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Review
. 2023 Feb 16:14:1118836.
doi: 10.3389/fpsyt.2023.1118836. eCollection 2023.

Association between anxiety and metabolic syndrome: An updated systematic review and meta-analysis

Shuang Ji  1 , Yujiao Chen  1 , Yuying Zhou  1 , Yiting Cao  1 , Xiao Li  2   3 , Guoyong Ding  4 , Fang Tang  1   5   6
Affiliations
Review

Association between anxiety and metabolic syndrome: An updated systematic review and meta-analysis

Shuang Ji et al. Front Psychiatry. .

Abstract

Objective: Previous studies have demonstrated an association between anxiety and metabolic syndrome (MetS). However, the association is still controversial. This updated meta-analysis aimed to reanalyze the association between anxiety and MetS.

Methods: We comprehensively searched PubMed, Embase and Web of Science for all related studies published before January 23, 2023. Observational studies that informed effect size with 95% confidence interval (CI) for the association between anxiety and MetS were included. According to heterogeneity between studies, fixed or random effects models were applied to calculate the pooled effect size. Publication bias was examined by funnel plots.

Results: The research included 24 cross-sectional studies: 20 studies used MetS as the dependent variable with a pooled OR of 1.07 (95% CI: 1.01-1.13) and four studies used anxiety as the dependent variable with a pooled OR of 1.14 (95% CI: 1.07-1.23). Three cohort studies were found: two studies detected the association of baseline anxiety with the risk of MetS, one of the studies demonstrated a significant association, but a similar result was not found in another study; one study showed no significant association between baseline MetS and the risk of anxiety.

Conclusion: Cross-sectional studies indicated an association between anxiety and MetS. The results from cohort studies are still inconsistent and limited. More large-scale prospective studies are needed to further reveal the causal relationship of anxiety with MetS.

Keywords: anxiety; cohort study; cross-sectional study; meta-analysis; metabolic syndrome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the literature search and study selection. HR, hazard ratio; IDF, International Diabetes Federation; NCEP-ATP III, National Cholesterol Education Program-Adult Treatment Panel III; OR, odds ratio; RR, relative risk; WHO, World Health Organization.
FIGURE 2
FIGURE 2
Forest plots of the association of anxiety with MetS among cross-sectional studies with MetS as the dependent variable. CI, confidence interval; MetS, metabolic syndrome; OR, odds ratio.
FIGURE 3
FIGURE 3
Sensitivity analyses of the association of anxiety with MetS. (A) Metabolic syndrome as the dependent variable; (B) anxiety as the dependent variable. MetS: metabolic syndrome.
FIGURE 4
FIGURE 4
Funnel plot of effect estimates for 20 cross-sectional studies with MetS as the dependent variable assessing the association between anxiety and MetS (P = 0.51 by Egger’s test and P = 0.50 by Begg’s test). MetS, metabolic syndrome; OR, odds ratio.
FIGURE 5
FIGURE 5
Forest plots of the association of anxiety with MetS among cross-sectional studies with anxiety as the dependent variable. CI, confidence interval; MetS, metabolic syndrome; OR, odds ratio.
See this image and copyright information in PMC

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