Association between depression and the combination of lower socioeconomic status and metabolic syndrome: the Korean National Health and Nutrition Examination Survey (KNHANES)

Abstract

Background: Accumulating evidence supports the existence of a metabolic–mood syndrome. Lower socioeconomic status (SES) is correlated with a higher prevalence of both depression and metabolic syndrome (MS). However, the nature of this association remains poorly understood. The objective of this study was to examine whether the combination of MS and lower SES was associated with the prevalence of depression. Methods: We conducted a cross-sectional study of 24,102 adults (>19 years of age) who participated in the 2008–2013 Korean National Health and Nutrition Examination Survey and for whom MS and depression data were available. MS was defined using the diagnostic criteria of the modified National Cholesterol Education Program Adult Treatment Panel III. Depression was assessed using a questionnaire. Multiple logistic regression analysis was used to evaluate the association between depression and MS as well as SES (alone and in combination). Results: Overall, 622 of the 24,102 subjects (2.2%) met the criteria for depression. The prevalence of depression was associated with MS, a lower high-density lipoprotein cholesterol level, an elevated triglyceride level, a lower education level, and a lower household income. Participants with MS and a low SES had a higher likelihood of depression than those without MS and a high SES (odds ratio [OR]=4.180 for low education level and OR=3.994 for low household income level). Conclusions: This study suggests that the combination of SES and MS may play an important role in depression, which has implications for healthcare policy and depression management.