Association of metabolic syndrome and its components with the risk of depressive symptoms: A systematic review and meta-analysis of cohort studies

Background: The purpose of this meta-analysis was to quantitatively analyze the association between metabolic syndrome (MetS) and the risk of depressive symptoms.Methods: Three electronic databases (PubMed, Embase, and PsycINFO) were searched for articles published through February 15, 2022. Cohort studies evaluating the association between MetS and depressive symptoms were selected for inclusion in this study. A random-effects model was used to evaluate the pooled estimates of MetS, including each of its components, associated with depressive symptoms.Results: A total of 11 cohort studies were selected including >2.65 million participants. There was a significant association between MetS and depressive symptoms risk, albeit with a high degree of heterogeneity (relative risk = 1.29, 95 % confidence interval: 1.12-1.48; I2 = 79.3 %). This association was consistently significant in Western countries, but it was not significant in Asian countries. When stratified by sex, age, and geographical region, MetS and its components exhibited varying degrees of association with depressive symptoms.Conclusions: MetS is a risk factor for depressive symptoms. Further large-scale prospective cohort studies are required to confirm our findings.