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1 , - A b s tract - T he A s s ociation betw een Job Characteris tic s, P sy cho s oc ial D is tre s s and Hom ocy s teine B on g S uk Ch a, S an g B aek Koh, S ei Jin Ch ang Department of Preventiv e Medicine and In stitut e of Occupational Medicine, W onju College of Medicine, Yon sei University, W onju, Korea T his study w as carried out to as ses s the relation ship betw een job strain, psy chosocial distress an d hom ocy steine. T he study design w as cross - sectional, an d included 152 indu strial w ork er s in middle sized city. A self- admin stered questionnaire measured g en eral ch aracteristic, job strain and psy chosocial distress. Blood w as draw n into EDT A tube, an d total pla sm a h om ocy stein e w as m easured by HPLC. Hom ocy steine in the high job dem an d group w as significantly high er th an that in the low job dem and. Cholesterol in the high job control group w a s significantly higher than that in th e low job contr ol. H om ocy st eine w as significantly high er in the high job str ain gr oup th an that in th e other group. F olate and vitamin B12 show ed a significantly negativ e corr elation w ith h om ocy stein e. Multiple regression analy sis w as u sed to determine w heth er the p sy ch osocial distr es s and other v ariable contributed t o ex plainin g the hom ocy stein e. Stress correlates w ith the hom ocy steine Key W ord : Job ch aracteristics, Job straine, psy chosocial distress, h om ocy stein e * 1998

2 I., -. Depue (1986), H ou se (1986). (An esh en sel, 1992).. Karasek (1988) (high strain group ). T heorell (1991),. (John son H all, 1988; John son, 1989).,., (preclinical stag e) (Schulte, 1993)..,, (Piper, 1989; Green John son,1990; Schnall, 1992). (h om ocy stein e), (Glueck, 1995; Verhoef, 1996). (m ethionine). S - aden osylm ethionin e S - adenosylhom ocy syteine. (adenosine), tran ssulfuration, rem ethylation (Ueland Refsum, 1989). v itamin e B 12 folate.,,. v itamin e B 1 2 folate, folate..

3 .,,,., F olate Vitamin B 1 2.,.

4 II. 1) W ,,. v itamin e,. ethylene diamine tetraacetic acid (EDT A ) 10cc,,. 2) (,,,,,, ) (, ),,, BMI,,,. ( ) John son Hall(1988) (Job Content Questionnaire: JCQ ). 2, 10,,, , 0-30, ( ) ( ). Karasek (1979) 4, (m edian ).,,, (, 1997). Goldberg GH Q (1993) PW I(P sy chosocial W ell- bein g In dex ). PW I Likert 4 ( )., 75,. 10. EDT A, 2 (15, 4, 4300rpm )

5 - 70. HPLC. folate vitamin B 12 radiolig and bin ding. (, HDL ) Hitachi ), t -, folate vitamin B12..

6 III %, %, %, % %, 44.1%.,, 32, %. 50.7%,,,,. 61.8%, 86.8%. 27.4% ( 1). 2.. (p < 0.05), (p > 0.05), (p < 0.05) ( 2). 3. Karasek 4,, m ol/ L 9.1 m ol/ L (p< 0.05). 75,. (p< 0.05),. folate vitamin B 12 ( 4)..,, ( 5)., folate vitamin B 12. folate vitamin B 12, folate vitamin B 1 2 (p< 0.01) ( 6). 3.,,,,,,,, 15% ( 7).

7 IV.,. (stan dard risk factor ),,,,, (W ilhelm sen, 1973; Kannel, 1976). 1. (fatty streak ),,.,,.,,, (Alfth an, 1994; Lolin, 1996) Stamfer (1992), Clark (1991),,.,.,. 7.7 m ol/ L 9.1 m ol/ L,. (Karsek, 1988; Piper, 1989; Reed, 1989; Schnall, 1990; Alterman, 1994), Kara sek (1979),., (cy stathione b eta syn sth eta se, m ethylen e tetrafolate reductase ) (vitamine B 1 2, vitamin e B 6, folate). F olate Vitamin B 12, v itamin e,. folate Vitamin B 12. Bou shey (1995) folic acid, folic acid 5 (Framingham H eart Study )

8 folate vitamin B 12 (Selhub, 1996). (early biological effect ),..,,,.. V., W ,.,..,. F olate vitamin B 12, folate..

9 V I...., 1993, ,,,,, ; 30(1): A lfth an G, Pekkan en J, Jauhiainen M. Relation of serum hom ocy steine an d liporotein (a ) con centration to atherosclerotic disea se in a prospectiv e F innish population based study. Athrosclerosis 1994; 106: 9-19 A lt erm an T, Shekelle R, Vern on SW, and Buran KD. Decision latitu de, p sy chologic dem an ds, job strain, an d coron ary h eart disease in the w estern electric study. Am J Epidemiol. 1994;139: A neshen sel CS. Social stress : th eory an d reseach. A nn Rev Sociol 1992; 18: Bou shey CJ, Beresford SA, Om enn GS, M otulsky A G. A Quantitativ e assessment of plasm a h om ocy stein e a s a risk factor for v ascular disea se. JA MA 1995; 274: Clark R, Daly L, Robbin son K. Hyperh om ocy stein e: an independent risk factor or for v ascular disease. N Eng J M ed 1991; 324: Depu e RA, M onroe SM. Con septu alization and m easurem ent of hum an disorder in life stress r esearch : T he problem of chronic disturbance. P sy chological Bulletin 1986; 99: Glueck CJ, Shaw O, Lang JE, T racy T, Siev e- Smith L, W an g Y. Eviden ce that hom ocy st eine is an independent risl factor for athr osclerosis in hyperlipidem ic patient s. Am J Card 1995; 75: Green KL, John son JV. T he effect s of psy ch osocial w ork org anization on pattern s of cig arette sm orking am on g male chemical plant employ ee. Am J Public H ealth 1990; 80: H ou se JS, Strecher V, M etzn er HL, Robbin s CA. Occupation al stress an d health among men and w omen in th e T ecum seh Community health stu dy. J H ealth Soc Behav 1986; 27: 66-77

10 John son JV, H all EM. Job strain, w ork place social support an d cardiov a scular disease: a cross - sectional study of a r andom sample of the S w edish w orkin g population. A m J Public Health 1988; 78: John son JV, Hall EM, T heorell T. Combined effect s of job strain and social isolation an cardiov a scular disease m orbidity and m ortality in a ran dom sample of th e Sw edish m ale w orking population. Scand J W ork Env iron Health 1989; 15: Kann el W B, M cgee D, Gordon T. A g eneral cardiov ascular risk profile : th e F ramingham study. Am J Cardiol 1976; 38: Kara sek RA. Job dem an ds, job desion latitude,and m ental str ain : im plication s of job redesign. A dmin Sci Q 1979; 24: Kara sek RA, T h eorell T, Schw artz JE, Schn all PL, Piper CF, Mich cla JL. Job characteristics in relation to the prev alen ce of my ocardial infarction in the US h ealth ex am in ation surv ey (HE S ) and the health and nutrition ex amination surv ey (HANES ). Am J Public H ealth 1988; 78: Lolin YI, San derson JE, Ch eng SK, Chan CF, Pand CP, W oo KS, M asarei JRL. Hyperh om ocy stein emia and prem ature coronary artery disea se in th e Chin ese. H eart 1996; 76: Pieper C, LacCroix AZ, Karasek RA. T he relation of psy ch ological dem an sion s of w ork w ith coronary h eart disease risk factor s : a m eta - analy sis of fiv e United States data bases. Am J Epidemiol. 1989; 129: Reed DM, LaCroix AZ, Karasek RA, Miller FD, M aclean CA. Occupational strain an d th e in ciden ce of coronary heart disease. A m J Epidemiol 1989; 129: Schnall PL, Pieper C, Schw artz JE, Karasek RA, Schlu ssel Y, Dev ereux R, Gnau A, A lderm an M, W arren K, Pickerrin g T G. T h e relation ship betw een job strain, w orkplace diastolic blood pr es sure, an d left v entricular m ass in dex. Result s of case- control study JA MA 1990; 263: Schnall PL, Schw artz JE, Landsb ergis PA, W arren K, Pickering T G. Relation betw een job strain, alcohol, an d ambulatory blood pressure. Hyperten sion 1992; 19: Schulte PA. A con ceptual and historical framew ork for m olecular epidemiology. Schelte PA, Perera FP (eds ), M olecular epidemiology principle an d practices. A cademic Press 1993; 4-36

11 Selhub J, Jacqu es PJ, Bostom A G, D 'A g ostino RB. A s sociation b etw een plasm a h om ocy stein e concentration an d ex tracranial carotid artery stenosis. N Eng J M ed 1995; 332: Stamfer MJ, M alinow MR, W ilett W C. A prospectiv e study of plasma hom ocy steine an d risk of my ocardial infarction in US phy sician s. JAMA 1992; 268: T hreoll T, Per ski A, Orth - Gom er K, H am sten A, F aire U. T he effect s of the strain of returnin g to w ork on the risk of cardiac death aftera fir st my ocardial infarction b efore th e age of 45. Int J Cardiol 1991; 30: U elan d PM,Refsum H. Pla sm a homocy steine, a risk factor for v ascular disease: Pla sm a levels in health, disease, and drug therpy. J Lab Clin M ed 1989; 114 (5): V erhoef P, Stampfer MJ, Burin g JE, Gaziano JM, Allen RH, Stabler SP. Hom ocy stein e metab olism an d risk of my ocardial infarction : relation w ith v itamin B6, B 1 2, and folate. Am J Epidemiol 1996; 143 (9): W ilhelm sen L, W edel H, T ibblin G. Multiv ariate analy sis of risk factor for coron ary heart disease. Circulation 1973; 48:

13 T able 1. General characteristics Variable N o % Variable No % A g e Religion None Christian Bu ddist Catholic Other Education High school Sm okin g Colleg e Yes No M arrital statu s Sin gle Alcohol M arried Yes No Incom e Regular ex ercise Yes No

14 T able 2. Comparison of param eter s according to job dem an d an d job decision latitude Job dem and Job decision latitude Low High High Low p v alue p v alu e M ean S.D. M ean S.D. M ean S.D. M ean S.D. A g e BMI(Kg/ m 2 ) Cholesterol(m g/ dl) HDL (m g/ dl) T rigly ceride (m g/ dl) H om ocy stein e ( m ol/ L ) F olate (ng/ ml) Vitamin B 12 (nmol/ L ) T able 3. Comparison param eter s according to job strain Job strain Low High p v alu e M ean S.D. M ean S.D. A g e BMI(Kg/ m 2 ) Cholesterol(m g/ dl) HDL (m g/ dl) T rigly ceride (m g/ dl) H om ocy stein e ( m ol/ L ) F olate (ng/ ml) Vitamin B 12 (nmol/ L )

15 T able 4. Comparison param eter s according to psy chosocial stres s P sy chosocial stress Low High p v alu e M ean S.D. M ean S.D. A g e BMI(Kg/ m 2 ) Cholesterol(m g/ dl) HDL (m g/ dl) T rigly ceride (m g/ dl) H om ocy stein e ( m ol/ L ) F olate (ng/ ml) Vitamin B 12 (nmol/ L ) T able 5. M ean v alue of hom ocy stein e, folate and vitamin B 12 according to life- style factor H om ocy stein e ( m ol/ L ) p v alue F olate (ng/ ml) p v alue Vitamin B 12 (nm ol/ L ) p v alue M ean S.D. M ean S.D. M ean S.D. Sm okin g Yes No Alcoh ol Yes No Ex ercise Yes No

16 T able 6. T he correlation betw een job characteristic, psy chosocial stress, hom ocy steine, folate and vitamine B 1 2 Stres s Job dem and Job decision latitude H om ocy stein e F olate Job dem an d 0.39 * * Job decision latitude * * hom ocy stein 0.23 * F olatet * * Vitamin B * * 0.47 * * *: p < 0.05 **: p < 0.01 T able 7. Multiple regression of hom ocy steine on selected v ariable Independent v ariable Beta p v alue A ge Smoking Alcohol Ex ercise Cholesterol HDL T riglyceride Job dem and Job decision latitude P sy ch osocial stress R square 0.15 A dj R square 0.11 F v alue 3.41 p v alu e 0.002

a16.PDF

a16.PDF ,,,, A B S T RA CT A S t u dy on S erv ic e Ch ara ct eri s t ic s of D ire c t ors of H e alt h Cen t ers in K ore a T his stu dy h as attempted to show general characteristics of health centre director