Research Review by Dr. Shawn Thistle©


Feb. 2006

Study Title:

Chronic stress at work and the metabolic syndrome


Chandola T, Brunner E, Marmot M

Publication Information:

British Medical Journal 2006; [Epub ahead of print]


Stress in the workplace had been linked in prospective and retrospective studies to coronary heart disease. The "metabolic syndrome" is a cluster of risk factors that greatly increases the risk of heart disease and Type II Diabetes. These risk factors include:
  • abdominal obesity
  • ↑ triglycerides
  • small LDL (bad cholesterol) molecules
  • ↓ HDL (good cholesterol)
  • high blood pressure
  • insulin resistance
  • prothrombotic and proinflammatory states
The exact relationship between work stress and the metabolic syndrome is currently unknown. This prospective cohort study attempted to more clearly define this relationship.

Over 10 000 men and women from 20 civil service departments in London, England were followed for an average of 14 years. Self-reported job stress was measured using the Job Strain Questionnaire. Metabolic syndrome was defined as any three of the above listed risk factors.

Pertinent Results:

  • a clear dose-response relationship was noted between work stress and incidence of metabolic syndrome
  • this relationship remained even after adjusting for certain health behaviours (note: obese men and women were excluded at baseline)
  • men with chronic work stress were nearly twice as likely to develop metabolic syndrome as those with no work stress
  • metabolic syndrome showed a social gradient: those in the lowest employment grades had more than double to odds of getting metabolic syndrome
  • metabolic syndrome was also associated with poor diet (no fruit and vegetable consumption), heavy alcohol consumption, smoking, and physical inactivity

Conclusions & Practical Application:

This study is one of the first to link stress at work with development of the metabolic syndrome. It also provides evidence for the biological plausibility of psychosocial stress contributing to the development of heart disease.

Further research is needed to more clearly define the exact mechanism, but this study provides a starting point for many interesting lines of work. rs should be providing to their patients, and highlight the proper lifestyle choices that all people should aspire to make.