Jia-In Lee

Background/Objectives: The relationship between metabolic syndrome (MetS) and mental health disorders has gained increasing attention, yet evidence from large population-based studies remains limited. This study aimed to examine the association between MetS and psychiatric morbidity in a nationwide Taiwanese adult cohort using a cross-sectional design. Methods: Between 2008 and 2019, a total of 121,575 adults aged 30–70 years were recruited from 29 community health screening stations across Taiwan. Demographic characteristics, lifestyle factors, medical history, and physical measurements were collected. Participants were classified as having MetS or not according to standard criteria. Psychiatric morbidity was defined as depressive and/or anxiety burden identified by validated screening instruments (Patient Health Questionnaire-2 score ≥3 or Generalized Anxiety Disorder-2 score ≥3) or self-reported physician-diagnosed depression. Multivariable logistic regression analyses were performed to evaluate the association between MetS and psychiatric morbidity after adjustment for potential confounders. Results: Psychiatric morbidity was identified in 1366 of 27,349 participants with MetS (5.0%) and in 4047 of 94,226 participants without MetS (4.3%). The prevalence of psychiatric morbidity was higher among participants with MetS than those without MetS (5.0% vs. 4.3%). After multivariable adjustment, MetS was significantly associated with increased odds of psychiatric morbidity (adjusted odds ratio [aOR] 1.235; 95% confidence interval [CI] 1.152–1.325). Among individual MetS components, hypertension, increased waist circumference, and hypertriglyceridemia were independently associated with higher odds of psychiatric morbidity. Conclusions: MetS was associated with a modest increase in psychiatric morbidity in this large Taiwanese community cohort. Because of the cross-sectional design, causal inference is limited. Future longitudinal studies are needed to clarify the direction of association and underlying mechanisms linking metabolic and mental health conditions.

Background/Objectives: Obesity has been linked to a number of diseases, including depression and anxiety. In addition to the commonly used body mass index (BMI) and waist circumference, many obesity-related indices have been proposed. We aimed to investigate the associations between 10 obesity-related indices and psychiatric morbidity in a large cohort of 121,601 Taiwanese participants. Methods: This cross-sectional study analyzed data from 121,601 adults aged 30–70 years enrolled in the Taiwan Biobank between 2012 and 2023. The mean age of the participants was 50 years, and the 10 obesity-related indices were BMI, waist circumference, waist-to-height ratio, waist-to-hip ratio, abdominal volume index, body roundness index, lipid accumulation product, visceral adiposity index, conicity index and triglyceride glucose index. Psychiatric morbidity, defined as the presence of depressive or anxiety symptoms, was identified using self-reported, physician-diagnosed depression, Patient Health Questionnaire 2-item (PHQ-2) score ≥ 3, or Generalized Anxiety Disorder 2-item (GAD-2) score ≥ 3. Multivariable logistic regression models were used to assess associations between each obesity-related index and psychiatric morbidity. Results: Psychiatric morbidity was observed in 5414 (5%), 1375 (3.0%) and 4039 (5%) individuals in the whole cohort, male participants and female participants, respectively. After adjusting for variables, all of the obesity-related indices were significantly associated with psychiatric morbidity, except for BMI in the male subjects. There were no significant interactions between sex and these 10 obesity-related indices. Conclusions: We found significant associations between multiple obesity-related indices and psychiatric morbidity; as these indices are simple and routinely collected, they may help identify individuals at higher psychological risk in population settings. Further research is warranted to clarify underlying mechanisms and their potential utility in screening or prevention.

Background: Hyperlipidemia is a significant risk factor for cardiovascular diseases. Hyperuricemia has also been linked to adverse cardiometabolic outcomes, including dyslipidemia. The relationship between hyperuricemia and hyperlipidemia is of particular concern due to their combined impact on cardiovascular risk. Methods: This study analyzed data from 119,037 participants in the Taiwan Biobank to explore the association between hyperuricemia and hyperlipidemia. The study compared baseline characteristics and metabolic profiles between participants with and without hyperuricemia. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with hyperlipidemia, focusing on hyperuricemia as an independent variable. Results: The participants with hyperuricemia had a more adverse cardiometabolic profile, including a higher body mass index (BMI), a higher prevalence of smoking and alcohol consumption, hypertension, and diabetes, and a worse lipid profile. Univariate analysis showed significant associations between hyperlipidemia and age, BMI, smoking history, alcohol consumption, hypertension, diabetes, and hyperuricemia (OR: 1.706, 95% CI: 1.625–1.791, p < 0.001). In multivariate analysis, hyperuricemia remained an independent predictor of hyperlipidemia (OR: 1.102, 95% CI: 1.041–1.165, p < 0.001), along with age, BMI, smoking, alcohol consumption, hypertension, diabetes, and a lower estimated glomerular filtration rate. Conclusion: Hyperuricemia is independently associated with hyperlipidemia, underscoring its role in the complex interplay of metabolic factors contributing to cardiovascular disease risk. Our findings highlight the importance of comprehensive risk factor management incorporating serum uric acid to mitigate the impact of hyperlipidemia and associated cardiovascular conditions.

This study investigated the associations of particulate matter (PM_2.5/PM₁₀) and wet-bulb globe temperature (WBGT) with incident depression. Participants were recruited from the Taiwan Biobank. Exposure to air pollutants and WBGT was calculated using geospatial artificial intelligence (Geo-AI) estimation. Depression was assessed via self-reported questionnaires, and multivariable-adjusted Cox regression models were used for analysis. A total of 21,445 participants were enrolled, among whom 263 (1.2%) developed depression over an average follow-up period of 43 months. Participants in the highest quartile of PM_2.5 exposure had a significantly increased depression risk (HR 1.844, 95% CI 1.315–2.587). PM₁₀ exposure was also positively associated with depression, though the association was less consistent across analyses. The greatest risk was observed among individuals residing in areas with both elevated PM and WBGT levels. Higher exposure to PM_2.5 was consistently associated with increased depression risk. These findings highlight the potential combined effects of air pollution and heat stress on mental health in subtropical regions.

Background/Objectives. This large, longitudinal follow-up cohort study aimed to explore how being a vegetarian and related factors impacted the incident gastroesophageal reflux disease (GERD) in a comprehensive Taiwanese cohort. Methods. The study cohort was enrolled from the Taiwan Biobank. Vegetarian status, duration of being a vegetarian, type of vegetarian diet, and whether or not the participants had GERD were recorded from self-reported surveys. Associations between vegetarian status, duration, and type of diet with incident GERD were analyzed with multivariate logistic regression with adjustments for confounding variables. Results. After excluding participants with pre-existing GERD, we included 23,714 participants into the study. Multivariable analysis showed that vegetarian status (current vs. never; hazard ratio [HR], 0.697; 95% confidence interval [CI], 0.546 to 0.889; p = 0.004) was significantly inversely associated with incident GERD; conversely, ever being a vegetarian was not associated (p = 0.489). In addition, those who had been a vegetarian for 6 years or more had 0.72 times lower risk of GERD compared to those who had never been a vegetarian (HR, 0.717; 95% CI 0.558 to 0.922, p = 0.009). No significant differences were observed regarding the type of vegetarian diet with incident GERD. Conclusions. The results showed that following a vegetarian diet was an independent protective factor for incident GERD, with a significant protective effect observed in those who adhered to a vegetarian diet for at least 6 years. Future research is warranted to explore the underlying mechanisms and whether adopting a vegetarian diet can decrease the incidence of GERD.

(1) Background: We aimed to explore the associations between menopause, postmenopausal hormone therapy, and metabolic syndrome in a large community-based group of Asian women. (2) Methods: This is a cross-sectional study in which we enrolled women aged 30 to 70 years with sufficient information about menopausal status from the Taiwan Biobank. The definition for metabolic syndrome used in this study aligns with the Bureau of Health Promotion’s (Taiwan) proposed definition. (3) Results: A total of 17,460 women were recruited. The postmenopausal group had a higher metabolic syndrome prevalence (30% vs. 14%) and 1.17 times higher odds ratio (OR) than the premenopausal group (95% confidence interval [CI] = 1.02 to 1.33). Regarding the types of menopause, surgical menopause was associated with metabolic syndrome (OR = 1.40; 95% CI = 1.20 to 1.63); however, natural menopause was not associated with metabolic syndrome. Interestingly, postmenopausal hormone therapy was associated with a lower risk of metabolic syndrome in the women with natural menopause (OR = 0.79; 95% CI = 0.70 to 0.89), but not in those with surgical menopause. (4) Conclusions: Our results suggest that menopause is associated with an increased prevalence of metabolic syndrome, while postmenopausal hormone therapy is associated with a lower prevalence of metabolic syndrome in women with natural menopause.

Obesity has become a major public health issue which relate to numerous physical problems and highly comorbid with depression and anxiety. Recently, some studies of technology-based interventions for weight reduction emerged to overcome the barriers from time, cost and distance. Mood component and eating behavior related to obesity are less discussed so far with technology-based intervention though. This pilot study was aimed to investigate the effect of telehealth assisted intervention on weight reduction, mood status, and eating behavior change under a smartphone application (app) with novel 3D food picture recognition and incorporated with cognitive behavioral training programs. Adult aged 30–60 years old with overweight were recruited and randomly assigned to control-first group and intervention-first group. In period 1, control-first group had regular life and intervention-first group underwent app intervention; in period 2, two groups went crossover. Body composition and psychological/behavioral questionnaires were collected at baseline, end of period 1, and end of period 2. Nonparametric statistics was performed for data analyzing. A total of 20 participants were enrolled. In control-first group, there were statistically significant reduction in body weight (− 0.55 kg,p = 0.02) and change of body weight percentage (− 0.6%,p = 0.02) after App use. In intervention-first group, the fat percentage decreased by 0.4% after App use in period 1, and increased by 0.05% in period 2. The integrated crossover data revealed that subjects of App group had significant improvements in mindful eating behavior. This pilot study showed the effectiveness in using CogniNU app for weight control and eating behavior. The difference of short-term and long-term effectiveness of technology-based weight control intervention deserves more investigation in the future.Clinical Trial Registration: ISRCTN16082909.

Background: Living alone has been linked to poor mental health, however large-scale epidemiological studies on the association between living alone and psychiatric morbidity including depression and anxiety are lacking. The aim of this study was to investigate this issue in a large Taiwanese cohort.Methods: In this cross-sectional study, we enrolled 121,601 volunteers from 29 community recruitment stations in Taiwan and divided them into two groups based on whether or not they lived alone. Psychiatric morbidity was defined as a Generalized Anxiety Disorder 2-item score ≥ 3, Patient Health Questionnaire 2-item score ≥ 3, or self-reported depression. Logistic regression was used to explore the associations between living alone and psychiatric morbidity.Results: The participants who lived alone had a higher prevalence of psychiatric morbidity [odds ratio (OR) = 1.608, 95% confidence interval (CI) = 1.473 to 1.755] after adjusting for potential confounders. In a subgroup analysis, married subjects who lived alone and divorce/separation (OR = 2.013, 95% CI = 1.763 to 2.299) or widowing (OR = 1.750, 95% CI = 1.373 to 2.229) were more likely to have psychiatric morbidity than those who were married and not living alone.Conclusions: Our findings suggest that living alone is a risk factor for psychiatric morbidity, especially for married subjects who live alone in concordance with divorce, separation, or the death of a spouse.