Tsai Kun-Zhe, Lin Ko-Huan, Hung Ai-Hsiu, Chang Yun-Chen, Sui Xuemei, Lavie Carl J, Lin Gen-Min
Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan.
Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan.
Front Cardiovasc Med. 2025 Aug 21;12:1432464. doi: 10.3389/fcvm.2025.1432464. eCollection 2025.
The association observed between mental stress and metabolic syndrome (MetS) has varied across studies and may be confounded by physical activity (PA) and fitness status.
This study included a military cohort of 2,854 participants in Taiwan who were not taking any medications and were free of baseline MetS. The Brief Symptoms Rating Scale (BSRS-5) includes five domains-depression, anxiety, hostility, insomnia, and interpersonal sensitivity-measured on a five-point Likert-type scale ranging from 0 to 4, with a maximum score of 20. PA (hrs/wk) was categorized into three levels: <150, 150-299 and ≥300. Aerobic fitness was evaluated by the amount of time taken to complete a 3,000 m run. MetS was defined according to the International Diabetes Federation (IDF) criteria. Multivariable Cox proportional hazards regression analysis with adjustments for potential covariates including PA and aerobic fitness was utilized to determine the associations of BSRS-5 scores (each 1-unit score increase) with the incidence of MetS and related features.
During a median follow-up period of 5.8 years, 662 new-onset cases of MetS (23.2%) developed. BSRS-5 scores were not associated with the risk of new-onset MetS [hazard ratio (HR): 1.006 [95% confidence interval (CI): 0.975, 1.039]]. Among the five MetS features, the only one associated with BSRS-5 scores was the risk of new-onset hypertension [HR: 1.038 (95% CI: 1.002, 1.075)], which was defined as blood pressure ≥130/85 mmHg or the use of antihypertensive medications, among 2,405 participants free of baseline hypertension.
Our findings suggest that in young adult military personnel, mental stress was not associated with the incidence of MetS but was associated with its hypertension component, which was independent of PA and aerobic fitness.
不同研究中观察到的心理压力与代谢综合征（MetS）之间的关联存在差异，且可能受到身体活动（PA）和健康状况的混淆。
本研究纳入了台湾地区2854名未服用任何药物且无基线MetS的军人队列。简明症状评定量表（BSRS - 5）包括五个领域——抑郁、焦虑、敌意、失眠和人际敏感——采用从0到4的五点李克特量表进行测量，最高分20分。PA（小时/周）分为三个水平：<150、150 - 299和≥300。通过完成3000米跑步所需的时间来评估有氧适能。MetS根据国际糖尿病联盟（IDF）标准定义。采用多变量Cox比例风险回归分析，并对包括PA和有氧适能在内的潜在协变量进行调整，以确定BSRS - 5评分（每增加1分）与MetS发病率及相关特征之间的关联。
在中位随访期5.8年期间，出现了662例新发MetS病例（23.2%）。BSRS - 5评分与新发MetS风险无关[风险比（HR）：1.006 [95%置信区间（CI）：0.975，1.039]]。在五个MetS特征中，唯一与BSRS - 5评分相关的是新发高血压风险[HR：1.038（95% CI：1.002，1.075）]，在2405名无基线高血压的参与者中，高血压定义为血压≥130/85 mmHg或使用抗高血压药物。
我们的研究结果表明，在年轻成年军人中，心理压力与MetS发病率无关，但与其高血压组分相关，且独立于PA和有氧适能。
