Feeling of Loneliness and Lack of Social Support as Predictors of Cardiometabolic Syndrome

Abstract

Background: Feeling of loneliness and lack of social support are key components of social health. Loneliness is a subjective, undesirable feeling of solitude, while social support refers to the quality and accessibility of human connections. Loneliness and lack of social support have been associated with disease and early mortality, particularly increased risk of cardiovascular outcomes. Cardiometabolic syndrome (CMS) is a cluster of metabolic disturbances, including high blood pressure, high BMI, raised cholesterol, and type 2 diabetes that elevate the risk of cardiovascular and metabolic diseases. Although prior studies have linked loneliness or lack of social support to individual CMS components, their combined or separate effects on CMS as a whole remain underexplored. Moreover, some biological, social, and behavioral factors known to influence CMS may also be linked to loneliness and lack of social support, an area of research that is yet to be investigated to understand the overall effects of all these factors combined on CMS. Study objective: This study aims to investigate whether loneliness and lack of social support are associated with an increased risk of cardiometabolic syndrome, while considering the link of biologic, social, and behavioral characteristics with these two social factors and CMS. Method: We employed a secondary data analysis of 154,317 adults in 26 states adopted from the 2023 Behavioral Risk Factor Surveillance System (BRFSS). Weighted Chi square tests and weighted logistic regressions were used to examine associations between feelings of loneliness, lack of social support, and cardiometabolic syndrome (CMS), along with the biologic, social and behavioral factors. Findings: Of the 154,317 respondents, 9.70% (n = 17,743) reported having CMS. Among the study population, 3.02% (n = 2,725) reported always feeling lonely, and 8.63% (n = 7,828) reported lacking social support. Unadjusted associations between CMS, primary predictors, and other covariates were computed, and the significant variables were used to build our adjusted models. Three main models were considered, the first examined loneliness and the aforementioned factors as predictors of CMS; the second included lack of social support and the same covariates as in the first model; and the third included both loneliness and lack of social support along with all covariates considered in models one and two. In all three models, loneliness and lack of social support emerged as significant predictors of CMS. Results from the third model that include the full adjustment showed that loneliness was associated with 1.66 times higher odds of CMS (95% CI: 1.22–2.25), and lack of social support had 1.20 times higher odds of CMS (95% CI: 1.10–1.44). Among the health determinants, male sex, 1 older age, non-White race, divorced/separated or widowed marital status, access to healthcare provider, former smokers, and physical inactivity were significantly associated with increased odds of CMS, and were also linked to both loneliness and lack of social support. Moreover, our results also showed that being never married and consuming alcohol had a protective effect on CMS. Conclusion: Loneliness emerged as an impactful correlate of cardiometabolic syndrome (CMS), followed by lack of social support, along with health determinants. Building on these important and novel findings, intervention strategies and health policies that address these factors should be implemented to alleviate their associated risk effects on CMS especially vis-à-vis its role as a precursor to cardiovascular and metabolic diseases.