Association of Depression with Metabolic Syndrome in Highly Educated Ethnic Koreans of China: A Case-Control Study

Background: Ethnic Koreans in China are a distinct minority group. Highly educated populations are at high risk of depression. The aim of this study was to explore the associations of depression and metabolic syndrome (MS) in highly educated ethnic Koreans in China, and determine whether the associations were dependent on gender. Methods: From March 11th to 27th 2017, the natural population of 18-70 year olds was continuously screened at Yanbian Korean Autonomous Region. Those who met the inclusion criteria were invited to complete Zung Self-Rating Depression Scale (SDS). The people with SDS 53 were assigned to depression group and those with SDS <= 53 were assigned to the control group. Demographic characteristics, clinical factors, life-style factors and family history were collected and compared. Besides, associations of depression with MS and its components were estimated by Spearman correlation analysis and logistic regression analysis. Results: The depression group included 367 highly educated ethnic Koreans with depression status and the control group consisted of 388 age-, education-, and gender matched ethnic Koreans without depression. A significantly higher prevalence of MS was observed in males and females with depression status relative to the control subjects (males, 28.5% vs 6.3%, X-2 = 16.162, P-value < 0.001; females, 33.0% vs 7.5%, X-2 = 57.896, P-value < 0.001). Depression status was positively correlated with MS in males (r = 0.311, P-value < 0.01) and females (r = 0.332, P-value < 0.01). After adjusting for potential confounding factors, mild and moderate depression statuses were found to be significantly associated with MS development in male and female ethnic Koreans, respectively. Conclusion: Our findings suggest a close link between depression and MS independent of gender in highly educated ethnic Koreans of China.