BASIC analysis of ---Stress/overwork and cardiovascular disease data

Sino-Japanese cooperation project

---------by Mile Xiu

Background about this project

Experimental design

• We focus on the relationship between work stress and cardiovascular disease. Work stress is assessed by Job demand control scale. Cardiovascular risk factors and the ankle-brachial index(ABI) and Brachial–ankle pulse wave velocity (baPWV) is also collected

• Participants: 3,000 Chinese people and 100 Japanese people work in Shanghai rolled in our research

• Inclusion criteria: Cooperate with the investigation;≥18 years old; blood and urine sample left.

• Exclusion criteria: Do not finish our questionnaire ;<18 years old; blood or urine sample missed

Protocol

ＷWORK HOURS

DECISION LATITUDE

SOCIAL SUPPORT

JOB DEMAND

JOB STRENGTH

ＳＰＹ

waist

ＳＹSBP

PP

HR

LDL

HDL

UUA

HbA1c

ＰPWV Albumin

Ussmoking

Working condition

Cardiovascular risk

Organ damage

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e15

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Baseline

• Basic information: Name, gender, birthday, occupational type ,educational level, marital status, address, phone number.

• Anthropometric: height; body weight, abdominal circumference, blood pressure, heart rate.

• Family history: focus on cardiovascular-related family history• Personal history: smoke(no/post/yes), alcohol intake(yes/no),

Fatty liver(mild/moderate or heavier/no), exercise situation• Drug therapy: Antihypertensive drug, Antidiabetic drugs

Antilipemic drugs, Aspirin.

Blood and urine laboratory

• Total cholesterol(TC); Triglyceride(TG); High-density lipoprotein cholesterol (HDL-C); Low-density lipoprotein cholesterol (LDL-C)

• Fasting blood; Glycosylated Hemoglobin A_(1C)(HbA1c%).• Alanine aminotransferase (ALT);Aspartate aminotransferase

(AST);r-GTP• Uric acid, Urea nitrogen, Total protein, Albumin, Urinary

protein• Vascular screening: ABI and baPWV

Work stress scale

• Work time per week(<25h;25-34;35-44;45-54;>55);sleep time and clock in weekday; walk time everyday (none; in 1 hour;1-2 hours; >hours); diet type(Never eating too much from youth; can't eat too full due to the health concerns; Eating too much or eating too little; Eating full)

• Desicion latitude: The higher the score the greater the power• Social support: The higher the score the lower the support• Job demand: The higher the score the lower the required

degree.• Job strength: The higher the score the lower the work

strength.

Traditional CVD risk factors

• Blood pressure ≥ 140/90 mm Hg and/or hypertension history• Diabetes mellitus fasting glucose ≥ 7.0 mmol/L and/or

diabetes mellitus history (HbA1c ≥6.5%??)• Hyperlipidemia total cholesterol ≥ 5.72 mmol/L, and/or total

triglyceride ≥1.7 mmol/L, and/or low-density lipoprotein ≥ 3.64 mmol/L, and/or Hyperlipidemia history.

• Body mass index (BMI) normal(≤24), overweight (>24 and <28), and obesity (≥28)

• Smoke• Alchol intake

Data analysis

• Soft ware : SPSS version17.0

• chi-square test or t test

• Logistic regression

Description by gender

Characteristic All 2504Mean SD

Male 1582Mean SD

Female 922Mean SD

P value

Gender 2504 1579(63.2) 922(36.8) <0.001Age 46.1 47.5(11.4) 43.7(16.2) 0.005Education        

Lower than senior high school; 259(10.5) 151 108

0.124Senior high school; 599(24.2) 366 233Bachelor 1455(58.9) 945 510Master OR higher 158(6.4) 101 57

Marital status         Unmarried 169 74(4.7%) 95(10.5%)

<0.001 Married 2268 1475(94.7%) 793(87.7%) Divorced 8 4(0.3%) 4(0.4%) Widowed 17 5(0.3%) 12(1.3%)Height 167.4(7.98) 171.4(6.4) 160(5.3) <0.001Body weight 67.7(16.5) 72.7(10.6) 59.1(20.7) <0.001BMI 24.08(5.96) 24.77(4.25) 22.89(7.97) <0.001Abdominal circumference 85.02(11.16) 88.8(8.96) 77.38(11.28) <0.001SBP 126.1(17.6) 129.2(16.3) 120.9(18.6) <0.001DBP 78.0(11.7) 80.0(11.0) 73.3(11.2) <0.001PP 48.2(11.2) 48.4(10.6) 47.7(12.0) 0.127Heart rate 73.7(10.9) 73.3(10.7) 74.2(11.2) 0.063Smoke history         Non-smoker 1638(65.7%) 740(47%) 898(97.9%)

<0.001 Post-smoker 126(5.1%) 123(7.8%) 3(0.3%) Smoker 729(29.2%) 713(45.2) 16(1.7)History of alcohol intake         Non-drinker 1682(67.5%) 805(51.1%) 877(95.8%)

<0.001 Post-drinker 58(2.3%) 57(3.6%) 1(0.1%) Drinker 751(30.1%) 714(45.3%) 37(4.0%)Adiposis hepatica situation         none 1612(64.8%) 863(53.5%) 749(81.4%)

<0.001 mild 665(26.7%) 541(34.5%) 124(13.5%) Moderate or heavier 212(8.5%) 165(10.5%) 47(5.1%)Active physical activity         no 1552(62.6%) 878(56.1%) 674(73.7%)

<0.001 yes 928(37.4%) 687(43.9%) 241(26.3%)baPWV 1357(255.7) 1399.5(235.4) 1284.1(272.1) <0.001ABI 1.06(0.085) 1.07(0.85) 1.04(0.83) <0.001

Description by stress score Characteristic Low score

≤104Frequency/Percentage

High score>105Frequency/Percentage

P value

Gender      

Male 688 799<0.001

Female 425 361

Education      

Lower than high school; 101 88

0.002(wilcoxon)

Senior high school; 270 243

Bachelor 661 727

Master OR higher 63 93

Marital status      

Unmarried 102 63

0.002 Married 985 1074

Divorced 3 4

Widowed 1 5

Smoker history      

Non-smoker 768(69.4%) 706(60.9%)

<0.001 Post-smoker 123(3.5%) 56(4.8%)

Smoker 713(27.1%) 397(34.3%)

History of alcohol intake      

Non-drinker 809(73.1%) 700(60.5%)

<0.001 Post-drinker 23(2.1%) 25(2.2%)

Drinker 275(24.8%) 432(37.3%)

Adiposis hepatica situation      

None 736(66.5%) 727(63.1%)

0.002 Mild 303(27.4%) 307(26.6%)

Moderate or heavier 68(6.1%) 118(10.2%)

Exercise situation      

No 685(62%) 716(62.2%)0.959

Yes 419(38%) 436(37.8%)

Antihypertensive drug situation      

No 926(83.5%) 993(85.7%)0.151

Yes 183(16.5%) 166(14.3%)

Antidiabetic Drugs situation      

No 1080(97.8%) 1130(97.7%)0.798

Yes 24(2.2%) 27(2.3%)

Antilipemic situation      

No 1096(99.2%) 1146(99%)0.729

Yes 9(0.8) 11(1%)

Aspirin situation      

No 1083(98.1%) 1134(97.9%)0.772

Yes 21(1.9%) 24(2.1%)

Characteristic Low score ≤104Mean SD

High score>105Mean SD

P value

BMI 23.74(3.34) 24.19(4.91) 0.011Age 44.7(11.4) 44.6(10.56) 0.789Abdominal circumference 84.2(10.55) 85.76(12.15) 0.005SBP 124.8(17.1) 125.6(16.4) 0.516PP 47.6(10.4) 46.9(9.99) 0.131Heart rate 73.9(11.2) 73.4(10.8) 0.301TC 4.75(0.85) 4.89(1.00) <0.001TG 1.53(1.28) 1.61(1.43) 0.181HDL-C 1.27(0.34) 1.3(0.46) 0.018LDL-C 2.78(0.7) 2.89(0.76) <0.001BG 4.86(1.03) 4.85(1.14) 0.848HbA1c(%) 5.31(0.842) 5.35(0.89) 0.847ALT 24.29(17.7) 27.25(23.29) <0.001AST 23.58(10.45) 23.87(15.8) 0.679r-GTP 30.8(34.74) 33.7(37.3) <0.001UA 321.8(95.4) 334.3(96.9) 0.002UN 5.23(3.51) 5.48(4.42) 0.147Total protein 73.1(5.67) 72.4(6.47) 0.002Albumin 46.5(3.2) 46.2(3.65) 0.066Urine protein 16.04(33.5)

(14.45-18.0)16.59(47.1)(13.85-19.33)

0.778

ABI 1.058(0.09) 1.059(0.081) 0.860baPWV 1340.6(261.8) 1338.8(219.7) 0.245Work hour/week      

<25 66(6%) 36(3.2%)

<0.00125-34 43(3.9%) 43(3.8%)35-44 762(69.8%) 615(54.1%)45-54 169(15.5%) 296(26.1%)≥55 52(4.8%) 146(12.9%)

Sleep duration 7.14(0.975) 7.16(0.968) 0.666Diet type       Never eating too much from youth 501(45.3%) 439(38.2)

<0.001 can't eat too full due to the health concerns 180(16.3%) 225(19.6%)

Eating too much or eating too little 186(16.8%) 161(14%) Eating full 239(21.6%) 325(28.3%)              

Thanks !!!