Cardiometabolic Risk Increased in Working-Aged Adults During the COVID-19 Pandemic

Abstract

Background: Public health measures necessary to mitigate the spread of coronavirus disease 2019 (COVID-19) impacted lifestyles and health practices. This multiyear cohort analysis of U.S. working-aged adults aims to evaluate the impact of the COVID-19 pandemic on metabolic syndrome and explores contributing factors. Methods: This longitudinal study (n = 19,543) evaluated year-to-year changes in metabolic syndrome and cardiometabolic risk factors through employer-sponsored annual health assessment before and during the COVID-19 pandemic using logistic mixed-effects model. Results: From prepandemic to pandemic (2019 to 2020), prevalence of metabolic syndrome increased by 3.5% for men and 3.0% for women, across all ethnic groups. This change was mainly driven by increased fasting glucose (7.3%) and blood pressure (5.2%). The increased risk of metabolic syndrome was more likely to occur in individuals with an elevated body mass index (BMI) combined with insufficient sleep or physical activity. Conclusions: Cardiometabolic risk increased during the COVID-19 pandemic compared with before the pandemic in a working-aged adult population, more so for those with a high BMI, unhealthy sleep, and low physical activity practices. Given this observation, identification of risk and intervention (including lifestyle and medical) is increasingly necessary to reduce the cardiovascular and metabolic risk, and improve working-aged population health.

Keywords: blood pressure; employee health; health risk factors; metabolic syndrome; prediabetes; workplace health.

FIG. 1.

Probability of metabolic syndrome and higher risk cardiometabolic risk factors by 2-year cluster (2018–2019, 2019–2020, 2020–2021). All P values <0.001 in mixed logistic regression models, comparing index year (2019/2020/2021) and previous year (2018/2019/2020), modeling the probability of metabolic syndrome or being in the higher risk group for each cardiometabolic risk factor, adjusted for age and sex.

FIG. 2.

Probability of metabolic syndrome by sex and BMI 2019–2020. All P values <0.001 in mixed logistic regression modeling the probability of metabolic syndrome (2020 versus 2019), adjusted for age and sex. BMI, body mass index.

FIG. 3.

Probability of metabolic syndrome by race 2019–2020. All P values <0.001 in mixed logistic regression modeling the probability of metabolic syndrome (2020 versus 2019), adjusted for age, sex, and BMI.

FIG. 4.

Probability of metabolic syndrome 2019–2020 by (A) sleep duration per night and by (B) weekly exercise level. All P values <0.001 in mixed logistic regression modeling the probability of metabolic syndrome (2020 versus 2019), adjusted for age, sex, BMI, and race.