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Psychological underpinnings of metabolic syndrome

  • Barbara J. Stewart-Knox (a1)

Metabolic syndrome (MS) is more common among socio-economically disadvantaged individuals and is associated with certain risky lifestyle practices. MS also appears to be triggered by adverse social circumstances and chronic stress. The present paper reviews accumulating evidence to imply that individuals who have certain personality and behaviour traits are particularly predisposed to develop MS, and brings together theories that relate to possible psychological mechanisms underlying MS. It considers how such factors might interact causally to encourage the development of MS. As part of the EU-funded LIPGENE Integrated Project, multi-level modelling will be undertaken to explore potential pathways to MS, taking into consideration the interplay between a range of psycho-social, demographic, cultural and lifestyle factors thought to contribute to the development of MS. Data will be gathered for this purpose from a representative sample of >50-year-olds living in Britain (n 1000) and Portugal (n 500). It is anticipated that this information will assist in the development and targetting of future intervention to prevent and treat MS in the normal population.

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Corresponding author
* Corresponding author: Dr Barbara J. Stewart-Knox, fax +44 2870 324 965,
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N Almeras , JP Despres , J Villeneuve , MF Demers , MA Roy , C Cadrin , JP Mottard & RH Bouchard (2004) Development of an atherogenic metabolic risk factor profile associated with the use of atypical antipsychotics. Journal of Clinical Psychiatry 65, 557564

T Baptista (1999) Body weight gain induced by anti-psychotic drugs: mechanisms and management. Acta Psychiatrica Scandinavica 100, 316

JC Barefoot , BL Peterson , WG Dahlstrom , IC Siegler , NB Anderson & RB Williams (1991) Hostility patterns and health implications: correlates of Cook-Medley Hostility Scale Scores in a national survey. Health Psychology 10, 1824

R Basu , JS Brar , KNR Chengappa , V John , H Parepally , S Gershon , P Schlicht & DJ Kupfer (2004) The prevalence of metabolic syndrome in patients with schizoaffective disorder – bipolar subtype. Bipolar Disorders 6, 314318

V Benetou , C Bamia , D Trichopoulos , T Mountokalalakis , T Psaltopoulou & A Trichopoulou (2004) The association of body mass index and waist circumference with blood pressure depends on age and gender: A study of 10 928 non-smoking adults in the Greek EPIC cohort. European Journal of Epidemiology 19, 803809

P Bjorntorp (1999) Neuroendocrine perturbations as a cause of insulin resistance. Diabetic Metabolism Research Reviews 15, 427441

P Bjorntorp (2000) Do stress reactions cause abdominal obesity and comorbidities. Obesity Reviews 2, 7386

P Bjorntorp & R Rosmond (1999) Hypothalamic origin of the metabolic syndrome X. Annals of the New York Academy of Sciences 892, 297307

P Bjorntorp & R Rosmond (2000) Neuroendocrine abnormalities in visceral obesity. International Journal of Obesity 24, S80S85

PH Black (2003) The inflammatory response is an integral part of the stress response: implications for atherosclerosis, insulin resistance, type II diabetes and metabolic syndrome X. Brain, Behaviour and Immunity 17, 350364

ES Brown , FP Varghese & BS McEwan (2004) Association of depression with mental illness: does cortisol play a role. Biological Psychiatry 55, 19

EJ Brunner , H Hemmingway , BR Walker , M Page , P Clarke , M Juneja . (2002) Adrenocortical, autonomic and inflammatory causes of the metabolic syndrome. Circulation 106, 26592665

EJ Brunner , MG Marmot , K Nanchahal , MJ Shipley , SA Stansfeld , M Juneja & KGMM Alberti (1997) Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study. Diabetologia 40, 13411349

J Buttriss (2003) Metabolic syndrome: new research underway. Nutrition Bulletin 28, 381385

W Chen , W Bao , S Begum , A Elkasabany & SR Srinivasan (2000) Age-related patterns of the clustering of cardio-vascular risk variables of Syndrome X from childhood to young adulthood in a population made up of black and white subjects. The Bogalusa Heart Study. Diabetes 49, 10421048

WW Cook & DM Medley (1954) Proposed hostility and parasisaic-virtue scales for the MMPI. Journal of Applied Psychology 38, 414418

EL Diamond (1982) The role of anger and hostility in essential hypertension and coronary heart disease. Psychological Bulletin 92, 410433

M Esler , M Rumantir , G Wiesner , D Kaye , J Hastings & G Lambert (2001) Sympathetic nervous system and insulin resistance: form obesity to diabetes. American Journal of Hypertension 14, S304S309

PJ Feldman & A Steptoe (2003) Psychosocial and socioeconomic factors associated with glycated hemoglobin in non-diabetic middle-aged men and women. Health Psychology 22, 398405

M Friedman & RH Rosenman (1959) Association of a specific overt behaviour pattern with increases in blood cholesterol, blood clotting time, incidence of arcus senilis and clinical coronary artery disease. Journal of the American Medical Association 169, 12861296

A Frost , J Eachus , J Sparrow , TJ Peters , C Hopper , G Davey-Smith & S Frankel (2001) Vision-related quality of life impairment in an elderly population: associations with age, sex, social class and material deprivation. Eye 15, 739744

M Gigolini , JC Seidell , G Targher , JP Deslypere , BM Ellsinger , J Charzewska , A Cruz & P Bjorntorp (1995) Fasting serum-insulin in relation to components of the metabolic syndrome in European healthy men – the European fat distribution study. Metabolism: Clinical and Experimental 44, 3540

JCG Halford (2001) Pharmacology of appetite suppression: implication for the treatment of obesity. Current Drug Targets 2, 353370

SG Haynes , S Levine , N Scotch , M Feinleib & WB Kannel (1980) The relationship of psychological factors to coronary heart disease in the Frammington Study: I. Methods and risk factors. American Journal of Epidemiology 107, 362383

T Hidvegi , K Hetyesi , L Biro & G Jermendy (2001) Education level and clustering of clinical characteristics of metabolic syndrome. Diabetes Care 24, 20132016

SC Ho , YM Chen , JLF Woo , SSF Leung , TH Lam & ED Janus (2001) Association between simple anthropometric indices and cardiovascular risk factors. International Journal of Obesity 25, 16891697

M Horsten , MA Mittleman , SP Wamala , K Schenck-Gustafsson , K Orth-Gomer (1999) Social relations and the metabolic syndrome in middle-aged Swedish women. Journal of Cardio-Vascular Risk 6, 391397

PT Katzmarzyk , L Perusse , J Bergeron , JP Despres & C Bouchard (2001) Stability of indicators of the metabolic syndrome from childhood and adolescence into young adulthood: the Quebec Family Study. Journal of Clinical Epidemiology 54, 190195

Z Kerenyi , AG Tabac , P Stella , Z Bosyak , K Simon , I Karadi & G Tamas (2000) Association between socioeconomic factors and the metabolic syndrome in women with prior gestational diabetes mellitus. Diabetes Care 23, 14441446

LS Kinder , MR Carnethon , LP Palaniappan , AC King & SP Fortmann (2004) Depression and the metabolic syndrome in young adults: findings from the third national health and nutrition examination survey. Psychosomatic Medicine 66, 316322

DE Laaksonen , HM Lakka , J Lynch , TA Lakka , L Niskanen , R Rauramaa , JT Salonen & J Kauhanen (2003) Cardiorespiratory fitness and vigorous leisure-time physical activity modify the association of small size at birth with the metabolic syndrome. Diabetes Care 26, 21562164

DE Laaksonen , HM Lakka , JT Salonen , LK Niskanen , R Rauramaa & TA Lakka (2002) Low levels of leisure-time physical activity and cardio-respiratory fitness predict development of the metabolic syndrome. Diabetes Care 25, 16121619

M Landen , F Baghaei , R Rosmond , G Holm , P Bjorntorp & E Eriksson (2004) Dystipiclemia and high waist-hip ratio in women with self reported social anxiety. Psychoneuroendocrinology 29, 10371046

DA Lawlor , S Ebrahim , G Davey-Smith (2004) The metabolic syndrome and coronary heart disease in older women: findings from the British Women's Heart and Health Study. Diabetic Medicine 21, 906913

J Lidfeldt , P Nyberg , C Nerbrand , G Samsioe , B Schersten & CD Agardh (2003) Socio-demographic and psychosocial factors are associated with features of the metabolic syndrome. The women's health in the Lund Area (WHILA) study. Diabetes, Obesity and Metabolism 5, 106

JM McCaffery , R Niaura , JF Todaro , GE Swan & D Carmelli (2003) Depressive symptoms and metabolic risk in adult male twins enrolled in the national heart, lung and blood institute twin study. Psychosomatic Medicine 65, 409497

SL McElroy , R Kotwal , S Malhotra , EB Nelson , PE Keck & CB Nemeroff (2004) Are mood disorders and obesity related? A review for the mental health professional. Journal of Clinical Psychiatry 65, 634651

IS Martins & SP Marinho (2003) The potential of central obesity anthropometric indicators as diagnostic tools. Revista de Saude Publica 37, 760767

JB Meigs , RB D'Agostino , PW Wilson & LA Cupples (1997) Risk variable clustering in the insulin resistance syndrome. Diabetes 46, 15941601

MF Muldoon , RH Mackey , KV Williams , MT Korytkowski , JD Flory & SB Manuck (2004) Low central nervous system serotonergic responsivity is associated with the metabolic syndrome and physical inactivity. Journal of Clinical Endocrinology and Metabolism 89, 266271

R Niaura , SM Banks , KD Ward , CM Stonay , A Spiro , CM Aldwin , L Landsberg & ST Weiss (2000) Psychosomatic Medicine 62, 716

K Nonogaki (2000) New insights into sympathetic regulation of glucose and fat metabolism. Diabetologia 43, 533549

S Okosun , RS Cooper , CN Rotimi , B Osotimehin & T Forrester (1998) Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans and African Americans. Diabetes Care 21, 18361839

S Okosun , YL Liao , CN Rotimi , TE Prewitt & S Cooper (2000) Abdominal adiposity and clustering of multiple metabolic syndrome in white, black and Hispanic Americans. Annals of Epidemiology 10, 263270

A Onat , GS Avci , MM Barlan , H Uyarel , B Uzunlar & V Sansoy (2004) Measures of abdominal obesity assessed for visceral adiposity and relation to coronary risk. International Journal of Obesity and Related Metabolic Diseases 28, 10181025

JM Oppert , N Lahlou , B Laferrere , M Roger , A Basdevant & B GuyGrand (1997) Plasma leptin and acute serotonergic stimulation of the corticotropic axis in women who are normal weight or obese. Obesity Research 5, 410416

RS Paffenbarger , AL Wing & RT Hyde (1978) Physical activity as an index of heart attack risk in college alumni. American Journal of Epidemiology 108, 161175

S Puttonen , L Keltikangas-Jarvinen , N Ravaja & J Viikari (2003) Affects and autonomic cardiac reactivity during experimentally-induced stress as related to precursors of insulin resistance syndrome. International Journal of Behavioural Medicine 10, 106124

K Raikkonen , L Keltikangas-Jarvinen , H Ladlercreutz & A Hautanen (1996) Psychosocial stress and the insulin resistance syndrome. Metabolism 45, 15331538

K Raikkonen , KA Matthews & LH Kuller (1999a) Anthropometric and psychosocial determinants of visceral obesity in healthy postmenopausal women. International Journal of Obesity 23, 775782

K Raikkonen , KA Matthews , LH Kuller , C Reiber & CH Bunker (1999b) Anger, hostility and visceral adipose tissue in healthy post-menopausal women. Metabolism 48, 11461151

K Raikkonen , KA Matthews & K Salomon (2003) Hostility predicts metabolic syndrome risk factors in children and adolescents. Health Psychology 22, 279286

N Ravaja , L Keltikangas-Jarvinen & J Viikari (1996) Life changes, locus of control and metabolic syndrome precursors in adolescents and young adults: a three-year follow-up. Social Science and Medicine 43, 5161

KL Rennie , N McCarthy , S Yazdgerdi , M Marmot & E Brunner (2003) Association of metabolic syndrome with both vigorous and moderate physical activity. International Journal of Epidemiology 32, 600

U Riserus , J Arnlov , K Brismar , B Zethelius , L Berglund & B Vessby (2004) Sagittal abdominal diameter is a strong anthropometric marker of insulin resistance and hyperproinsulinemia in obese men. Diabetes Care 27, 20412046

R Rosmond , G Holm & P Bjorntorp (2000) Food-induced cortisol secretion in relation to anthropometric, metabolic and haemodynamic variables in men. International Journal of Obesity 24, 416422

S Roy , C Rink , S Khanna , C Phillips , D Bagchi , M Bagchi & CK Sen (2004) Bodyweight and abdominal fat gene expression profile in response to a novel hydroxycitric acid-based dietary supplement. Gene Expression 11, 251262

PA Sargent , AL Sharpley , C Williams , EM Goodall & PJ Cowen (1997) 5-HT2C receptor activation decreases appetite and body weight in obese subjects. Psychopharmacology 133, 309312

G Seematter , C Binnert , JL Martin & L Tappy (2004) Relationship between stress, inflammation and metabolism. Current Opinion in Clinical Nutrition and Metabolic Care 7, 169173

A Siani , FP Cappuccio , G Barba , M Trevisan , E Farinaro , R Iacone , O Russo , P Russo , M Mancini & P Strazzullo (2002) The relationship of waist circumference to blood pressure: the Olivetti Heart Study. American Journal of Hypertension 15, 780786

MB Snijder , PZ Zimmet , M Visser , JM Dekker , JC Seidell & JE Shaw (2004) Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study. International Journal of Obesity 28, 402409

A Steptoe & M Marmot (2003) Burden of psychological adversity and vulnerability in middle age: associations with biobehavioural risk factors and quality of life. Psychosomatic Medicine 65, 10291037

MJ Vanhala , PT Vanhala , SM Keinanen-Kiukaanniemi , EA Kumpusalo & JK Takala (1999) Relative weight gain and obesity as a child predict metabolic syndrome as an adult. International Journal of Obesity 23, 656659

E Vieta (2004) Olanzapine in bipolar disorder. Expert Opinion on Pharmacotherapy 5, 16131619

SR Waldstein , HO Burns , MJ Toth & ET Poehlman (1999) Cardiovascular reactivity and central adiposy in older African Americans. Health Psychology 18, 221228

S Wallerius , R Rosmond , T Ljung , G Holm & P Bjorntorp (2003) Rise in morning saliva cortisol is associated with abdominal obesity in men: a preliminary report. Journal of Endocrinological Investigation 26, 616619

SP Wamala , J Lynch , M Horsten , MA Mittleman , K Schenck-Gustafsson , K Orth-Gomer (1999) Education and the metabolic syndrome in women. Diabetes Care 22, 19992003

AMV Ward , HE Syddall , PJ Wood , EM Dennison & DIW Phillips (2004) Central hypothalamic-pituitary-adrenal activity and the metabolic syndrome: studies using the corticotrophin-releasing hormone test. Metabolism: Clinical and Experimental 53, 720726

PJ Wellman , SL Jones & DK Miller (2003) Effects of preexposure to dexfenfluramine, phentermine, dexfenfluramine-phentennine or fluoxetine on sibutramine-induced hypophagia in the adult rat. Pharmacology Biochemistry and Behavior 75, 103114

KL Woodall & KA Matthews (1993) Change in and stability of hostile characteristics: results form a 4-year longitudinal study of children. Journal of Personality and Social Psychology 64, 491499

U Zimmermann , T Kraus , H Himmerich , A Schuld & T Pollmacher (2003) Epidemiology, implications and mechanisms underlying drug-induced weight gain in psychiatric patients. Journal of Psychiatric Research 37, 193220

DE Yarbrough , E Barrett-Connor , D Kritz-Silverstein & DL Wingard (1998) Birth weight, adult weight and girth as predictors of the metabolic syndrome in postmenopausal women. Diabetes Care 21, 16521659

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