Association between Metabolic Syndrome and Psychological Characteristics in Korean Postmenopausal Women

Eunjoo Kwon; Eun-Hee Nah; Hyekyeong Kim; Sook-Haeng Joe; Han-Ik Cho

doi:10.15384/kjhp.2016.16.2.119

Korean J Health Promot > Volume 16(2); 2016 > Article

Kwon, Nah, Kim, Joe, and Cho: Association between Metabolic Syndrome and Psychological Characteristics in Korean Postmenopausal Women

Original Article

Korean Journal of Health Promotion 2016;16(2):119-126.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.2.119

Association between Metabolic Syndrome and Psychological Characteristics in Korean Postmenopausal Women

¹Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea

²Department of Health Convergence, Ewha Womans University College of Science and Industry Convergence, Seoul, Korea

³Department of Psychiatry, Korea University College of Medicine, Seoul, Korea

⁴Korea Association of Health Promotion, Seoul, Korea

⁵Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea

Eunjoo Kwon¹, Eun-Hee Nah^1,, Hyekyeong Kim², Sook-Haeng Joe³, Han-Ik Cho^4,⁵

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

Received September 25, 2015 Accepted June 02, 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.

요약

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.

Keywords: Metabolic syndrome X, Mental health, Anxiety, Depression, Postmenopause

Table 1.

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

	Group without MetS	Group with MetS	Total	P^a
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
Stress^b				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 anxiety^c				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 status^d				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 level^e				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 income^f				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).

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

^b5 missing.

^c20 missing.

^d1 missing.

^e1 missing.

^f19 missing.

Table 2.

Correlation between mental health score and risk factors of metabolic syndrome

	Stress		Trait anxiety		Depression
	r	P^a	r	P^a	r	P^a
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.

^aCalculated by Spearman rank correlation.

Table 3.

Factors associated with metabolic syndrome in middle-aged menopausal women^a

MetS	OR	95% CI	P^b
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

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

^bCalculated by multiple logistic regression.

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