{
  "schemaVersion": 1,
  "capturedAt": "2026-10-29T10:31:13.704Z",
  "sha256": "5637f08ef630d8077478cff85ba609dd35815deae28f29115203e886677d5616",
  "work": {
    "type": "RDN",
    "kind": "note",
    "key": "kivimaki-2012",
    "id": "TAP-RDN-0060",
    "locale": "zh",
    "path": "/zh/research/kivimaki-2012/",
    "title": "TAP 导读: Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data",
    "description": "在欧洲在职者中，高需求与低控制组成的工作紧张与随后冠心病相关。年龄和性别调整后HR=1.23；再调整社会经济地位后为1.17（95%CI 1.05—1.31）。这是工作条件与长期健康的前瞻关联证据。",
    "rights": "© The Allostasis Project。保留所有权利。除法律允许的例外外，转载或改编需另行授权。",
    "version": "1.0",
    "updatedAt": "2026-10-29",
    "editorial": {
      "contentType": "evidence-review",
      "reviewState": "draft",
      "reviewedAt": null,
      "reviewedVersion": null,
      "updatedAt": "2026-10-29",
      "version": "1.0",
      "byline": "team",
      "author": null,
      "reviewer": null,
      "workflow": {
        "ai": {
          "usage": "used",
          "system": "OpenAI Codex",
          "scope": "Assisted source comparison, evidence extraction and bilingual research-note preparation. The materials consulted and unresolved scientific issues are specified in each note.",
          "version": "1.0",
          "tasks": [
            "Source comparison and evidence extraction",
            "Bilingual research-note drafting and editorial comparison"
          ]
        }
      },
      "revisions": [
        {
          "date": "2026-10-29",
          "version": "1.0",
          "description": "新增工作紧张与冠心病关联，区分调整模型与因果归因假设。"
        }
      ]
    },
    "original": {
      "id": "kivimaki-2012",
      "title": "Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data",
      "authors": "Kivimäki M · Nyberg ST · Batty GD · Fransson EI · Heikkilä K · Alfredsson L · Bjorner JB · Borritz M · Burr H · Casini A · Clays E · De Bacquer D · Dragano N · Ferrie JE · Geuskens GA · Goldberg M · Hamer M · Hooftman WE · Houtman IL · Joensuu M · Jokela M · Kittel F · Knutsson A · Koskenvuo M · Koskinen A · Kouvonen A · Kumari M · Madsen IE · Marmot MG · Nielsen ML · Nordin M · Oksanen T · Pentti J · Rugulies R · Salo P · Siegrist J · Singh-Manoux A · Suominen SB · Väänänen A · Vahtera J · Virtanen M · Westerholm PJ · Westerlund H · Zins M · Steptoe A · Theorell T · IPD-Work Consortium",
      "journal": "The Lancet",
      "year": "2012",
      "url": "https://doi.org/10.1016/s0140-6736(12)60994-5",
      "doi": "10.1016/s0140-6736(12)60994-5",
      "pmid": "22981903"
    },
    "references": [
      {
        "id": "kivimaki-2012",
        "title": "Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data",
        "authors": "Kivimäki M · Nyberg ST · Batty GD · Fransson EI · Heikkilä K · Alfredsson L · Bjorner JB · Borritz M · Burr H · Casini A · Clays E · De Bacquer D · Dragano N · Ferrie JE · Geuskens GA · Goldberg M · Hamer M · Hooftman WE · Houtman IL · Joensuu M · Jokela M · Kittel F · Knutsson A · Koskenvuo M · Koskinen A · Kouvonen A · Kumari M · Madsen IE · Marmot MG · Nielsen ML · Nordin M · Oksanen T · Pentti J · Rugulies R · Salo P · Siegrist J · Singh-Manoux A · Suominen SB · Väänänen A · Vahtera J · Virtanen M · Westerholm PJ · Westerlund H · Zins M · Steptoe A · Theorell T · IPD-Work Consortium",
        "journal": "The Lancet",
        "year": "2012",
        "url": "https://doi.org/10.1016/s0140-6736(12)60994-5",
        "doi": "10.1016/s0140-6736(12)60994-5",
        "pmid": "22981903"
      }
    ],
    "sections": [
      {
        "id": "finding",
        "title": "研究发现",
        "paragraphs": [
          "在欧洲在职者中，高需求与低控制组成的工作紧张与随后冠心病相关。年龄和性别调整后HR=1.23；再调整社会经济地位后为1.17（95%CI 1.05—1.31）。这是工作条件与长期健康的前瞻关联证据。"
        ]
      },
      {
        "id": "limits",
        "title": "范围与局限",
        "paragraphs": [
          "13个队列、197,473名基线无冠心病的在职者，发生2,358例冠心病事件。",
          "工作紧张主要在基线测量一次，仍可能存在剩余混杂、暴露变化和逆向因果。已发表与未发表资料的估计不同。论文给出的人群归因比例依赖因果假设，不能当作改善工作条件已被证明可预防的事件比例。"
        ]
      },
      {
        "id": "sample",
        "title": "研究人群与样本",
        "paragraphs": [
          "13个队列、197,473名基线无冠心病的在职者，发生2,358例冠心病事件。"
        ]
      },
      {
        "id": "exposure",
        "title": "暴露或干预",
        "paragraphs": [
          "基线工作高需求与低控制，对比无工作紧张者；个体参与者数据荟萃分析。"
        ]
      },
      {
        "id": "outcomes",
        "title": "观察结局",
        "paragraphs": [
          "冠心病事件及分层、发表状态和混杂调整后的风险估计。"
        ]
      },
      {
        "id": "duration",
        "title": "时间范围",
        "paragraphs": [
          "平均随访7.5年。"
        ]
      },
      {
        "id": "funding",
        "title": "研究资金来源",
        "paragraphs": [
          "EU New OSH ERA项目及芬兰、瑞典、德国、丹麦的职业健康机构；Academy of Finland 132944；BUPA Foundation 22094477；荷兰社会事务与就业部；MRC及NIH R01HL036310、R01AG034454；G. D. Batty获Wellcome研究支持。各队列另有资助。"
        ]
      },
      {
        "id": "conflicts",
        "title": "研究利益关系",
        "paragraphs": [
          "作者声明无利益冲突，并报告资助者未参与研究及发表决策。"
        ]
      },
      {
        "id": "basis",
        "title": "导读范围",
        "paragraphs": [
          "全文人群和结局定义、分层结果、发表状态比较与讨论；暴露重复测量和全部原队列资料未逐一核读。"
        ],
        "links": [
          {
            "label": "PubMed Central全文",
            "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3486012/"
          }
        ]
      }
    ]
  }
}