title: Metabolic syndrome and the risk of suicide: a community-based integrated screening samples cohort study.
abstract: OBJECTIVE
  Metabolic syndrome (MetS) is reportedly associated with mental disorders that are known to increase the risk of suicide. However, it is not known whether this association is independent of other risk indicators of suicide. This study therefore investigated whether metabolic abnormalities increase the risk of suicide during a 10-year follow-up period.
  
  
  METHODS
  This prospective study enrolled participants from a community-based integrated screening samples cohort in Taiwan. Of the 76,297 people recruited for this study, 12,094 had MetS at baseline. The independent variables were MetS and its components such as high blood pressure and high blood lipid levels. The outcome was death from suicide (n = 146).
  
  
  RESULTS
  MetS was associated with an increased risk of suicide risk by 16% per MetS component (95% confidence interval [CI] = 1%-33%), adjusting for demographics, life-style factors, and clinical correlates. Of the five MetS components, elevated blood pressure was independently associated with suicide-related mortality (adjusted hazard ratio [aHR] = 1.49, 95% CI = 1.03-2.15).
  
  
  CONCLUSIONS
  This analysis of community-based longitudinal data showed that MetS and its components, particularly elevated blood pressure, correlated positively with suicide risk after controlling other factors. Therefore, public mental health interventions targeting suicide reduction may need to specifically focus on individuals with hypertension and other components of the MetS.
authors.affiliation: Department of Nursing, College of Medicine, National Taiwan University, No. 1 Jen-Ai Road Sec.1, Taipei 10051, Taiwan. jungchenchang@ntu.edu.tw.
authors.forename: Jung-Chen
authors.initials: JC
authors.lastname: Chang
authors.forename: Amy Ming-Fang
authors.initials: AM
authors.lastname: Yen
authors.forename: Chau-Shoun
authors.initials: CS
authors.lastname: Lee
authors.forename: Sam Li-Sheng
authors.initials: SL
authors.lastname: Chen
authors.forename: Sherry Yueh-Hsia
authors.initials: SY
authors.lastname: Chiu
authors.forename: Jean Ching-Yuan
authors.initials: JC
authors.lastname: Fann
authors.forename: Hsiu-Hsi
authors.initials: HH
authors.lastname: Chen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology
keywords: blood pressure; community-based integrated screening samples; hypertension; metabolic syndrome; mood disorders; suicide