Psychophysiological Status and Life Quality in Individuals with Metabolic Syndrome Living in Central Kazakhstan

  • Berik Koichubekov Department of Informatics and Biostatistics, Karaganda Medical University, Karaganda, Republic of Kazakhstan
  • Marina Sorokina Department of Informatics and Biostatistics, Karaganda Medical University, Karaganda, Republic of Kazakhstan
  • Ilya Korshukov Department of Informatics and Biostatistics, Karaganda Medical University, Karaganda, Republic of Kazakhstan
  • Riszhan Bakirova
  • Ernur Bekov
  • Nazgul Omarbekova Department of Informatics and Biostatistics, Karaganda Medical University, Karaganda, Republic of Kazakhstan
Keywords: Metabolic syndrome, Heart rate variability, Functional activity of central nervous system, State and trait anxiety, Quality of life


BACKGROUND: Morbidity rate of circulatory system diseases (CSD) in Kazakhstan continues to grow and the metabolic syndrome (MetS) contributes significantly to cardiovascular risk development. It was known that MetS altered autonomic nervous system (ANS) by decreasing parasympathetic activity and global heart rate variability (HRV), at the same time, the decrease in sympathetic modulation is unclear. Studies investigated associations between anxiety and MetS disorders are rather controversial. Research findings of the MetS influence on health-related quality of life (HRQoL) were also contradictory. The above-mentioned justifies the necessity of research to clarify and deepen the MetS etiology and pathogenesis, as well as to improve its diagnostics efficiency and treatment.

AIM: The research goals were to study psychophysiological status and HRQoL in individuals with MetS living in Central Kazakhstan.

MATERIALS AND METHODS: Three hundred MetS patients were examined in Karaganda city clinical hospital. Statistical methods and spectral analysis of HRV, simple visual-motor reaction (SVMR), the Spielberger State-Trait Anxiety Inventory, and the Lüscher color test were used. SF-36 questionnaire was used for HRQoL assessment.

RESULTS: General decrease in the activity of both sympathetic and parasympathetic branches of ANS was observed in MetS patients. More than half of the examined MetS patients have had a high level of trait anxiety. Most MetS patients have had a low level of the central nervous system (CNS) functional activity. MetS patients are active both in physical and social spheres. Bodily pain syndrome greatly influences MetS patients’ life quality. The patients evaluate their health level as being low.

CONCLUSION: Individuals with MetS living in Central Kazakhstan had decreased activity of ANS, prevalence of inhibition processes in CNS, high level of trait anxiety, and bodily pain syndrome affecting life quality.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017;70(1):1-25. PMid:28527533

Marchenko AB, Nildibayeva FU, Sorokina MA, Laryushina EM, Turgunova LG, Turmukhambetova AA. Level of FABP3, FABP4, Nt-proBNP and total cardiovascular risk in the population of Central Kazakhstan. Open Access Maced J Med Sci. 2017;5(1):33-6. PMid:28293313

Ibraeva LK, Azhimetova GN, Amanbekova AU, Bakirova RE. Cardiovascular diseases in the population of industrial towns and environmental factors. Ter Arkh. 2015;87(1):76-8. https:// PMid:25823273

Scott CL. Diagnosis, prevention, and intervention for the metabolic syndrome. Am J Cardiol. 2003;92(1A):35I-42I. PMid:12867253

Grassi G, Seravalle G, Colombo M, Bolla G, Cattaneo BM, Cavagnini F, et al. Body weight reduction, sympathetic nerve traffic, and arterial baroreflex in obese normotensive humans. Circulation. 1998;97(20):2037-42. cir.97.20.2037 PMid:9610534

Abreu LC. Heart rate variability as a functional marker of development. J Hum Growth Dev. 2012;22(3):279-81.

Stuckey MI, Tulppo MP, Kiviniemi AM, Petrella RJ. Heart rate variability and the metabolic syndrome: a systematic review of the literature. Diabetes Metab Res Rev. 2014;30(8):784-93. PMid:24816921

Carnethon MR, Prineas RJ, Temprosa M, Zhang ZM, Uwaifo G, Molitch ME, et al. The association among autonomic nervous system function, incident diabetes, and intervention arm in the diabetes prevention program. Diabetes Care. 2006;29(4):914-9. PMid:16567837

La Rovere MT, Bigger JT, Marcus FI, Mortara A, Schwartz PJ, Investigators A. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet. 1998;351(9101):478-84. s0140-6736(97)11144-8 PMid:9482439

Kleiger RE, Miller JP, Bigger JT, Moss AJ. Decreased heart-rate-variability and its association with increased mortality after acute myocardial-infarction. Am J Cardiol. 1987;59(4):256-62. https:// PMid:3812275

Koskinen T, Kahonen M, Jula A, Mattsson N, Laitinen T, Keltikangas-jarvinen L, et al. Metabolic syndrome and short-term heart rate variability in young adults. Diabetic Med. 2009;26(4):354-61. PMid:19388964

Liao DP, Sloan RP, Cascio WE, Folsom AR, Liese AD, Evans GW, et al. Multiple metabolic syndrome is associated with lower heart rate variability the atherosclerosis risk in communities study. Diabetes Care. 1998;21(12):2116-22. diacare.21.12.2116 PMid:9839103

Booth RW, Sharma D, Leader TI. The age of anxiety? It depends where you look: Changes in STAI trait anxiety, 1970-2010. Soc Psychiatry Psychiatr Epidemiol. 2016;51(2):193-202. https://doi. org/10.1007/s00127-015-1096-0 PMid:26190152

Carroll D, Phillips AC, Thomas GN, Gale CR, Deary I, Batty GD. Generalized anxiety disorder is associated with metabolic syndrome in the Vietnam experience study. Biol Psychiatry. 2009;66(1):91-3. biopsych.2009.02.020 PMid:19344891

Luppino FS, Dortland AK, Wardenaar KJ, Bouvy PF, Giltay EJ, Zitman FG, et al. Symptom dimensions of depression and anxiety and the metabolic syndrome. Psychosom Med. 2011;73(3):257- 64. PMid:21257975

Ribeiro RP, Marziale MH, Martins JT, Ribeiro PH, do Carmo Cruz Robazzi ML, Dalmas JC. Prevalence of metabolic syndrome among nursing personnel and its association with occupational stress, anxiety and depression. Rev Lat Am Enfermagem. 2015;23(3):435-40. https://doi. org/10.1590/0104-1169.0383.2573 PMid:26155007

Kahl KG, Schweiger U, Correll C, Mueller C, Busch ML, Bauer M, et al. Depression, anxiety disorders, and metabolic syndrome in a population at risk for Type 2 diabetes mellitus. Brain Behav. 2015;5(3):e00306. PMid:25642391

Hildrum B, Mykletun A, Midthjell K, Ismail K, Dahl AA. No association of depression and anxiety with the metabolic syndrome: the Norwegian HUNT study. Acta Psychiatr Scand. 2009;120(1):14- 22. PMid:19120047

Skilton MR, Moulin P, Terra JL, Bonnet F. Associations between anxiety, depression, and the metabolic syndrome. Biol Psychiatry. 2007;62(11):1251-7. biopsych.2007.01.012 PMid:17553465

Takeuchi T, Nakao M, Nomura K, Yano E. Association of metabolic syndrome with depression and anxiety in Japanese men. Diabetes Metab. 2009;35(1):32-6. diabet.2008.06.006 PMid:19046916

Amiri P, Hosseinpanah F, Rambod M, Montazeri A, Azizi F. Metabolic syndrome predicts poor health-related quality of life in women but not in men: Tehran lipid and glucose study. J Womens Health. 2010;19(6):1201-7. jwh.2009.1710 PMid:20482255

Slagter SN, van der Klauw MM, van Vliet-Ostaptchouk J, Keers JC, Lutgers HL, van Beek AP, et al. Health-related quality of life and the relation to metabolic syndrome, Type 2 diabetes, degree of obesity and low-grade inflammation in obese individuals. Diabetologia. 2014;57:S424-S. https://doi. org/10.1371/journal.pone.0140599

Tsai AG, Wadden TA, Sarwer DB, Berkowitz RI, Womble LG, Hesson LA, et al. Metabolic syndrome and health-related quality of life in obese individuals seeking weight reduction. Obesity. 2008;16(1):59-63. PMid:18223613

Tziallas D, Kastanioti C, Kostapanos MS, Skapinakis P, Elisaf MS, Mavreas V. The impact of the metabolic syndrome on health-related quality of life: A cross-sectional study in Greece. Eur J Cardiovasc Nurs. 2012;11(3):297-303. https://doi. org/10.1016/j.ejcnurse.2011.02.004 PMid:21398183

Oshakbayev K, Dukenbayeva B, Togizbayeva G, Durmanova A, Gazaliyeva M, Sabir A, et al. Weight loss technology for people with treated Type 2 diabetes: A randomized controlled trial. Nutr Metab. 2017;14:11. PMid:28163748

Sadykova A, Shalkharova ZS, Shalkharova ZN, Sadykova K, Madenbay K, Zhunissova M, et al. Metabolic syndrome and its components in Southern Kazakhstan: A cross-sectional study. Int Health. 2018;10(4):268-76. PMid:29718371

Alberti K, Zimmet P, Shaw J. The metabolic syndrome a new worldwide definition. Lancet. 2005;366(9491):1059-62. https:// PMid:16182882

Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 Practice guidelines for the management of arterial hypertension of the European society of hypertension (ESH) and the European society of cardiology (ESC). Blood Pressure. 2018;27(6):314-40. hjh.0000000000001961 PMid:30380928

Republican Center for Health Development of Healthcare and Social Development Ministry of Kazakhstan: E-database of Clinical Protocols Available from: en. [Last accessed on 2020 Mar 03].

Camm AJ, Malik M, Bigger JT, Breithardt G, Cerutti S, Cohen RJ, et al. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J. 1996;17(3):354-81. PMid:8598068

Woods DL, Wyma JM, Yund EW, Herron TJ, Reed B. Factors influencing the latency of simple reaction time. Front Hum Neurosci. 2015;9:131. fnhum.2015.00131 PMid:25859198

Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1983.

Lüscher M. In: Scott IA, editor. The Lüscher Color Test. New York: Washington Square Press; 1969.

McHorney CA, Ware JE, Raczek AE. The mos 36-item short-form health survey (sf-36) 2. Psychometric and clinical-tests of validity in measuring physical and mental-health constructs. Med Care. 1993;31(3):247-63. https://doi. org/10.1097/00005650-199303000-00006 PMid:8450681

Berntson GG, Bigger JT, Eckberg DL, Grossman P, Kaufmann PG, Malik M, et al. Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology. 1997;34(6):623-48. tb02140.x PMid:9401419

Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL. Hypertension and antihypertensive therapy as risk factors for Type 2 diabetes mellitus. N Engl J Med. 2000;342(13):905-12. PMid:10738048

Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol. 2010;141(2):122-31. https:// PMid:19910061

Ryden L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2013;34(39):3035. eurheartj/eht108 PMid:23996285

Grassi G, Arenare F, Quarti-Trevano F, Seravalle G, Mancia G. Heart rate, sympathetic cardiovascular influences, and the metabolic syndrome. Prog Cardiovasc Dis. 2009;52(1):31-7. PMid:19615491

Kahn R. Metabolic syndrome what is the clinical usefulness? Lancet. 2008;371(9628):1892-3. s0140-6736(08)60731-x PMid:18501420

Spielberger CD, Reheiser EC. Assessment of emotions: Anxiety, anger, depression, and curiosity. Appl Psychol Health Well Being. 2009;1(3):271-302. https://doi. org/10.1111/j.1758-0854.2009.01017.x

Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC. Anxiety disorders and cardiovascular disease. Curr Psychiatry Rep. 2016;18(11):101. s11920-016-0739-5 PMid:27671918

Tang F, Wang G, Lian Y. Association between anxiety and metabolic syndrome: A systematic review and meta-analysis of epidemiological studies. Psychoneuroendocrinology. 2017;77:112-21. PMid:28027497

Akbari H, Sarrafzadegan N, Aria H, Garaei AG, Zakeri H. Anxiety but not depression is associated with metabolic syndrome: The Isfahan healthy heart program. J Res Med Sci. 2017:22:90. PMid:28919917

Lemche AV, Chaban OS, Lemche E. Trait anxiety but not state anxiety level associates with biomarkers for hypertension in the metabolic syndrome. Psychophysiology. 2016;53(6):914-20. PMid:26841205

Endler NS, Kocovski NL. State and trait anxiety revisited. J Anxiety Disord. 2001;15(3):231-45. s0887-6185(01)00060-3 PMid:11442141

Corotto LV, Hafner JL. The luscher color test relationship between color preferences and behavior. Perceptual Motor Skills. 1980;50(3):1066. PMid:7413380

How to Cite
Koichubekov B, Sorokina M, Korshukov I, Bakirova R, Bekov E, Omarbekova N. Psychophysiological Status and Life Quality in Individuals with Metabolic Syndrome Living in Central Kazakhstan. Open Access Maced J Med Sci [Internet]. 2020May15 [cited 2020Oct.29];8(B):463-9. Available from:

Most read articles by the same author(s)