title: The impact of the metabolic syndrome on health-related quality of life: a cross-sectional study in Greece.
abstract: BACKGROUND
  Metabolic syndrome [MetS] is a chronic, progressive and multi-complex health problem that can trigger physical, emotional and psychosocial problems. The aim of this study is to investigate the association between MetS and health-related quality of life (HRQoL) as well as depressive and anxiety disorders.
  
  
  METHODS
  New consecutive patients who attended an outpatient lipid clinic for evaluation for MetS were eligible for inclusion in the study. The MetS was defined according to the new definition of International Diabetes Federation (IDF). The medical outcomes study, short form-36 (SF-36) was used to assess HRQoL. Anxiety and depressive symptoms were assessed by a validated Greek version of the hospital anxiety and depression scale (HADS).
  
  
  RESULTS
  Three hundred and fifty-nine subjects were involved of whom 206 [57.4%] met the diagnostic criteria for the MetS (cases) and 153 [42.6%] were free of MetS criteria (comparator group). MetS was associated with lower scores of all subscales of the SF-36 except of bodily pain. The physical component summary score of SF-36 was independently associated with gender (β = 2.41, P = .01), married or living together (β = 5.18, P = .001) and satisfactory household income (β = 5.77, P < .0001). The mental component summary score of SF-36 was independently associated with gender (β = 3.20, P = .003) and satisfactory household income (β = 3.94, P = .02). A predominance of anxiety and depressive symptoms was observed among subjects with MetS.
  
  
  CONCLUSIONS
  Our study demonstrated that subjects with MetS have significantly more impaired HRQoL than those without MetS. These findings suggest that HRQoL should be considered in the management of subjects with MetS.
authors.affiliation: Department of Internal Medicine, University of Ioannina, Ioannina, Greece. dtziallas@gmail.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tziallas
authors.forename: Catherine
authors.initials: C
authors.lastname: Kastanioti
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kostapanos
authors.forename: Petros
authors.initials: P
authors.lastname: Skapinakis
authors.forename: Moses S
authors.initials: MS
authors.lastname: Elisaf
authors.forename: Venetsanos
authors.initials: V
authors.lastname: Mavreas
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D006115:Greece; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric