Depression and metabolic syndrome across epidemiological transition

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dc.contributor.advisorDugas, Lara
dc.contributor.advisorMtintsilana, Asanda
dc.contributor.authorDikoko, Viwe
dc.date.accessioned2025-11-04T06:14:09Z
dc.date.available2025-11-04T06:14:09Z
dc.date.issued2025
dc.date.updated2025-11-04T06:06:55Z
dc.description.abstractBackground: 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.
dc.identifier.apacitationDikoko, V. (2025). <i>Depression and metabolic syndrome across epidemiological transition</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/42095en_ZA
dc.identifier.chicagocitationDikoko, Viwe. <i>"Depression and metabolic syndrome across epidemiological transition."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025. http://hdl.handle.net/11427/42095en_ZA
dc.identifier.citationDikoko, V. 2025. Depression and metabolic syndrome across epidemiological transition. . University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/42095en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Dikoko, Viwe AB - 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. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Depression KW - Metabolic syndrome LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Depression and metabolic syndrome across epidemiological transition TI - Depression and metabolic syndrome across epidemiological transition UR - http://hdl.handle.net/11427/42095 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42095
dc.identifier.vancouvercitationDikoko V. Depression and metabolic syndrome across epidemiological transition. []. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42095en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectDepression
dc.subjectMetabolic syndrome
dc.titleDepression and metabolic syndrome across epidemiological transition
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMSc
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