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Published on: June 19, 2019
Association between perceived stress and metabolic parameters: a systematic review and meta-analysis
Karla Fernanda Garcia-Ravelo1,2, Alexandro J Martagon1,2,3, Gabriela A Galán-Ramírez1,2
1Unidad de Investigación de Enfermedades Metabólicas, INCMNSZ, Mexico City, Mexico.
Diabetology & Metabolic Syndrome
|June 27, 2026
Summary
Higher perceived stress may be linked to insulin resistance, but not other metabolic syndrome components. This exploratory finding suggests stress management could be relevant for metabolic health, pending more evidence.
Area of Science:
- Endocrinology
- Psychoneuroimmunology
- Public Health
Background:
- Metabolic syndrome (MetS) is a significant global health issue linked to cardiovascular disease, type 2 diabetes mellitus (T2D), and mortality.
- Chronic psychological stress is implicated in metabolic dysfunction, yet its direct link to MetS and its components via perceived stress remains unclear.
- The Perceived Stress Scale (PSS) is a common tool, but its association with metabolic outcomes needs systematic review.
Purpose of the Study:
- To systematically review existing evidence on the association between perceived stress (measured by PSS) and metabolic parameters relevant to MetS.
- To evaluate the relationship between subjective stress levels and individual components of metabolic syndrome.
Main Methods:
- A systematic literature search identified 30 studies (12,491 participants) using PSS-10 or PSS-14 and reporting metabolic outcomes.
- Random-effects meta-regression models were employed to analyze associations, standardizing stress scores for comparability.
- Key outcomes included anthropometric measures, blood pressure, glycaemic markers, lipid profiles, and insulin resistance (HOMA-IR).
Main Results:
- Most metabolic parameters (BMI, waist circumference, blood pressure, fasting glucose, triglycerides) showed no significant association with perceived stress.
- Insulin resistance (HOMA-IR) was positively associated with perceived stress (β=0.463).
- Borderline associations were found for HDL cholesterol and total cholesterol; the HOMA-IR finding was exploratory and heterogeneous.
Conclusions:
- Elevated perceived stress may be linked to insulin resistance (HOMA-IR), but not traditional MetS anthropometric, glycaemic, or blood pressure measures.
- This exploratory finding suggests psychosocial stress could contribute to metabolic vulnerability.
- Further research is needed to establish causality and inform clinical strategies for stress assessment in metabolic health.
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