ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1432464
Mental Stress and the Risks of Metabolic Syndrome and Related Components in Military Personnel: CHIEF Cohort Study
Provisionally accepted
- 1Mackay Memorial Hospital, Taipei, Taipei County, Taiwan
- 2Hualien Tzu Chi Hospital, Hualien, Taiwan
- 3China Medical University (Taiwan), Taichung, Taiwan
- 4Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
- 5Ochsner Health System, New Orleans, Louisiana, United States
- 6Hualien Armed Forces General Hospital, Hualien City, Taiwan
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The association observed between mental stress and metabolic syndrome (MetS) has varied across studies and may be confounded by physical activity (PA) and fitness status.Method: This 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 3000-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.Results: During 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 newonset 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.Conclusions: Our 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.
Keywords: cohort study, mental stress, metabolic syndrome, Military Personnel, Hypertension
Received: 19 May 2024; Accepted: 05 Aug 2025.
Copyright: © 2025 Tsai, Lin, Chang, Sui, Lavie and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gen-Min Lin, Hualien Armed Forces General Hospital, Hualien City, Taiwan
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