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Gender difference in the association between social support and metabolic syndrome in Japan: The "enkai" effect?
  1. Ai Ikeda1,
  2. Ichiro Kawachi1,
  3. Hiroyasu Iso2,*,
  4. Manami Inoue3,
  5. Shoichiro Tsugane3
  1. 1 Harvard School of Public Health, United States;
  2. 2 Graduate School of Medicine, Osaka University, Japan;
  3. 3 Research Center for Cancer Prevention and Screening, National Cancer Center, Japan
  1. Correspondence to: , ; iso{at}


Background: Recent reports have found an association between social support and reduced prevalence of metabolic syndrome (or its components) in the west; however, no study has been carried out in Asian populations.

Methods: We examined 12,537 men and women who were part of the Japan Public Health Center-based Prospective Study initiated in 1993. Perceived emotional support was assessed through questionnaire as receipt of confidant support and esteem support from family members or friends. Metabolic syndrome was defined based on the modified criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF), while its components were obtained through health examinations conducted during the same year as the questionnaire.

Results: We found an association between social support and metabolic syndrome among Japanese men that was in the opposite direction to what has previously been reported in western studies. Among men, the multivariate odds ratios and 95% confidence intervals for metabolic syndrome in the lowest vs. highest level of social support was 0.75(0.58-0.97) based on AHA/NHLBI criteria and 0.69 (0.51-0.92) based on IDF criteria. Among women, we found no association between social support and metabolic syndrome.

Conclusions: In our study, men with higher social support appeared to engage in heavier drinking and also reported a higher fat intake pattern, both of which may increase the risk of metabolic syndrome mainly through overweight. Our findings lend weight to the notion that the pattern of association between social support and health outcomes is both culturally contingent and gender-specific.

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