RT Journal Article SR Electronic T1 Occupational distribution of metabolic syndrome prevalence and incidence differs by sex and is not explained by age and health behavior: results from 75 000 Dutch workers from 40 occupational groups JF BMJ Open Diabetes Research & Care JO BMJ Open Diab Res Care FD American Diabetes Association SP e001436 DO 10.1136/bmjdrc-2020-001436 VO 8 IS 1 A1 Sander K R van Zon A1 Benjamin C Amick III A1 Trynke de Jong A1 Sandra Brouwer A1 Ute Bültmann YR 2020 UL http://drc.bmj.com/content/8/1/e001436.abstract AB Introduction This study examines the association between 40 occupational groups and prevalence and incidence of metabolic syndrome (MetS), separately for male and female workers, and whether age and health behaviors can explain the association.Research design and methods Data from 74 857 Lifelines Cohort and Biobank Study participants were used to regress occupational group membership, coded by Statistics Netherlands, on the prevalence and incidence of MetS using logistic and Cox regression analyses. MetS diagnosis was based on physical examinations, blood analysis, and recorded medication use. Information on age, smoking status, physical activity, diet and alcohol consumption was acquired using questionnaires.Results Baseline MetS prevalence was 17.5% for males and 10.6% for females. During a median 3.8 years of follow-up, MetS incidence was 7.8% for males and 13.2% for females. One occupational group was associated with an increased MetS risk in both sexes. Six additional occupational groups had an increased risk for MetS among men, four among women. Highest risks were found for male ‘stationary plant and machine operators’ (HR: 1.94; 95% CI 1.26 to 3.00) and female ‘food preparation assistants’ (HR: 1.80; 95% CI 1.01 to 3.22).Conclusions Findings suggest that occupational group matters for men and women in MetS development, and that differences in MetS prevalence across occupations are not merely a reflection of selection of metabolically unhealthy workers into specific occupations. The striking sex differences in the occupational distribution of MetS indicate that preventive measures should, with some exceptions, target men and women separately.