职业应激与糖化血红蛋白的关系

The relationship between occupational stress and serum glycosylated hemoglobin Alc level

目的探讨职业应激对血清中糖化血红蛋白（HbAlc）水平的影响。方法采用横断面研究方法对115名机车调度员进行调查，使用职业应激测量工具测试职业应激因素、个性特征和应激反应，采用阳离子交换树脂层析法测定血清中HbAlc浓度。结果轮班作业组血清中HbAlc浓度（6．63％＋1．93％）高于常白班作业组（5．73％＋1．57％），差异有统计学意义0=2．422，P〈0．05）；A型行为倾向与HbAlc水平呈明显的正相关（r=0．221，P〈0．05），组织忠诚度与HbAlc水平呈明显的负相关（r=-0．218，P〈0．05）；工作负荷需求、工作控制评分组间HbAlc浓度的差异有统计学意义（P〈0．05），高工作需求、低工作控制评分组血清中HbAlc浓度较高；个性特征中A型行为、内控性、应激易感性和组织忠诚度评分组间血清中HbAlc浓度的差异有统计学意义（P〈0．05），A型行为和应激易感性高水平组HbAlc浓度高于低水平组，内控性和组织忠诚度高水平组HbAlc浓度低于低水平组。逐步回归分析结果显示，轮班作业对HbAlc浓度有较大影响（R^2=0．082），内控性和工作前景未知性也是影响HbAlc改变的预测因子（R2〉0．05）。结论血清中HbAlc可能是预测职业应激的生物标志物。

Objective To explore the relationship between occupational stress and serum glycosylated hemoglobin Alc（HbAle） level. Methods A cross-sectional epidemiologieal study was conducted in 115 dis- patchers. The occupational stressors, personality, occupational strain and coping with stress were measured us- ing Occupational Stress Instrument. Serum HbAlc levels were measured by stratographic analysis of cation ex- change resin. Results Serum HbAlc level（6.63%＋l.93%） in the shiftwork group was significantly higher than that（5.73%＋1.57% ） in the daily relay work group （P〈0.05）. Spearman correlation analyses showed the positive correlation between type A behavior and serum HbAlc level（r=0.221 ）, the negative correlation between organi- zational commitment and serum HbAle level （r=-0.218）.Variance analyses revealed that serum HbAlc levels among high, middle and low job requirement groups and job control groups were significantly different （P〈0.05）. There were significant differences of serum HbAlc levels among different type A behavior, internal control, sus- ceptibility of stress and organizational commitment groups （P〈0.05）. Stepwise regression analyses indicated that shfftwork affects obviously serum HbAIc level, internal control and job future were the predictors of serum HbAlc level（R2=0.082）. Conclusion Serum HbAlc may be a potential biomarker in field investigation of the effects of occupational stress.