The Relationship of Metabolic Syndrome with Stress, Coronary Heart Disease and Pulmonary Function--An Occupational Cohort-Based Study.
OBJECTIVE
Higher levels of stress impact the prevalence of metabolic syndrome (MetS) and coronary heart disease. The association between MetS, impaired pulmonary function and low level of physical activity is still pending assessment in the subjects exposed to stress. The study aimed to examine whether higher levels of stress might be related to MetS and the plaque presence, as well as whether MetS might affect pulmonary function.


METHODS
The study embraced 235 police officers (mean age 40.97 years) from the south of Poland. The anthropometrics and biochemical variables were measured; MetS was diagnosed using the International Diabetes Federation criteria. Computed tomography coronary angiography of coronary arteries, exercise ECG, measurements of brachial flow-mediated dilation, and carotid artery intima-media thickness were completed. In order to measure the self-perception of stress, 10-item Perceived Stress Scale (PSS-10) was applied. Pulmonary function and physical activity levels were also addressed. Multivariate logistic regression analyses were applied to determine the relationships between: 1/ incidence of coronary plaque and MetS per se, MetS components and the number of classical cardiovascular risk factors, 2/ perceived stress and MetS, 3/ MetS and pulmonary function parameters.


RESULTS
Coronary artery atherosclerosis was less associated with MetS (OR = 2.62, 95%CI 1.24-5.52; p = 0.011) than with a co-existence of classical cardiovascular risk factors (OR = 5.67, 95% CI 1.07-29.85, p = 0.03; for 3 risk factors and OR = 9.05; 95% CI 1.24-66.23, p = 0.02; for 6 risk factors, respectively). Perceived stress increased MetS prevalence (OR = 1.07, 95% CI 1.03-1.13; p = 0.03), and impacted coronary plaque prevalence (OR = 1.05, 95% CI 1.001-1.10; p = 0.04). Leisure-time physical activity reduced the chances of developing MetS (OR = 0.98 95% CI 0.96-0.99; p = 0.02). MetS subjects had significantly lower values of certain pulmonary function parameters.


CONCLUSIONS
Exposure to job-specific stress among police officers increased the prevalence of MetS and impacted coronary plaque presence. MetS subjects had worse pulmonary function parameters. Early-stage, comprehensive therapeutic intervention may reduce overall risk of cardiovascular events and prevent pulmonary function impairment in this specific occupational population.
Department of Anesthesiology and Intensive Pulmonary Care, The John Paul II Hospital, Krakow, Poland.
Miroslaw
M
Janczura
Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland.
Grazyna
G
Bochenek
Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland; Unit of Rehabilitation in Internal Diseases, Faculty of Public Health, Jagiellonian University School of Medicine, Krakow, Poland.
Roman
R
Nowobilski
Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland.
Jerzy
J
Dropinski
Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland.
Katarzyna
K
Kotula-Horowitz
Department of Radiology and Diagnostic Imaging, The John Paul II Hospital, Krakow, Poland.
Bartosz
B
Laskowicz
Department of Bioinformatic and Telemedicine, Jagiellonian University School of Medicine, Krakow, Poland.
Andrzej
A
Stanisz
Department of Electrocardiology, Institute of Cardiology, The John Paul II Hospital, Krakow, Poland.
Jacek
J
Lelakowski
Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland.
Teresa
T
Domagala
D000328:Adult; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000453:epidemiology; D012129:Respiratory Function Tests; D012307:Risk Factors; D013312:Stress, Physiological / Q000502:physiology*