Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers

BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p