Gender difference in the association between social support and metabolic syndrome in Japan: the 'enkai' effect?

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 The authors 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 The authors 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 ORs and 95% CIs for metabolic syndrome in the lowest versus highest level of social support was 0.75 (0.58 to 0.97) based on AHA/NHLBI criteria and 0.69 (0.51 to 0.92) based on IDF criteria. Among women, the authors found no association between social support and metabolic syndrome. Conclusions In this 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.