Combined effect of metabolic syndrome and cancer on depression

Abstract

Background Cancer survivors frequently experience depression and metabolic dysfunction; however, the combined impact of these conditions remains understudied. Aim This study aimed to examine the joint associations between cancer, metabolic syndrome, and depression. Methods Data from the 2007–2021 Korea National Health and Nutrition Examination Survey encompassed 57,176 participants aged ≥ 19 years. Cancer diagnosis and components of metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose) were obtained through self-report or clinical measurement. Depression was assessed using a single-item question regarding persistent sadness or hopelessness. Multivariable logistic regression models evaluated the associations among cancer, metabolic syndrome, and depression, adjusting for sociodemographic and lifestyle factors. Results Among participants, 1,691 (3.0%) had cancer, 17,510 (30.7%) met criteria for metabolic syndrome, and 7,472 (13.1%) reported depression. Cancer was independently associated with increased risk of depression (odds ratio: 1.26; 95% confidence interval: 1.10–1.45). While metabolic syndrome alone was not significantly associated with depression, patients with cancer who had elevated triglycerides (≥ 150 mg/dL) or decreased high-density lipoprotein cholesterol exhibited substantially higher risk of depression (odds ratio: 1.51; 95% confidence interval: 1.17–1.95 and odds ratio: 1.32; 95% confidence interval: 1.07–1.62, respectively). The association between elevated triglycerides in cancer survivors and depression remained robust after FDR correction. Conclusions Specific lipid abnormalities, rather than metabolic syndrome as a whole, were significantly associated with a higher prevalence of depression among cancer survivors. These findings underscore the need for integrated screening and management that address both metabolic dysfunction and mental health in cancer survivorship care.