Stress prevalence and associated risk factors among patients with metabolic syndrome defined by NCEP ATP III criteria

Janavi Saravanan Gauradas; Monisha Mohanraj; Venkateswaramurthy Nallasamy; Shankar Ganesh Muthusamy

Janavi Saravanan Gauradas The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India https://orcid.org/0009-0005-1886-4864
Monisha Mohanraj Department of Pharmacy Practice, JKKN College of Pharmacy, Kumarapalayam, Tamil Nadu, India https://orcid.org/0009-0008-7002-1057
Venkateswaramurthy Nallasamy Department of Pharmacy Practice, JKKN College of Pharmacy, Kumarapalayam, Tamil Nadu, India https://orcid.org/0000-0002-8623-7898
Shankar Ganesh Muthusamy Department of Pharmacy Practice, JKKN College of Pharmacy, Kumarapalayam, Tamil Nadu, India https://orcid.org/0009-0007-1322-3413

Keywords: metabolic syndrome, stress, NCEP ATP III, DASS-21, sleep quality, physical activity

Abstract

Metabolic syndrome (MetS) is a major cardiometabolic disorder characterized by the clustering of abdominal obesity, hypertension, impaired glucose regulation, hypertriglyceridemia, and reduced high-density lipoprotein cholesterol. Psychosocial stress may further increase the disease burden by adversely affecting lifestyle behaviors, treatment adherence, and control of cardiometabolic risk factors. However, evidence regarding the prevalence and determinants of stress among individuals with MetS in routine clinical settings remains limited. To determine the prevalence of stress and identify its associated factors among adults with metabolic syndrome. A hospital-based analytical cross-sectional study was conducted among 486 adult participants. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Stress was assessed using the stress subscale of the Depression, Anxiety and Stress Scale-21 (DASS-21). Sociodemographic, behavioral, clinical, and metabolic characteristics were collected using a structured proforma. Associations between stress and potential predictors were assessed using bivariate analysis, followed by multivariable logistic regression to identify independent correlates. Metabolic syndrome was present in 59.5% of participants. Overall, 61.3% experienced stress. Stress was significantly more prevalent among participants with MetS than among those without MetS (72.7% vs. 44.7%). Among individuals with MetS, stress prevalence increased progressively with a greater number of abnormal NCEP ATP III components. Poor sleep quality showed the strongest independent association with stress (AOR=3.81), while lower educational status, low physical activity, female sex, abdominal obesity, and greater metabolic clustering were also independently associated with stress. Stress was highly prevalent among individuals with MetS and was strongly associated with adverse behavioral, socioeconomic, and metabolic characteristics. Routine screening and management of psychosocial stress should be integrated into comprehensive MetS care.