Key result
Severe depressive symptoms linked to ~92% higher risk of incident metabolic syndrome.
Why the study?
Findings linking depression to metabolic syndrome in Japanese populations have been inconsistent and limited to cross-sectional studies.
Are depressive symptoms associated with an increased incidence of metabolic syndrome in middle-aged Japanese workers?
Cohort (n=2,969)
Are depressive symptoms associated with an increased incidence of metabolic syndrome in middle-aged Japanese workers?
Odds Ratio: 1.92 (95% CI 1.4–2.64)
Absolute Event Rate: 14.9% vs 10.2%
Depressive symptoms are non-linearly associated with an increased risk of developing metabolic syndrome in middle-aged Japanese workers, with risk plateauing at a CES-D-11 score of approximately 10.
May support depressive symptom screening in metabolic risk assessment; leaves open causal effects and intervention benefits.
BackgroundDepression has been associated with various chronic conditions, including metabolic syndrome (MetS), but findings from Japanese studies have been inconsistent and are limited to cross-sectional design.We therefore examined the longitudinal association between depressive symptoms and incidence of MetS and its components in middle-aged Japanese workers. MethodsData were analysed from 2969 public servants (aged 35-65, 73.1% male) in the Aichi Workers' Cohort Study who were free of MetS at baseline (2013), with at least one follow-up assessment ( between 2014 and 2018).Depressive symptoms were assessed at baseline using the 11-item Centre for Epidemiological Studies Depression scale (CES-D-11) and categorized into tertiles: first tertile (0-4), second tertile (5-7), and third tertile (≥8).MetS was defined by the harmonized criteria for Japanese, based on waist circumference (≥90 cm for men and ≥80 cm for women), triglycerides, HDL cholesterol, blood pressure, and blood glucose levels.Multivariable logistic regression estimated ORs and 95% CIs.Restricted cubic A c c e p t e d V e r s i o n 4 splines and piecewise logistic regression evaluated non-linearity and a threshold. ResultsDuring five years, 391 participants (13.2%) developed MetS, with a cumulative incidence rate of 10.2% in the first tertile, 15.8% in the second tertile, and 14.9% in the third tertile.In the fully adjusted model, participants in the second and third tertile had higher odds of incident MetS (OR: 1.89, 95% CI, 1.44-2.48;OR: 1.92, 95% CI, 1.40-2.64,respectively) and high triglycerides (OR: 1.43, 95% CI, 1.08-1.90;OR:1.80, 95% CI, 1.31-2.48,respectively) compared with those in the first tertile.Restricted cubic spline suggested non-linearity (p < 0.001) with a threshold at CES-D-11 approximately 10. Below this threshold, each 1-SD increase in CES-D-11 was associated with higher odds of incident MetS (OR 1.59, 95% CI, 1.31-1.92). ConclusionDepressive symptoms were associated with incident MetS among middle-aged Japanese workers, particularly with high triglyceride component.The association appeared non-linear, with risk increasing up to a CES-D-11 score of approximately 10 and then plateauing.This potential threshold may help improve understanding of the relationship between depressive symptoms and MetS risk, although further A c c e p t e d V e r s i o n 5 studies are needed before it can be used for risk stratification and prevention efforts.
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Endale et al. (2026) conducted a cohort in Metabolic Syndrome (n=2,969). Depressive symptoms (CES-D-11 score ≥8) vs. Low depressive symptoms (CES-D-11 score 0-4) was evaluated on Incident Metabolic Syndrome (OR 1.92, 95% CI 1.40-2.64). Depressive symptoms were associated with a higher risk of incident metabolic syndrome, with participants in the highest tertile of symptoms having nearly twice the odds (OR 1.92) compared to the lowest.
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