Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort study

BackgroundThe association observed between mental stress and metabolic syndrome (MetS) has varied across studies and may be confounded by physical activity (PA) and fitness status.MethodThis study included a military cohort of 2,854 participants in Taiwan who were not taking any medications and were...

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Main Authors: Kun-Zhe Tsai, Ko-Huan Lin, Ai-Hsiu Hung, Yun-Chen Chang, Xuemei Sui, Carl J. Lavie, Gen-Min Lin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1432464/full
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author Kun-Zhe Tsai
Kun-Zhe Tsai
Kun-Zhe Tsai
Ko-Huan Lin
Ai-Hsiu Hung
Yun-Chen Chang
Yun-Chen Chang
Xuemei Sui
Carl J. Lavie
Gen-Min Lin
Gen-Min Lin
author_facet Kun-Zhe Tsai
Kun-Zhe Tsai
Kun-Zhe Tsai
Ko-Huan Lin
Ai-Hsiu Hung
Yun-Chen Chang
Yun-Chen Chang
Xuemei Sui
Carl J. Lavie
Gen-Min Lin
Gen-Min Lin
author_sort Kun-Zhe Tsai
collection DOAJ
description BackgroundThe association observed between mental stress and metabolic syndrome (MetS) has varied across studies and may be confounded by physical activity (PA) and fitness status.MethodThis study included a military cohort of 2,854 participants in Taiwan who were not taking any medications and were free of baseline MetS. The Brief Symptoms Rating Scale (BSRS-5) includes five domains—depression, anxiety, hostility, insomnia, and interpersonal sensitivity—measured on a five-point Likert-type scale ranging from 0 to 4, with a maximum score of 20. PA (hrs/wk) was categorized into three levels: <150, 150–299 and ≥300. Aerobic fitness was evaluated by the amount of time taken to complete a 3,000 m run. MetS was defined according to the International Diabetes Federation (IDF) criteria. Multivariable Cox proportional hazards regression analysis with adjustments for potential covariates including PA and aerobic fitness was utilized to determine the associations of BSRS-5 scores (each 1-unit score increase) with the incidence of MetS and related features.ResultsDuring a median follow-up period of 5.8 years, 662 new-onset cases of MetS (23.2%) developed. BSRS-5 scores were not associated with the risk of new-onset MetS [hazard ratio (HR): 1.006 [95% confidence interval (CI): 0.975, 1.039]]. Among the five MetS features, the only one associated with BSRS-5 scores was the risk of new-onset hypertension [HR: 1.038 (95% CI: 1.002, 1.075)], which was defined as blood pressure ≥130/85 mmHg or the use of antihypertensive medications, among 2,405 participants free of baseline hypertension.ConclusionsOur findings suggest that in young adult military personnel, mental stress was not associated with the incidence of MetS but was associated with its hypertension component, which was independent of PA and aerobic fitness.
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spelling doaj-art-88f8780a62be41328da1ca4a0ce189772025-08-21T05:27:16ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-08-011210.3389/fcvm.2025.14324641432464Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort studyKun-Zhe Tsai0Kun-Zhe Tsai1Kun-Zhe Tsai2Ko-Huan Lin3Ai-Hsiu Hung4Yun-Chen Chang5Yun-Chen Chang6Xuemei Sui7Carl J. Lavie8Gen-Min Lin9Gen-Min Lin10Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, TaiwanDepartment of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, TaiwanDepartments of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Psychiatry, Hualien Tzu Chi General Hospital, Hualien City, TaiwanDepartment of Nursing, Hualien Armed Forces General Hospital, Hualien, TaiwanNursing Department, China Medical University Hospital, Taichung, TaiwanSchool of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, TaiwanArnold School of Public Health, University of South Carolina, Columbia, SC, United StatesJohn Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, United StatesDepartment of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan0Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanBackgroundThe association observed between mental stress and metabolic syndrome (MetS) has varied across studies and may be confounded by physical activity (PA) and fitness status.MethodThis study included a military cohort of 2,854 participants in Taiwan who were not taking any medications and were free of baseline MetS. The Brief Symptoms Rating Scale (BSRS-5) includes five domains—depression, anxiety, hostility, insomnia, and interpersonal sensitivity—measured on a five-point Likert-type scale ranging from 0 to 4, with a maximum score of 20. PA (hrs/wk) was categorized into three levels: <150, 150–299 and ≥300. Aerobic fitness was evaluated by the amount of time taken to complete a 3,000 m run. MetS was defined according to the International Diabetes Federation (IDF) criteria. Multivariable Cox proportional hazards regression analysis with adjustments for potential covariates including PA and aerobic fitness was utilized to determine the associations of BSRS-5 scores (each 1-unit score increase) with the incidence of MetS and related features.ResultsDuring a median follow-up period of 5.8 years, 662 new-onset cases of MetS (23.2%) developed. BSRS-5 scores were not associated with the risk of new-onset MetS [hazard ratio (HR): 1.006 [95% confidence interval (CI): 0.975, 1.039]]. Among the five MetS features, the only one associated with BSRS-5 scores was the risk of new-onset hypertension [HR: 1.038 (95% CI: 1.002, 1.075)], which was defined as blood pressure ≥130/85 mmHg or the use of antihypertensive medications, among 2,405 participants free of baseline hypertension.ConclusionsOur findings suggest that in young adult military personnel, mental stress was not associated with the incidence of MetS but was associated with its hypertension component, which was independent of PA and aerobic fitness.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1432464/fullcohort studymental stressmetabolic syndromemilitary personnelhypertension
spellingShingle Kun-Zhe Tsai
Kun-Zhe Tsai
Kun-Zhe Tsai
Ko-Huan Lin
Ai-Hsiu Hung
Yun-Chen Chang
Yun-Chen Chang
Xuemei Sui
Carl J. Lavie
Gen-Min Lin
Gen-Min Lin
Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort study
Frontiers in Cardiovascular Medicine
cohort study
mental stress
metabolic syndrome
military personnel
hypertension
title Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort study
title_full Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort study
title_fullStr Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort study
title_full_unstemmed Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort study
title_short Mental stress and the risks of metabolic syndrome and related components in military personnel: CHIEF cohort study
title_sort mental stress and the risks of metabolic syndrome and related components in military personnel chief cohort study
topic cohort study
mental stress
metabolic syndrome
military personnel
hypertension
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1432464/full
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