Associations of gastrointestinal, sleep, and affective symptom combinations with cardiometabolic conditions: a cross-sectional study
- 1Center of Integrated Chinese and Western Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University
Abstract
Background: Gastrointestinal, sleep, and affective symptoms frequently co-occur, but their combined associations with cardiometabolic conditions are poorly characterized. We examined associations of specific symptom combinations and the number of co-occurring symptom domains with prevalent cardiometabolic conditions.
Methods: This cross-sectional study included 5,203 adults aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 2009–2010. Gastrointestinal, sleep, and affective symptoms were classified into eight mutually exclusive combinations. Survey-weighted logistic regression was used to examine associations with hypertension, dyslipidemia, diabetes, and metabolic syndrome, adjusting for demographic characteristics, body mass index (BMI), and lifestyle factors. We also examined the number of co-occurring symptom domains (0–3) and performed sensitivity analyses using alternative symptom definitions.
Results: Compared with participants classified as negative for all three symptom domains, those with gastrointestinal and sleep symptoms (G+S) had higher adjusted odds of hypertension (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.27–2.89), as did those with all three domains (G+S+A; OR, 2.31; 95% CI, 1.38–3.86). Sleep and affective symptoms (S+A) were associated with dyslipidemia (OR, 1.67; 95% CI, 1.06–2.61), and G+S+A was associated with diabetes (OR, 1.63; 95% CI, 1.15–2.30). Increasing numbers of symptom domains showed positive trends for hypertension (P for trend = 0.007) and diabetes (P for trend = 0.041). No symptom combination showed a statistically significant adjusted association with metabolic syndrome. Associations of G+S+A with hypertension and diabetes were generally consistent across sensitivity analyses.
Conclusion: Specific combinations of gastrointestinal, sleep, and affective symptoms were associated with prevalent cardiometabolic conditions, particularly hypertension and diabetes. Both symptom composition and the number of co-occurring domains warrant evaluation in longitudinal studies.
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BibTeX
@article{wu2026associations,
title = {{Associations of gastrointestinal, sleep, and affective symptom combinations with cardiometabolic conditions: a cross-sectional study}},
author = {Jielong Wu and Bo Li and Zhihai Zhang and Miaona Cai and Nengjiang Zhao and Xin Hu and Shuyu Yang},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.1968651},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1968651/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Associations of gastrointestinal, sleep, and affective symptom combinations with cardiometabolic conditions: a cross-sectional study
AU - Jielong Wu
AU - Bo Li
AU - Zhihai Zhang
AU - Miaona Cai
AU - Nengjiang Zhao
AU - Xin Hu
AU - Shuyu Yang
PY - 2026
DA - 2026/11/04
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1968651
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1968651/full
AB - Background: Gastrointestinal, sleep, and affective symptoms frequently co-occur, but their combined associations with cardiometabolic conditions are poorly characterized. We examined associations of specific symptom combinations and the number of co-occurring symptom domains with prevalent cardiometabolic conditions. Methods: This cross-sectional study included 5,203 adults aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 2009–2010. Gastrointestinal, sleep, and affective symptoms were classified into eight mutually exclusive combinations. Survey-weighted logistic regression was used to examine associations with hypertension, dyslipidemia, diabetes, and metabolic syndrome, adjusting for demographic characteristics, body mass index (BMI), and lifestyle factors. We also examined the number of co-occurring symptom domains (0–3) and performed sensitivity analyses using alternative symptom definitions. Results: Compared with participants classified as negative for all three symptom domains, those with gastrointestinal and sleep symptoms (G+S) had higher adjusted odds of hypertension (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.27–2.89), as did those with all three domains (G+S+A; OR, 2.31; 95% CI, 1.38–3.86). Sleep and affective symptoms (S+A) were associated with dyslipidemia (OR, 1.67; 95% CI, 1.06–2.61), and G+S+A was associated with diabetes (OR, 1.63; 95% CI, 1.15–2.30). Increasing numbers of symptom domains showed positive trends for hypertension (P for trend = 0.007) and diabetes (P for trend = 0.041). No symptom combination showed a statistically significant adjusted association with metabolic syndrome. Associations of G+S+A with hypertension and diabetes were generally consistent across sensitivity analyses. Conclusion: Specific combinations of gastrointestinal, sleep, and affective symptoms were associated with prevalent cardiometabolic conditions, particularly hypertension and diabetes. Both symptom composition and the number of co-occurring domains warrant evaluation in longitudinal studies.
SN - 1664-2392
ER -