Stressful Life Events and the Metabolic Syndrome

The Prevalence, Prediction and Prevention of Diabetes (PPP)-Botnia Study

  1. Antti-Jussi Pyykkönen, MA1,
  2. Katri Räikkönen, PHD1,
  3. Tiinamaija Tuomi, MD, PHD2,3,
  4. Johan G. Eriksson, MD, PHD2,4,5,6,7,
  5. Leif Groop, MD, PHD3,8 and
  6. Bo Isomaa, MD, PHD2,9
  1. 1Department of Psychology, University of Helsinki, Helsinki, Finland;
  2. 2Folkhälsan Research Center, Helsinki, Finland;
  3. 3Department of Medicine, Helsinki University Central Hospital and Research Program for Molecular Medicine, University of Helsinki, Helsinki, Finland;
  4. 4Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland;
  5. 5National Institute for Health and Welfare, Helsinki, Finland;
  6. 6Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland;
  7. 7Vasa Central Hospital, Vasa, Finland;
  8. 8Department of Clinical Sciences–Diabetes and Endocrinology, Clinical Research Center, Lund University, Malmö University Hospital, Malmö, Sweden;
  9. 9Malmska Municipal Health Care Center and Hospital, Jakobstad, Finland.
  1. Corresponding author: Katri Räikkönen, katri.raikkonen{at}


OBJECTIVE Stress may play a role in the pathogenesis of the metabolic syndrome. However, the scant evidence available is not population-based, restricting the external validity of the findings. Our aim was to test associations between stressful life events, their accumulation, and the metabolic syndrome in a large population-based cohort. We also tested associations between stress and the individual components related to the metabolic syndrome.

RESEARCH DESIGN AND METHODS This was a population-based, random sample of 3,407 women and men aged 18–78 years residing in Western Finland. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III and International Diabetes Federation criteria. The severity of 15 stressful life events pertaining to finance, work, social relationships, health, and housing was self-rated.

RESULTS In comparison with subjects not reporting any extremely stressful life events, those reporting work- or finance-related events had an increased odds for having the metabolic syndrome. The risk was further increased according to accumulation of stressful finance-related events and to having at least three stressful life events in any of the life domains assessed. Accumulation of stressful life events was associated with insulin resistance, obesity, and triglycerides. The associations were not confounded by sex, age, lifestyle, or family history of diabetes.

CONCLUSIONS Life events perceived as stressful, particularly those related to finance and work, may be a signal for poor metabolic health.


  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received June 4, 2009.
    • Accepted October 20, 2009.
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