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Predictors of elevated capillary blood glucose in overweight railway French employees: a cross-sectional analysis.

ABSTRACT: BACKGROUND:Hyperglycaemia is a risk factor of cardiovascular disease and a high risk state for progression to type 2 diabetes. Moreover, overweight, defined as a body mass index (BMI) between 25 and 29.9 kg/m2, increases the risk of diabetes. Information about the feasibility of measuring, during routine occupational health examinations, predictors of elevated capillary blood glucose in overweight individuals is scarce. This study aims to identify factors that are associated with elevated capillary blood glucose and can be routinely measured in French overweight employees to develop targeted preventive strategies in the workplace. METHODS:Cross-sectional study based on data collected during a workplace health promotion programme of the French National Railways Company (SNCF) from January 2011 to March 2015. A self-administered questionnaire was completed by overweight volunteers during the routine occupational health examination. Data collected included health, anthropometric, sociodemographic, occupational, and lifestyle characteristics. Elevated capillary blood glucose was defined as capillary blood glucose equal to or higher than 7 mmol/L. Multivariate logistic regression analysis was used to examine factors associated with elevated capillary blood glucose and results were described with odds ratios (OR) and 95% confidence intervals (CI). RESULTS:The analysis concerned 2248 overweight employees (mean age: 43 years) with complete data (total population: 7724). The prevalence of elevated capillary blood glucose was 20.0%. In the multivariate analysis, significant predictors of elevated capillary blood glucose were: male sex (OR 1.66, 95% CI 1.21-2.28), age ≥ 50 years (OR 1.61, 95% CI 1.01-2.55), high blood pressure (OR 1.35, 95% CI 1.07-1.69), and daily intake of sugary food (OR 1.53, 95% CI 1.17-2.00). No association with occupational characteristics (work schedule, job seniority, professional grade, and job sector) was found possibly due to lack of statistical power. CONCLUSIONS:Our findings provide information for setting up specific diabetes prevention strategies in the workplace. Overweight men, aged 50 and older, with high blood pressure and daily sugary food intake should be considered for capillary blood glucose measurements during their occupational medical surveillance. Hypertension screening and management as well as health policy measures to target sugary food consumption could be included in workplace prevention strategies.

SUBMITTER: Lucas Garcia EL

PROVIDER: S-EPMC5902963 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundWe aimed to determine the prevalence of elevated alanine aminotransferase (eALT) in employees of a German chemical company, and analyze its association with sociodemographic, work- and lifestyle-related factors.MethodsThe cross-sectional study is based on data surveyed from occupational health check-ups between 2013 and 2018 at the site clinic of a chemical company based in Ludwigshafen, Germany. We used logistic regression analyses to assess the association between sociodemographic, work- and lifestyle-related characteristics and eALT. Quantile regression technique was applied to investigate if associations vary across different quantiles of the ALT distribution.ResultsParticipants (n = 15,348) were predominantly male (78.3%) with a mean age of 42.2 years (SD 10.7). The prevalence of eALT was 18.5% (21.6% in men/7.2% in women) with a geometric mean of 28.9 U/L (32.8 U/L in men/18.5 U/L in women). In the multivariable logistic regression model, odds of eALT were significantly higher for males (OR 2.61; 95%-CI 2.24-3.05), manual workers (OR 1.23; 95%-CI 1.06-1.43), overweight (OR 2.66; 95%-CI 2.36-3.00) or obese respondents (e.g. OR 7.88; 95%-CI 5.75-10.80 for obesity class III), employees who consume any number of alcoholic drinks/week (e.g. OR 1.32; 95%-CI 1.16-1.49 for ≥ 3 drinks per week) and diabetics (OR 1.47; 95%-CI 1.22-1.78). Additionally, season of participation was significantly associated with eALT, with odds being higher for participation in spring, fall or winter, as compared to summer. A significant interaction between age and gender (pInteraction < 0.001) was found, showing approximately a u-shaped age/ALT relationship in women and an inversely u-shaped relationship in men. Quantile regression showed an increasing positive effect of male gender, overweight/obesity, and for diabetics on ALT level when moving from the lowest (q0.1) to the highest (q0.9) considered quantile. Additionally, from the lowest to the highest quantile an increasing negative effect on ALT for older age was observed.ConclusionsPrevalence of eALT in our sample of employees can be considered as high, with almost one in five participants affected. Identification of risk groups allows the implementation of targeted preventive measures in order to avoid transition to severe morbidity.

Project description:Background: To overcome the problem of a high prevalence of undiscovered or untreated arterial hypertension in people of working age, the effects of behavioral change counseling in occupational health (OH) services should be investigated. The technique of motivational interviewing (MI) to support health-related lifestyle changes by physicians and/or occupational nurses ('health coach') has been shown to be successful in patients with chronic diseases. In 2010, we planned a randomized controlled trial (RCT) with employees who suffer from mild arterial hypertension. A preliminary feasibility study was performed in a large manufacturing company in Germany. Methods: All employees with elevated blood pressure measured by the OH-service were invited to undergo validation by 30 self-measurements. Persons with validated elevated values and without medical treatment received either usual hypertension counseling (control group, CG) or intensified MI-counseling (intervention group, IG) by the occupational health physician. Subsequently, the IG received MI-support from the 'health coach' in four telephone counseling sessions. Assessed feasibility factors included organizational processes, the acceptance of the validation procedure and the MI-counseling, and as primary outcome for an RCT the extent to which participants made health-related changes to their lifestyles. Results: Initially, 299 individuals were included in Study Part A (screening). At the end of Study Part B (intervention), out of 34 participants with validated and non-treated mild hypertension, only 7 (IG) and 6 (CG) participants completed the intervention including documentation. The high drop-out rate was due to the frequent lack of willingness to perform the 30 self-measurements at home with their own equipment. Acceptance was little higher when we changed the method to two repeated measurements in the OH service. MI-counseling, especially by the health coach, was evaluated positively. Conclusions: Despite the promising counseling approach, the feasibility study showed that an RCT with previous screening in the operational setting can only be implemented with high financial and personnel effort to reach an appropriate number of subjects. This substantial result could only be achieved through this comprehensive feasibility study, which investigated all aspects of the planned future RCT.

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Predictors of elevated capillary blood glucose in overweight railway French employees: a cross-sectional analysis.

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