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Depression and metabolic syndrome across epidemiological transition

Background: Depression and metabolic syndrome (MetS) are growing global health concerns, but limited research focuses on African-origin populations. This study investigates the association between MetS and depression among individuals in Ghana, South Africa (SA), Jamaica, Seychelles, and the United...

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Main Author: Dikoko, Viwe
Other Authors: Dugas, Lara
Format: Thesis
Language:English
English
Published: Department of Public Health and Family Medicine 2025
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access_status_str Open Access
author Dikoko, Viwe
author2 Dugas, Lara
author_browse Dikoko, Viwe
Dugas, Lara
author_facet Dugas, Lara
Dikoko, Viwe
author_sort Dikoko, Viwe
collection Thesis
description Background: Depression and metabolic syndrome (MetS) are growing global health concerns, but limited research focuses on African-origin populations. This study investigates the association between MetS and depression among individuals in Ghana, South Africa (SA), Jamaica, Seychelles, and the United States (US), emphasizing gender and regional disparities. Methods: Secondary data of 446 participants from the METS (2008-2010) and METS- Microbiome study (2017-2019), a prospective cohort, were analyzed. MetS was defined as meeting at least three of the following criteria: elevated blood pressure, low HDL(High- Density Lipoprotein), elevated triglycerides, or high glucose. Depression was assessed using the CES-D scale (score ≥16 indicating depressive symptoms). Depression was assessed only at follow-up (2019), while MetS was measured at baseline (2010). Logistic regression examined the MetS-depression relationship, stratified by gender, adjusting for demographic and behavioural factors. Findings: The prevalence of MetS was 12% in Ghana (N=23), 17% in SA (N=9), 29% in Jamaica (N=26), 27% in Seychelles (N=33), and 39% in the US (N=36). The prevalence of depression was 15% in Ghana (N=29), 25% in SA (N=13), 18% in Jamaica (N=16), 9% in Seychelles (N=11) and 33% in the US (N=30). No significant overall association between MetS and depression was found. However, in men, individual MetS components showed weak associations at p < 0.1. High blood pressure (OR = 3.46, p<0.1) and low HDL (OR = 3.45, p<0.1) were associated with higher odds of depression, while obesity appeared protective (OR = 0.20, p<0.1). Women showed higher rates of obesity, abdominal adiposity, and depression, particularly in Jamaica, Seychelles, and the US. Age inversely correlated with depression in both genders, with older individuals reporting fewer symptoms. Regionally, living in Ghana, Seychelles, and Jamaica was linked to lower odds of depression compared to the US. Interpretation: This study highlights significant gender and regional differences in the MetS-depression relationship. Women face greater vulnerabilities related to obesity and psychological distress, while men are at higher risk due to elevated blood pressure and low HDL. Tailored public health strategies are needed to address these distinct risks and regional disparities, focusing on mitigating the dual burden of metabolic and mental health challenges. Policy strategies should prioritize integrated screening, targeted education, and community-based services—particularly in low-resource settings—to reduce the dual burden of MetS and depression in populations of African origin.
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language English
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2025
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spelling oai:open.uct.ac.za:11427/42095 Depression and metabolic syndrome across epidemiological transition Dikoko, Viwe Dugas, Lara Mtintsilana, Asanda Depression Metabolic syndrome Background: Depression and metabolic syndrome (MetS) are growing global health concerns, but limited research focuses on African-origin populations. This study investigates the association between MetS and depression among individuals in Ghana, South Africa (SA), Jamaica, Seychelles, and the United States (US), emphasizing gender and regional disparities. Methods: Secondary data of 446 participants from the METS (2008-2010) and METS- Microbiome study (2017-2019), a prospective cohort, were analyzed. MetS was defined as meeting at least three of the following criteria: elevated blood pressure, low HDL(High- Density Lipoprotein), elevated triglycerides, or high glucose. Depression was assessed using the CES-D scale (score ≥16 indicating depressive symptoms). Depression was assessed only at follow-up (2019), while MetS was measured at baseline (2010). Logistic regression examined the MetS-depression relationship, stratified by gender, adjusting for demographic and behavioural factors. Findings: The prevalence of MetS was 12% in Ghana (N=23), 17% in SA (N=9), 29% in Jamaica (N=26), 27% in Seychelles (N=33), and 39% in the US (N=36). The prevalence of depression was 15% in Ghana (N=29), 25% in SA (N=13), 18% in Jamaica (N=16), 9% in Seychelles (N=11) and 33% in the US (N=30). No significant overall association between MetS and depression was found. However, in men, individual MetS components showed weak associations at p < 0.1. High blood pressure (OR = 3.46, p<0.1) and low HDL (OR = 3.45, p<0.1) were associated with higher odds of depression, while obesity appeared protective (OR = 0.20, p<0.1). Women showed higher rates of obesity, abdominal adiposity, and depression, particularly in Jamaica, Seychelles, and the US. Age inversely correlated with depression in both genders, with older individuals reporting fewer symptoms. Regionally, living in Ghana, Seychelles, and Jamaica was linked to lower odds of depression compared to the US. Interpretation: This study highlights significant gender and regional differences in the MetS-depression relationship. Women face greater vulnerabilities related to obesity and psychological distress, while men are at higher risk due to elevated blood pressure and low HDL. Tailored public health strategies are needed to address these distinct risks and regional disparities, focusing on mitigating the dual burden of metabolic and mental health challenges. Policy strategies should prioritize integrated screening, targeted education, and community-based services—particularly in low-resource settings—to reduce the dual burden of MetS and depression in populations of African origin. 2025-11-04T06:14:09Z 2025-11-04T06:14:09Z 2025 2025-11-04T06:06:55Z Thesis / Dissertation Masters MSc http://hdl.handle.net/11427/42095 en eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Depression
Metabolic syndrome
Dikoko, Viwe
Depression and metabolic syndrome across epidemiological transition
thesis_degree_str Master's
title Depression and metabolic syndrome across epidemiological transition
title_full Depression and metabolic syndrome across epidemiological transition
title_fullStr Depression and metabolic syndrome across epidemiological transition
title_full_unstemmed Depression and metabolic syndrome across epidemiological transition
title_short Depression and metabolic syndrome across epidemiological transition
title_sort depression and metabolic syndrome across epidemiological transition
topic Depression
Metabolic syndrome
url http://hdl.handle.net/11427/42095
work_keys_str_mv AT dikokoviwe depressionandmetabolicsyndromeacrossepidemiologicaltransition