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BACKGROUND: Metabolic syndrome (MetS) presents significant challenges to public health, yet prospective evidence on the associations of social isolation and loneliness with mortality in this population remains limited. METHODS: We analyzed 347,864 participants from the UK Biobank, including 101,276 with MetS. Social isolation and loneliness were assessed using self-reported questionnaires. Among individuals with MetS, Cox proportional hazards models were used to examine their associations with all-cause, cardiovascular disease (CVD), and cancer mortality. Joint associations of social isolation and loneliness were also examined, and multiple sensitivity analyses were conducted. RESULTS: During a median follow-up of 12.48 years, 12,664 deaths occurred among participants with MetS. Social isolation was associated with higher risks of all-cause, CVD, and cancer mortality; for index ≥2 versus 0, hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.29 (1.23-1.36), 1.39 (1.26-1.53), and 1.18 (1.10-1.28), respectively. Loneliness was associated with higher risks of all-cause and CVD mortality, with HRs (95% CIs) of 1.16 (1.09-1.25) and 1.32 (1.15-1.50) for index 2 versus 0, but not cancer mortality. Co-occurring higher social isolation and loneliness was associated with the highest mortality risk. Findings were robust in sensitivity analyses. CONCLUSIONS: Social isolation and loneliness were associated with increased risks of all-cause and CVD mortality among individuals with MetS, with social isolation also associated with cancer mortality. Mortality risk was highest among individuals with coexisting social isolation and loneliness.
Zhang et al. (Tue,) studied this question.