The relationship between psychological risk attributes and the metabolic syndrome in healthy women: antecedent or consequence?

The metabolic syndrome is an important risk factor for major chronic diseases in women. A key component of the syndrome, central adiposity, is correlated with psychological risk factors associated with coronary artery disease in prior epidemiological studies. We evaluated if psychological risk factors predicted the metabolic syndrome and if the metabolic syndrome predicted psychological distress. A population-based cohort of 425 women who were middle-aged, and pre-, peri-, and postmenopausal was followed for an average 7.4 years. Psychological risk factors, including depression, anxiety, tension, current perceived stress, and anger, and biological components of the metabolic syndrome, including glucose, triglycerides, high-density lipoprotein (HDL)-cholesterol, waist circumference, and blood pressure (BP) were measured at baseline and at examinations 1 to 8 years postmenopause. Women were classified according to the National Heart, Lung, and Blood Institute (NHLBI) criteria for metabolic syndrome. Women who exhibited high levels of depression, tension, and anger at baseline, and increased in anger during the follow-up had elevated risk for developing the metabolic syndrome during follow-up, P <.04. The metabolic syndrome at baseline, in turn, predicted increasing anger and anxiety 7.4 years later, P <.001. Psychological risk factors affect the development of the metabolic syndrome. The association between anger and the metabolic syndrome is reciprocal. Reduction in the level of psychological distress may prevent the development of the metabolic syndrome in women.