvantage.DesignProspective observational study with follow up of 21 years and repeat screening of half the cohort 5 years from baseline. Measures included perceived psychological stress, coronary risk factors, self reported angina, and ischaemia detected by electrocardiography.Setting27 workplaces in Scotland.Participants5606 men (mean age 48 years) at first screening and 2623 men at second screening with complete data on all measuresResultsBoth prevalence and incidence of angina increased with increasing perceived stress (fully adjusted odds ratio for incident angina, high versus low stress 2.66, 95% confidence interval 1.61 to 4.41; P for trend <0.001). Prevalence and incidence of ischaemia showed weak trends in the opposite direction. High stress was associated with a higher rate of admissions to hospital generally and for admissions related to cardiovascular disease and psychiatric disorders (fully adjusted rate ratios for any general hospital admission 1.13, 1.01 to 1.27, cardiovascular disease 1.20, 1.00 to 1.45, and psychiatric disorders 2.34, 1.41 to 3.91). High stress was not associated with increased admission for coronary heart disease (1.00, 0.76-1.32) and showed an inverse relation with all cause mortality, mortality from cardiovascular disease, and mortality from coronary heart disease, that was attenuated by adjustment for occupational class (fully adjusted hazard ratio for all cause mortality 0.94, 0.81 to 1.11, cardiovascular mortality 0.91, 0.78 to 1.06, and mortality from coronary heart disease 0.98, 0.75 to 1.27).ConclusionsThe relation between higher stress, angina, and some categories of hospital admissions probably resulted from the tendency of participants reporting higher stress to also report more symptoms. The lack of a corresponding relation with objective indices of heart disease suggests that these symptoms did not reflect physical disease. The data suggest that associations between psychosocial measures and disease outcomes reported from some other studies may be spurious.

What is already known on this topic

Higher psychological stress has predicted coronary heart disease in several observational studiesExposure to stress and heart disease outcomes were often based on self report so that a general tendency to negative perceptions may have generated a spurious association between higher perceived stress and heart disease symptoms

What this study adds

Perceived stress was strongly related to subjective symptoms of heart disease, including those leading to hospital admissionHowever, stress showed a weakly inverse relation to all objective indices of heart disease: socially advantaged men perceived themselves to be most stressed, and the “protective” effect of stress was probably attributable to residual confoundingSuggestions that psychological stress is an important determinant of heart disease may be premature