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Open Access Highly Accessed Research article

Elevated depressive symptoms in metabolic syndrome in a general population of Japanese men: a cross-sectional study

Atsuko Sekita12, Hisatomi Arima1*, Toshiharu Ninomiya3, Tomoyuki Ohara12, Yasufumi Doi3, Yoichiro Hirakawa1, Masayo Fukuhara1, Jun Hata1, Koji Yonemoto4, Yukiko Ga12, Takanari Kitazono3, Shigenobu Kanba2 and Yutaka Kiyohara1

Author Affiliations

1 Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan

2 Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan

3 Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan

4 Biostatistics Center, Kurume University, 67 Asahimachi, Kurume 830-0011, Japan

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BMC Public Health 2013, 13:862  doi:10.1186/1471-2458-13-862

Published: 18 September 2013

Abstract

Background

Uncertainty still surrounds the association between metabolic syndrome (MetS) and depression. We aimed to evaluate the association between MetS and elevated depressive symptoms in a general Japanese population.

Methods

This is a cross-sectional survey of 3,113 community-dwelling individuals aged 40 years or over. MetS was defined according to the joint interim statement. MetS was diagnosed when a subject had three or more of the following components: 1) central obesity (waist circumference ≥90 cm for men, ≥80 cm in for women); 2) elevated blood pressure (≥130/85 mmHg or current use of antihypertensive medication); 3) hypertriglyceridemia (≥1.7 mmol/L); 4) low HDL cholesterol (< 1.0 mmol/L for men, < 1.3 mmol/L for women); and 5) elevated fasting plasma glucose (≥5.55 mmol/L or current use of antidiabetic medication). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The age- and multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated using a logistic regression model.

Results

Elevated depressive symptoms were observed in 4.3% of male and 6.3% of female participants. In men, the age-adjusted prevalence of elevated depressive symptoms was significantly higher in subjects with MetS than in those without (7.1% versus 3.6%, p = 0.04). The prevalence of elevated depressive symptoms rose progressively as the number of MetS components increased (3.5%, 3.6%, 5.8%, and 9.2% in male subjects with 0–1, 2, 3, and ≥4 components, respectively; p = 0.02 for trend). This association remained significant even after adjustment for age, marital status, history of cardiovascular disease, smoking habit, alcohol intake, and regular exercise. In women, on the other hand, there was no clear association between MetS and depressive symptoms.

Conclusions

MetS was associated with elevated depressive symptoms in a general population of Japanese men.

Keywords:
Depressive symptoms; Metabolic syndrome; Population-based; Japanese