Scientific evidence on the association between burnout and metabolic syndrome: integrative review

Merces, Magno Conceição das; Gomes, Antonio Marcos Tosoli; Coelho, Julita Maria Freitas; Servo, Maria Lúcia Silva; Marques, Sergio Correa; D’Oliveira, Argemiro

doi:10.1590/1982-0194201900064

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Integrative Review • Acta Paul Enferm 32 (4) • Jul-Aug 2019 • https://doi.org/10.1590/1982-0194201900064 linkcopy

Scientific evidence on the association between burnout and metabolic syndrome: integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To evaluate the scientific evidence available in the literature on the association between Burnout Syndrome and Metabolic Syndrome.

Methods Integrative literature review, searching the databases of the Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online and Springer Link. The selected articles were analyzed according to the Agency for Healthcare Research and Quality.

Results Most (80%) of the 5 studies that met the selection criteria were in English language and indexed in the Web of Science and Scopus databases. Among the studies, 80% had physicians as the main authors. The Asian continent (Israel, Japan and China) concentrated the majority of production. There was no predominance of study design. The financial area corresponded to 60% of the study participants.

Conclusion The available evidence in the literature is incipient, only 20% of the eligible articles showed association between the syndromes studied and the others, indicate association between Burnout and MS components separately.

Burnout, professional; Metabolic syndrome; Occupational health; Epidemiology

Year of publication/Author/Journal	Type and country of study / Level of Evidence	Thematic considerations	Summary conclusions
2006 Melamed S, Shirom A, Toker S, Berliner S, Shapira I⁽¹⁵⁾ Psychological Bulletin	Systematic review Israel Level V	They evaluate the accumulated evidence in the international literature on Burnout and exhaustion associated with the increased risk of cardiovascular events, highlighting Metabolic Syndrome.	Burnout can trigger sleep disorders, depression, inflammatory processes, immune changes, diabetes mellitus, Metabolic Syndrome and other cardiometabolic events.
2008 Ranchal-Sánchez A, Vaquero-Abellán M⁽³³⁾ Medicina y Seguridad del Trabajo	Cross-sectional Spain Level VI	They evaluate the association between Burnout and biochemical dosages, namely: serum glucose and cholesterol levels, as well as body mass index in a random sample of 186 secondary school teachers.	The findings indicate that there was no association between Burnout and the components of the Metabolic Syndrome, however, it was found that the higher the professional achievement, which integrates one of the dimensions of Burnout, the lower the body mass index.
2009 Kitaoka-Higashiguchi K, Morikawa Y, Miura K⁽³⁴⁾ Journal of Occupational Health	Cohort Japan Level IV	Investigate the Burnout and risk factors for atherosclerotic disease, highlighting the Metabolic Syndrome among 442 middle managers of a factory.	Changes in waist circumference, body weight and body mass index were significantly higher in managers with Burnout. Despite describing the biological plausibility that indicates the association between Burnout and Metabolic Syndrome, no statistical significance was found in the path described.
2013 Tsai HH, Yeh CY, Su CT, Chen CJ, Peng SM, Chen RY ⁽¹⁹⁾ Industrial Health	Quasi-experimental non-randomized China Level III	They estimate that physical activity is an intervention factor that affects the relationship between Burnout and components of the Metabolic Syndrome among 109 financial advisors and administrators of an insurance bank.	A well-designed exercise program establishes better health behavior in the workplace, relieving Burnout and components of the Metabolic Syndrome. There is an association between Burnout and components of the Metabolic Syndrome.
2018 Metlaine A, Sauvet F, Gomez-Merino D, Boucher T, Elbaz M, Delafosse JY⁽¹⁷⁾ PloS ONE	Case-control France Level IV	They investigate chronic exposure to stress (Burnout), sleep quality and specific biological repercussion, in particular metabolic and inflammatory responses among 140 employees of a financial company.	Burnout participants had higher levels of HbA1c, glycemia, CRP, lower levels of vitamin D, increased numbers of leukocytes, neutrophils and monocytes (P <0.001 for all) and higher total cholesterol (P = 0.01). There was no association between Burnout and Metabolic Syndrome.

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