Association between anxiety and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies

Tang, Fang; Wang, Gangpu; Lian, Ying

doi:10.1016/j.psyneuen.2016.11.025

Cited by 117Diabetes, Cardiovascular Risks, and LipoproteinsCardiac Health and Mental HealthAdipokines, Inflammation, and Metabolic Diseases

Association between anxiety and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies

Tang, Fang, Wang, Gangpu, Lian, Ying·2017·Psychoneuroendocrinology

DOI 10.1016/j.psyneuen.2016.11.025

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Abstract

Objective Epidemiological studies have repeatedly investigated the association between anxiety and metabolic syndrome (MetS). However, the results have been inconsistent. We performed a meta-analysis of observational studies to summarize the evidence regarding the relation of anxiety and MetS risk.Methods We performed a systematic literature search of all studies published in PubMed and EMBASE from its inception to June 2016. Cross-sectional and cohort studies that reported an association between the two conditions in adults were included. Data on prevalence, incidence, unadjusted or adjusted odds ratio (OR), and 95% CI were extracted or provided independently by the authors. Random effects model was used to report the pooled OR. The I 2 statistic was used to assess heterogeneity. Egger's test and Begger's test were used to evaluate the publication bias.Results The search yielded 18 cross-sectional studies and two cohort studies. The pooled finding from cross-sectional studies showed that anxiety had a significant positive association with MetS (OR 1.07, 95% CI 1.01-1.12), with moderate heterogeneity (I 2=45.7%, P=0.018). Findings from two cohort studies indicated that the association between anxiety and MetS was insignificant.Conclusion Our results suggest that there is an association between anxiety and MetS. In individuals with MetS anxiety should be detected and managed. Further prospective studies are needed to explore the bidirectional association between anxiety and MetS.

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The odds of developing major depressive disorder and anxiety increase as a function of the number of coexisting metabolic impairments, such as those characteristic of metabolic syndrome.
“The odds of developing major depressive disorder (MDD) and anxiety increase as a function of the number of coexisting metabolic impairments, such as those characteristic of metabolic syndrome [3,4].”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [4]

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Anxiety disorders in childhood are associated with youth IL-6 levels: A mediation study including metabolic stress and childhood traumatic events
de Baumont, A., Bortoluzzi, A., de Aguiar, B. W., Scotton, E., Guimarães, L. S. P., Kapczinski, F. P., da Silva, C. T. B., & Manfro, G. G. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.05.011 · Cited by 24 · see citing works
Neuroticism, Worry, and Cardiometabolic Risk Trajectories: Findings From a 40‐Year Study of Men
Lee, L. O., Grimm, K. J., Spiro, A., & Kubzansky, L. D. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.022006 · Cited by 21 · see citing works
Depression, Anxiety, and Risk of Metabolic Syndrome in Women With Polycystic Ovary Syndrome: A Longitudinal Study
Lee, I. T., Rees, J., King, S., Kim, A. E., Cherlin, T., Hinkle, S. N., Mumford, S. L., & Dokras, A. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae256 · Cited by 21 · see citing works
Changes in health-related quality of life, motivation for physical activity, and the levels of anxiety and depression after individualized aerobic training in subjects with metabolic syndrome
Zupkauskienė, J., Laucevičienė, I., Navickas, P., Ryliškytė, L., Puronaitė, R., Badarienė, J., & Laucevičius, A. (2022) · Hellenic Journal of Cardiology · doi:10.1016/j.hjc.2022.04.003 · Cited by 24 · see citing works
Pharmacological and physiological roles of adipokines and myokines in metabolic-related dementia
Arjunan, A., & Song, J. (2023) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2023.114847 · Cited by 19 · see citing works
Diet Overall and Hypocaloric Diets Are Associated With Improvements in Depression but Not Anxiety in People With Metabolic Conditions: A Systematic Review and Meta-Analysis
Paris, T., Daly, R. M., Abbott, G., Sood, S., Freer, C. L., Ryan, M. C., & George, E. S. (2024) · Advances in Nutrition · doi:10.1016/j.advnut.2024.100169 · Cited by 18 · see citing works
“Those with depression and anxiety have higher rates of metabolic conditions [14,15] and vice versa [16 – 18].”
Background
Exposure to Vicarious Social Defeat Stress and Western-Style Diets During Adolescence Leads to Physiological Dysregulation, Decreases in Reward Sensitivity, and Reduced Antidepressant Efficacy in Adulthood
Sial, O. K., Gnecco, T., Cardona-Acosta, A. M., Vieregg, E., Cardoso, E. A., Parise, L. F., & Bolaños‐Guzmán, C. A. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.701919 · Cited by 18 · see citing works
“Reward dysregulation is a common phenotype that often emerges after early-life chronic exposure to palatable substances (Sato et al., 1991; Teegarden et al., 2009), drugs of abuse (Iñiguez et al., 2009; Naneix et al., 2017), or stress (Iñiguez et al., 2010; Parise et al., 2013).”
Background
Effects of a diverse prebiotic fibre blend on inflammation, the gut microbiota and affective symptoms in metabolic syndrome: a pilot open-label randomised controlled trial
Hall, C. V., Hepsomali, P., Dalile, B., Scapozza, L., & Gurry, T. (2024) · British Journal Of Nutrition · doi:10.1017/s0007114524002186 · Cited by 20 · see citing works
Association between Symptoms of Depression and Generalised Anxiety Disorder Evaluated through PHQ-9 and GAD-7 and Anti-Obesity Treatment in Polish Adult Women
Witaszek, T., Kłoda, K., Mastalerz–Migas, A., & Babicki, M. (2024) · Nutrients · doi:10.3390/nu16152438 · Cited by 18 · see citing works
“Anxiety also has a significant positive correlation with metabolic syndrome [17].”
Background
Alexithymia and metabolic syndrome: the mediating role of binge eating
Conti, C. M., Francesco, G. D., Severo, M., Lanzara, R., Richards, K. L., Guagnano, M. T., & Porcelli, P. (2020) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-020-00964-x · Cited by 16 · see citing works
The prevalence and related factors of metabolic syndrome in outpatients with first-episode drug-naive major depression comorbid with anxiety
Zhong, Y., Hu, M., Wang, Q., Yang, Z.-D., Zhu, N., Wang, F., Zhang, X.-Y., Zhang, C.-F., Min, J., Wang, H., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-81653-2 · Cited by 14 · see citing works
Unconscious loss processing in diabetes: associations with medication adherence and quality of care
Marchini, F., Langher, V., Napoli, A., Balonan, J. T., Fedele, F., Martino, G., Amorosi, F. R., & Caputo, A. (2021) · Psychoanalytic Psychotherapy · doi:10.1080/02668734.2021.1922492 · Cited by 16 · see citing works
Metabolic syndrome and incident depressive symptoms in young and middle-aged adults: A cohort study
Jeon, S. W., Lim, S., Shin, D., Ryu, S., Chang, Y., Kim, S. Y., Oh, K., Shin, Y.-C., & Kim, Y. H. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.12.073 · Cited by 15 · see citing works
DIAGNOSIS OF METABOLIC SYNDROME USING MACHINE LEARNING, STATISTICAL AND RISK QUANTIFICATION TECHNIQUES: A SYSTEMATIC LITERATURE REVIEW
Kakudi, H. A., Kiong, L. C., Moy, F. M., Kau, L. C., & Pasupa, K. (2021) · Malaysian Journal of Computer Science · doi:10.22452/mjcs.vol34no3.1 · Cited by 14 · see citing works
Common and specific aspects of anxiety and depression and the metabolic syndrome
Hoffmann, M. S., Brunoni, A. R., Stringaris, A. K., Viana, M. C., Lotufo, P. A., Benseñor, I. M., & Salum, G. A. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.02.052 · Cited by 14 · see citing works
Association Between Obesity and Post-stroke Anxiety in Patients With Acute Ischemic Stroke
Zhu, B., Hu, A.-Y., Huang, G., Qiu, H., Hong, X., Hu, P., Yuan, C., Ruan, Y., Yang, B., & He, J. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.749958 · Cited by 13 · see citing works
Prevalence of Mood and Anxiety Disorders in Canadians with Cardiovascular Disease: A Cross-Sectional Study
Sohier, L., Dallaire-Habel, S., Turcotte, S., & Foldes‐Busque, G. (2024) · Heart and Mind · doi:10.4103/hm.hm-d-23-00060 · Cited by 12 · see citing works
Role of glucocorticoid receptor phosphorylation-mediated synaptic plasticity in anxiogenic and depressive behaviors induced by monosodium glutamate
Zhu, W., Yang, F., Cai, X., Zhang, W., Zhang, J., Cai, M., Li, X., Xiang, J. Y., & Cai, D. (2020) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-020-01845-x · Cited by 12 · see citing works
Effectiveness of wearable devices as a support strategy for maintaining physical activity after a structured exercise intervention for employees with metabolic syndrome: a randomized controlled trial
Bayerle, P., Kerling, A., Kück, M., Rolff, S., Boeck, H. T., Sundermeier, T., Ensslen, R., Tegtbur, U., Lauenstein, D., Böthig, D., et al. (2022) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-022-00409-1 · Cited by 11 · see citing works
“PA and physical exercise on a regular basis have a positive influence on mental health and QoL both in people who are healthy [25] and people with diseases [26], considering that there is a correlation between MetS and depression [27] as well as MetS and anxiety [28].”
Background
angptl4 gene expression as a marker of adaptive homeostatic response to social isolation across the lifespan in zebrafish
Alnassar, N., Hillman, C., Fontana, B. D., Robson, S. C., Norton, W., & Parker, M. O. (2023) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2023.08.004 · Cited by 9 · see citing works
Mental health is related to metabolic syndrome: The Hispanic community health study/ study of Latinos
Richard, S. L., Renn, B. N., Kim, J., Tran, D.-M. T., & Du, F. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106085 · Cited by 10 · see citing works
PENGARUH PRENATAL YOGA TERHADAP KECEMASAN PADA IBU HAMIL TRIMESTER III DI KECAMATAN PLAJU
Yuniza, Y., Tasya, T., & Suzanna, S. (2021) · Jurnal Keperawatan Sriwijaya · doi:10.32539/jks.v8i2.15951 · Cited by 10 · see citing works
Increased Prevalence of Depression and Anxiety Among Subjects With Metabolic Syndrome in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Berto, L. F., Suemoto, C. K., Moreno, A. B., da Fonseca, M. D. J. M., Nunes, M. A., Molina, M. D. C. B., Barreto, S. M., Diniz, M. D. F. H. S., Lotufo, P. A., Benseñor, I. M., et al. (2022) · Journal of the Academy of Consultation-Liaison Psychiatry · doi:10.1016/j.jaclp.2022.06.001 · Cited by 9 · see citing works
Association of Sleep Duration and Self-Reported Insomnia Symptoms with Metabolic Syndrome Components among Middle-Aged and Older Adults
Zhang, Y., Xie, Y., Huang, L., Zhang, Y., Li, X., Fang, Q., & Wang, Q. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811637 · Cited by 9 · see citing works
“A meta-analysis of epidemiological evidence indicated that sleep fragmentation, fatigue, anxiety and depressive symptoms might be comorbidity and confounding factors which could accelerate the development of MetS [42].”
Background
The role of multiparity and maternal age at first pregnancy in the association between early menarche and metabolic syndrome among middle-aged and older women
Rocha, T. N., Macêdo, P. R. D. S., Vafaei, A., Guedes, D. T., Azevedo, I. G., Maciel, Á. C. C., & da Câmara, S. M. A. (2021) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000001809 · Cited by 8 · see citing works
Analysis of the association between anxiety, depression and obesity in individuals with metabolic syndrome
Silva, J. D. V., de Lima, C. R. O. C., Brandão, N. A., dos Santos, L. A., Dias, V. C., Corrêa, A. D. B., de Almeida, D. O., da Conceição, G. C., Florence, T. C. M., Almeida, A. G.-D., et al. (2023) · Endocrine Regulations · doi:10.2478/enr-2023-0011 · Cited by 7 · see citing works
“…and depression may also have a hyper-activation of the hypothalamic-pituitary-adrenal axis (HPA), which increases cortisol levels (Franco 2012; Tang et al. 2017) and thus, have some physiological alterations that may be observed in gluconeogenesis, leptin synthesis, adipocyte differentiation,…”
Different Impact of Metabolic Syndrome on the Risk of Incidence of the Peripheral Artery Disease and the Venous Thromboembolism: A Nationwide Longitudinal Cohort Study in South Korea
Park, M. S., Ok, J. S., Sung, J., Kim, D., Han, S. W., Kim, T., Kim, B. S., Kim, H.-J., Kim, H., & Kim, H. (2023) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2404113 · Cited by 6 · see citing works
“MetS has been reported to be associated with cardiovascular disease (CVD) [5].”
Background
Gender differences in prevalence and clinical correlates of anxiety in first-episode and drug-naïve patients with major depressive disorder comorbid with metabolic syndrome
Gao, W., Deng, Z., Cai, X., Zhang, D., Han, X., & Zhang, X. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05574-w · Cited by 7 · see citing works
“Zhong et al. reported a significant positive association between metabolic syndrome and anxiety [14].”
Background
High persistence and low treatment rates of metabolic syndrome in patients with mood and anxiety disorders: A naturalistic follow-up study
Brouwer, J., Wardenaar, K. J., Liemburg, E. J., Doornbos, B., Mulder, H., & Cath, D. C. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.042 · Cited by 6 · see citing works
Association between Adherence to SSRI Treatment and Mortality among Individuals with Metabolic Syndrome Components
Avrahamy, H., Shoval, G., Hoshen, M., Balicer, R. D., Kamhi-Nesher, S., Zalsman, G., Weizman, A., & Krivoy, A. (2021) · Pharmacopsychiatry · doi:10.1055/a-1425-7246 · Cited by 6 · see citing works
AFFECTIVE DISORDERS IN WOMEN WITH ARTERIAL HYPERTENSION IN COMBINATION WITH METABOLIC SYNDROME
Yaskevich, R. A., & Moskalenko, O. L. (2022) · Siberian Journal of Life Sciences and Agriculture · doi:10.12731/2658-6649-2022-14-3-267-286 · Cited by 6 · see citing works
“няющих высокую вероятность формирования МС у лиц с тревожно-депрессивными расстройствами [1, 5, 12, 22, 28, 30, 32].”
Influential
The Interaction of Glycemia with Anxiety and Depression Is Related to Altered Cerebellar and Cerebral Functional Correlations
Shearrer, G. E. (2023) · Brain Sciences · doi:10.3390/brainsci13071086 · Cited by 6 · see citing works
“Unsurprisingly, anxiety is also related to metabolic syndrome, a constellation of closely related cardiovascular risk factors, including hyperglycemia [4].”
Background
Towards precision psychiatry: Metabolomics identifies three biological subtypes of depression
Ma, S., Nie, Z., Zhang, M., Mei, J., Zhou, E., Hu, Z., Lv, H., Gong, Q., Wang, G., Wang, H., et al. (2025) · PLOS Digital Health · doi:10.1371/journal.pdig.0001125 · Cited by 6 · see citing works
METABOLIC SYNDROME: ASSESSMENT OF QUALITY OF LIFE, ANXIETY AND DEPRESSION IN PATIENTS
Moskalenko, O. L., Smirnova, O. V., Каспаров, Э. В., & Каспарова, И. Э. (2021) · Siberian Journal of Life Sciences and Agriculture · doi:10.12731/2658-6649-2021-13-6-11-28 · Cited by 5 · see citing works
AFFECTIVE DISORDERS IN MEN WITH ARTERIAL HYPERTENSION IN COMBINATION WITH METABOLIC SYNDROME
Yaskevich, R. A., & Moskalenko, O. L. (2022) · Siberian Journal of Life Sciences and Agriculture · doi:10.12731/2658-6649-2022-14-4-126-145 · Cited by 5 · see citing works
“Поэтому лицам с уже диагностированным МС, в свою очередь, необходимо проводить психологическое обследование (скрининг) для выявления сопутствующих тревожно-депрессивных состояний [28, 32].”
Inversely Regulated Inflammation-Related Processes Mediate Anxiety–Obesity Links in Zebrafish Larvae and Adults
Yehuda, H., Madrer, N., Goldberg, D., Soreq, H., & Meerson, A. (2023) · Cells · doi:10.3390/cells12131794 · Cited by 5 · see citing works
“Although a high-fat diet and obesity are often reported to have adverse effects, inducing chronic low-grade inflammation [100,103] and increased risks of diabetes and cardiovascular diseases [8,103], recent studies report that HFDs and obesity can have a protective role, as implied by our study.”
BackgroundResult
Non-alcoholic fatty liver disease (NAFLD) and potential links to depression, anxiety, and chronic stress
Shea, S., Lionis, C., Kite, C., Atkinson, L., Chaggar, S. S., Randeva, H. S., & Kyrou, I. (2021) · Biomedicines · doi:10.3390/biomedicines9111697 · Cited by 4 · see citing works
“This significant association of anxiety with metabolic syndrome is also supported by systematic review and meta-analysis data, which pooled findings from 18 relevant cross-sectional studies [35].”
Background
Taste receptor type 1 member 3 enables western diet-induced anxiety in mice
Song, J. W., Lee, K.-H., Seong, H., Shin, D., & Shon, W.-J. (2023) · BMC Biology · doi:10.1186/s12915-023-01723-x · Cited by 4 · see citing works
“Several studies showed that high-calorie western diet-induced obesity is a potential risk factor for anxiety [29, 30].”
Background
Overgeneralization of autonomic defensive reactions in obesity
Manassero, E., Scarpina, F., Tagini, S., Concina, G., Scacchi, M., Pollo, A., Mauro, A., & Sacchetti, B. (2024) · Scientific Reports · doi:10.1038/s41598-024-72439-3 · Cited by 4 · see citing works
A prospective registry analysis of psychosocial and metabolic health between women with and without metabolic syndrome after a complicated pregnancy
Aldridge, E., Schubert, K. O., Pathirana, M. M., Sierp, S., Leemaqz, S., Roberts, C. T., Dekker, G., & Arstall, M. A. (2022) · BMC Women s Health · doi:10.1186/s12905-022-02035-y · Cited by 4 · see citing works
“The association between anxiety and metabolic syndrome has been more contentious, but a 2017 meta-analysis reported a significant positive association between the two [47].”
Background
The psychological burden associated with metabolic syndrome: Evidence from UK and US older adults
Robinson, E., Daly, M., & Putra, I. G. N. E. (2024) · Obesity Science & Practice · doi:10.1002/osp4.780 · Cited by 4 · see citing works
“5,17 In addition, MetSyn was associated with a range of other negative psychosocial factors, including hopelessness, cynical hostility, increased negative affect, decreased positive affect, social support and purpose in life.”
Background
Rutinitas Senam Hamil dengan Melahirkan Spontan
Universitas Lampung, L., Sari, R. D. P., Sutarto, S., Universitas Lampung, L., Utama, W. T., Universitas Lampung, L., Pratiwi, D., & Universitas Lampung, L. (2022) · Jurnal Ilmu Medis Indonesia · doi:10.35912/jimi.v2i2.1376 · Cited by 4 · see citing works
Effects of Physical Exercise on the Quality of Life of Type 2 Diabetes Patients
Tomás-Carús, P., Leite, N. J. C., & Raimundo, A. M. D. M. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.87110 · Cited by 4 · see citing works
Development and validation of a predictive nomogram for the risk of MAFLD in postmenopausal women
Yang, M., Chen, X., Shen, Q., Xiong, Z., Liu, T., Leng, Y., & Jiao, Y. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1334924 · Cited by 3 · see citing works
“In the systematic review by Tang (29), two cohort studies were included, which reported no correlation between MetS and anxiety (30, 31).”
Presence of Mood and/or Anxiety Disorders Does Not Affect Success of Weight Management Therapies in Metabolic Dysfunction-Associated Steatotic Liver Disease
Bollinger, B., Cotter, R. J., Deng, Y., Ilagan‐Ying, Y. C., & Gupta, V. (2024) · Digestive Diseases and Sciences · doi:10.1007/s10620-024-08724-y · Cited by 3 · see citing works
“Patients with psychiatric conditions such as major depressive disorder (MDD) and generalized anxiety disorder (GAD) are more likely to develop metabolic syndrome than those without such conditions [3–5].”
Outcomes of metabolic syndrome and anxiety levels in light and heavy smokers
Şahin, M., & Yüzügüllü, D. (2025) · PeerJ · doi:10.7717/peerj.19069 · Cited by 3 · see citing works
“A recent meta-analysis of 18 cross-sectional studies examining anxiety ’ s impact on metabolic syndrome risk reported a modest yet discernible increase in risk (OR = 1.07) ( Tang, Wang & Lian, 2017 ).”
Influential
Stress and Anxiety Are Associated with Increased Metabolic Syndrome Risk Among Young Adults Living in the Deep South
Renna, M. E., Wilbourne, F. N., Johal, S. K., Fergerson, A., Behringer, K. F., Brandner, C. F., Stavres, J., & Graybeal, A. (2025) · Healthcare · doi:10.3390/healthcare13040359 · Cited by 4 · see citing works
“In addition to the numerous biological risks of MetS, psychological factors such as anxiety and depression are associated with MetS in middle-aged and older adults [6,7].”
Associations Between Anxiety Symptoms and Health-Related Quality of Life: A Population-Based Twin Study in Sri Lanka
Nas, Z., Zavos, H. M. S., Sumathipala, A., Jayaweera, K., Siribaddana, S., Hotopf, M. H., & Rijsdijk, F. V. (2021) · Behavior Genetics · doi:10.1007/s10519-021-10051-1 · Cited by 4 · see citing works
“Anxiety symptoms impact not only emotional wellbeing, but are also associated with chronic health problems (Davies and Allgulander 2013; El-Gabalawy et al. 2014; Tang et al. 2017), bodily pain (Lerman et al.”
Background
Re-establishing alliances: “Old Friends” confronting obesity, inflammation, and stress-related psychiatric disorders
Desmond, L. W., & Lowry, C. A. (2026) · Brain Behavior and Immunity Integrative · doi:10.1016/j.bbii.2026.100166 · Cited by 2 · see citing works
Risk of Glaucoma Associated with Components of Metabolic Disease in Taiwan: A Nationwide Population-Based Study
Chang, Y., Sung, F., Tzeng, Y., Mou, C.-H., Tien, P., Su, C.-W., & Teng, Y. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010305 · Cited by 2 · see citing works
“Studies have also linked MetD with age-related cataract [13], age-related macular degeneration (AMD) [10], obstructive sleep apnea (OSA) [14], nonalcoholic fatty liver disease [15], depression, anxiety [16,17], and hypothyroidism [18].”
Background
Environmental Factors in the Etiology of Mental Disorders in the Czech Republic
Hosák, L., Hosakova, K., Malekirad, M., Kamarádová, D., Zapletalová, J., & Látalová, K. (2023) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s379811 · Cited by 3 · see citing works
Prevalence and risk factors of anxiety symptoms in first-episode and drug-naïve major depressive disorder patients with metabolic syndrome
Liu, J., Yang, Y., Zhang, Y., Wang, H., Wei, W., Lang, X., & Zhang, X. (2023) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2023.07.001 · Cited by 2 · see citing works
Hazardous alcohol use and cardiometabolic risk among firefighters
Levitt, D. E., Wohlgemuth, K. J., Burnham, E. F., Conner, M. J., Collier, J. J., & Mota, J. A. (2025) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.15517 · Cited by 2 · see citing works
Multidimensional analysis of the association between metabolic abnormality combinations and depressive symptoms in overweight and obese populations: Cross-sectional evidence from two multinational cohorts
Chen, Y.-X., Lin, Y., Yang, Q.-W., Ye, B., Gao, Z.-H., Hu, D.-S., Liu, J.-T., Yang, D.-C., Dong, Y., Cui, G.-W., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119794 · Cited by 2 · see citing works
Physical activity and exercise for the prevention and management of anxiety
Schuch, F. B., Stubbs, B., & Kandola, A. A. (2021) · Society for Transparency, Openness, and Replication in Kinesiology eBooks · doi:10.51224/b1016 · Cited by 2 · see citing works
“For example, people with anxiety disorders are at increased risk of cardiovascular disease (Batelaan et al., 2016), diabetes (Smith et al., 2018), and metabolic syndrome (Tang et al., 2017).”
Background
Relationship Between Depression, Generalized Anxiety, and Metabolic Syndrome Among Buddhist Temples Population in Nakhon Pathom-Thailand
Peltzer, K., & Pengpid, S. (2018) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs.60829 · Cited by 2 · see citing works
“This study did not find, contrary to the general findings of two meta-reviews (5, 8), an association between MDD, GAD, and MetS among a temples population in Nakhon Pathom in Thailand.”
BackgroundResult
Fatores sociodemográficos e clínicos associados à ansiedade em mulheres hipertensas: estudo transversal
da Silva, T. C., Santos, V. B., Cavalcante, Á. M. R. Z., Hirano, G. S. B., Lopes, J. D. L., & de Barros, A. L. B. L. (2023) · Acta Paulista de Enfermagem · doi:10.37689/acta-ape/2023ao02951 · Cited by 2 · see citing works
AFFECTIVE DISORDERS IN MEN WITH ARTERIAL HYPERTENSION IN COMBINATION WITH METABOLIC SYNDROME
Yaskevich, R. A., & Moskalenko, O. L. (2023) · Siberian Journal of Life Sciences and Agriculture · doi:10.12731/2658-6649-2023-15-1-327-345 · Cited by 2 · see citing works
Identifying the Role of Vasopressin and Oxytocin in the Microbiota-Gut-Brain-Behavior Axis
Peters, N. V. (2022) · Digital Archive @ GSU · doi:10.57709/14972899 · Cited by 2 · see citing works
Association of Depression with Metabolic Syndrome in Highly Educated Ethnic Koreans of China: A Case–Control Study
Wen, Y., Liu, G., Shang, Y.-W., & Wáng, Q. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s280716 · Cited by 2 · see citing works
Evaluation of inflammatory and metabolic impairments regarding depression dimensions: a case control study
Sabri, Y., & Abdelsalam, N. M. (2022) · Middle East Current Psychiatry · doi:10.1186/s43045-022-00178-0 · Cited by 1 · see citing works
“Recently, anxiety disorders have been related to metabolic syndrome [17].”
BackgroundInfluential
Koexistenz von Depression, Angst, traumatischem Stress und körperlicher Krankheit – allgemeine Positionen
Kapfhammer, H. (2022) · Springer eBooks · doi:10.1007/978-3-662-65873-4_1 · Cited by 1 · see citing works
Induction of obesity by a high-carbohydrate diet in zebrafish modulates genes related to feeding behavior and inflammation
Virote, B. D. C. R., da Silva, K. C. D., Júnior, R. E. M., Carneiro, W. F., Valadares, L. P. D. A., de Souza, S. P., Guimarães, I. G., Cagnini, D. Q., Godard, A. L. B., Vianna, A. R. D. C. B., et al. (2025) · Life Sciences · doi:10.1016/j.lfs.2025.123807 · Cited by 1 · see citing works
Risk of acute myocardial infarction and ischemic stroke in young patients with Somatic Symptom Disorder: A nationwide study in Korea
Kim, I. B., Kim, J., Choi, H. S., Lee, J., Choi, J., Kim, E., Kim, H., Kim, H.-J., & Lee, S.-H. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120667 · Cited by 1 · see citing works
Interrelationship Between Socioeconomic Status, Depression, and Neuropathy in People with Diabetes: A Cross-Sectional Study
Pasha, R., Quartey, G., Kalteniece, A., Faber, C. G., Lauria, G., Marshall, A. G., Azmi, S., Malik, R. A., Soran, H., & Ferdousi, M. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15093215 · Cited by 1 · see citing works
“However, given the cross-sectional design, these relationships remain associative and causal pathways cannot be established. https://doi.org/10.3390/jcm15093215 Depression has further been linked with metabolic syndrome, characterised by hyperglycaemia, dyslipidaemia, and central obesity [23].”
Influential
Metabolic Syndrome and Psychological Effects of Exercise in Hemodialysis Patients
Hornik, B., Duława, J., & Durmała, J. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182211952 · Cited by 1 · see citing works
“Most of the authors suggested the need for further prospective studies to determine a two-way relationship between these clinical conditions [57].”
Background
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Oluoha, R. U., Offiong, A. A., N., O. P., Nwaigbo, E., & Ifeanyi, N. (2023) · International Journal of TROPICAL DISEASE & Health · doi:10.9734/ijtdh/2023/v44i241507 · Cited by 1 · see citing works
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Depresijas un trauksmes saistība ar kardiovaskulārām slimībām un kardiovaskulārās mirstības risku (SCORE) tuvāko 10 gadu laikā primārajā aprūpē Latvijā. Promocijas darbs
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Chakraborty, K., Chatterjee, M., Bhattacharyya, R., Dan, A., & Neogi, R. (2020) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20205690
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“including 18 cross-sectional studies revealed a correlation between anxiety and MetS [5].”
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Authors: Tang, F., Wang, G., & Lian, Y.
Affiliations: Shandong University (CN)
Fourth People’s Hospital of Jinan (CN)
Corresponding author: Lian, Ying
ORCID: Tang, Fang
Wang, Gangpu
Lian, Ying
Venue: Psychoneuroendocrinology
Publisher: Elsevier BV
Published: 2017-03
Volume: 77
Pages: 112-121
ISSN: 0306-4530 (ISSN-L)
DOI: 10.1016/j.psyneuen.2016.11.025
OpenAlex: W2558935924
Cited by: 117
References: 49
Citations by year: 2026: 4 · 2025: 9 · 2024: 16 · 2023: 21 · 2022: 18 · 2021: 24 · 2020: 11 · 2019: 4 · 2018: 8 · 2017: 2
FWCI: 0.69
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Psychoneuroendocrinology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords: anxiety, metabolic syndrome, psychological stress, cardiovascular risk factors, bidirectional relationship, prevalence, incidence
MeSH terms: Anxiety, Anxiety Disorders, Humans, Comorbidity, Prevalence, Metabolic Syndrome

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Association between anxiety and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies

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