kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2016.16.2.119 kjhp-16-119 Original Article Association between Metabolic Syndrome and Psychological Characteristics in Korean Postmenopausal Women KwonEunjoo 1 NahEun-Hee 1 KimHyekyeong 2 JoeSook-Haeng 3 ChoHan-Ik 4 5 Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea Department of Health Convergence, Ewha Womans University College of Science and Industry Convergence, Seoul, Korea Department of Psychiatry, Korea University College of Medicine, Seoul, Korea Korea Association of Health Promotion, Seoul, Korea Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea Corresponding author: Eun-Hee Nah, MD, PhD Health Promotion Research Institute, Korea Association of Health Promotion, 350 Hwagok ro, Gangseo-gu, Seoul 07653, Korea Tel: +82-2-2600-0107, Fax: +82-2-2690-4915 E-mail: cellonah@hanmail.net 01 2016 20 01 2016 16 2 119 126 25092015 02062016 Copyright © 2016 The Korean Society of Health Promotion and Disease Prevention 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

Metabolic syndrome is a major health problem in postmenopausal women, along with psychological issues. Hence, this study was conducted to investigate the relationship between metabolic syndrome and mental health properties targeting middle-aged menopausal women, and analyzed the psychological factors affecting the prevalence of metabolic syndrome.

 Methods

The study subjects were 479 postmenopausal women aged 45–64 years, who had taken their routine health screenings from August to October in 2012. The presence of 3 or more of 5 risk factors constitutes diagnosis of metabolic syndrome. Depression, trait anxiety, and stress level were measured by Beck Depression Inventory, State-Trait Inventory, and Brief Encounter Psychological Instrument, respectively. Multiple logistic regression analysis was performed to confirm the relationship between the metabolic syndrome and psychological characteristics.

 Results

The prevalence of metabolic syndrome in postmenopausal women was 16.5%. Metabolic syndrome was significantly related with trait anxiety (odds ratio [OR]=16.53, P=0.007) and depression (OR=0.16, P=0.012), after adjusting for age, marital status, educational level, monthly income, body mass index, eating habits and exercise.

 Conclusions

Trait anxiety and depression were found to be related with the prevalence of metabolic syndrome in postmenopausal women.

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Characteristics of the study population according to the presence of metabolic syndrome

  Group without MetS Group with MetS Total Pa
N 400 (83.5) 79 (16.5) 479 (100.0)  
Age, y 57.0 (54.0–60.5) 57.0 (53.0–61.0) 57.0 (54.0–61.0) 0.591
Stressb       0.197
Mild 224 (56.7) 51 (64.6) 275 (58.0)  
Moderate to severe 171 (43.3) 28 (35.4) 199 (42.0)  
Trait anxietyc       0.039
Normal 373 (98.2) 74 (93.7) 447 (97.4)  
Mild to moderate 7 (1.8) 5 (6.3) 12 (2.6)  
Depression       0.008
Normal 260 (65.0) 62 (78.5) 322 (67.2)  
Mild 73 (18.3) 3 (3.8) 76 (15.9)  
Moderate 48 (12.0) 12 (15.2) 60 (12.5)  
Severe 19 (4.8) 2 (2.5) 21 (4.4)  
BMI, kg/m2 23.1 (21.8–24.8) 26.2 (23.5–28.1) 23.4 (21.9–25.5) <0.001
Waist circumference, cm 77.0 (73.0–82.0) 86.0 (79.0–90.0) 78.0 (73.0–83.0) <0.001
Systolic BP, mmHg 118.0 (110.0–127.0) 131.0 (124.0–137.0) 118.0 (110.0–130.0) <0.001
Diastolic BP, mmHg 74.0 (70.0–80.0) 83.0 (78.0–88.0) 76.0 (70.0–81.0) <0.001
Total cholesterol, mg/dL 209.0 (185.0–235.0) 219.0 (186.0–238.0) 211.0 (186.0–235.0) 0.373
HDL-cholesterol, mg/dL 57.0 (51.0–64.0) 46.0 (39.0–50.0) 56.0 (50.0–63.0) <0.001
LDL-cholesterol, mg/dL 129.0 (106.0–153.5) 131.2 (103.4–154.8) 129.0 (105.6–154.0) 0.728
Triglycerides, mg/dL 90.0 (66.0–126.0) 174.0 (122.0–210.0) 98.0 (69.0–145.0) <0.001
Fasting glucose, mg/dL 93.0 (88.0–99.0) 105.0 (94.0–116.0) 94.0 (89.0–101.0) <0.001
Marital statusd       0.607
Married living with partner 347 (87.0) 67 (84.8) 414 (86.6)  
Widow/divorced/single 52 (13.0) 12 (15.2) 64 (13.4)  
Educational levele       0.037
≤Middle school 158 (39.5) 43 (55.1) 201 (42.1)  
High school 164 (41.0) 23 (29.5) 187 (39.1)  
College/Universe 78 (19.5) 12 (15.4) 90 (18.8)  
Monthly incomef       0.940
≤2 million won 146 (38.0) 27 (35.5) 173 (37.6)  
2–3 million won 76 (19.8) 14 (18.4) 90 (19.6)  
3–5 million won 99 (25.8) 21 (27.6) 120 (26.1)  
≥5 million won 63 (16.4) 14 (18.4) 77 (16.7)  

Abbreviations: MetS, metabolic syndrome; BMI, body mass index; BP, blood pressure; HDL, high density lipoprotein; LDL, low density lipoprotein. Values are presented prevalence (%) or median (range).

Calculated by chi-square test, Fisher's exact test or Mann-Whitney U test.

5 missing.

20 missing.

1 missing.

1 missing.

19 missing.

Correlation between mental health score and risk factors of metabolic syndrome

  Stress Trait anxiety Depression
  r Pa r Pa r Pa
Waist circumference, cm –0.058 0.209 –0.035 0.454 -0.118 0.010
Systolic blood pressure, mmHg –0.114 0.013 –0.060 0.203 –0.101 0.026
Diastolic blood pressure, mmHg –0.114 0.013 –0.071 0.127 –0.107 0.019
HDL-cholesterol, mg/dL 0.031 0.497 0.007 0.885 0.054 0.240
Triglycerides, mg/dL 0.021 0.652 0.042 0.368 0.004 0.928
Fasting glucose, mg/dL 0.016 0.723 0.015 0.746 –0.054 0.237
No. of metabolic components –0.055 0.234 –0.016 0.737 -0.103 0.025

Abbreviations: HDL, high density lipoprotein.

Calculated by Spearman rank correlation.

Factors associated with metabolic syndrome in middle-aged menopausal womena

MetS OR 95% CI Pb
Stress      
Mild (Reference) 1.00    
Moderate to severe 0.64 0.288–1.400 0.260
Triat anxiety      
Normal (Reference) 1.00    
Mild to moderate 16.53 2.161–126.506 0.007
Depression      
Normal (Reference) 1.00    
Mild 0.16 0.039–0.667 0.012
Moderate 0.87 0.271–2.781 0.867
Severe 0.15 0.014–1.548 0.147
BMI 1.46 1.305–1.639 <0.001

Abbreviations: Mets, metabolic syndrome; OR, odds ratio; CI, confidence interval; BMI, body mass index

This model was adjusted for age, educational level, monthly income, BMI, eating habit and exercise.

Calculated by multiple logistic regression.