The Association of Burnout and Vital Exhaustion With (Measures of) the Metabolic Syndrome: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis aims to investigate the association of burnout and vital exhaustion (VE) symptoms with (measures of) the metabolic syndrome (MetS). Method: PubMed, Embase, and PsycINFO were systematically searched until April 26, 2024. Studies investigating adult populations, burnout, or VE as exposures and (measures of) MetS as outcomes were included. Data extraction and quality assessment were performed independently by two observers. If at least three independent effect measures (in at least two studies) were available per association, meta-analyses were performed using randomeffects models. Results: We included 101 studies (71% cross-sectional, 11% case-control, 13% prospective, 5% alternative) comprising 22 strong, 55 moderate, and 24 weak quality studies. Meta-analyses showed relevant but statistically nonsignificant associations of burnout and VE symptoms with higher incident (odds ratio [OR]=1.53 [0.82, 2.87], I20%) and prevalent MetS (OR=1.28 [0.99, 1.64], I2= 85%), incident obesity (OR=1.88 [0.81, 4.36], I2= 0%), waist-to-hip ratio (standardized mean difference= 0.62 [−0.65, 1.90], I2= 95%), prevalent high waist circumference (OR= 1.14 [0.80, 1.62], I2=28%), high triglycerides (OR=1.49 [0.82, 2.71], I2=40%), and a significantly higher prevalent hypertension (OR= 1.63 [1.44, 1.84], I2= 51%). We found no clinically relevant associations with remaining MetS measures. Conclusions: Burnout and VE symptoms might be associated with a higher odds of prevalent and incident MetS, however, not statistically significant. These results should be interpreted with caution due to the cross-sectional design of most studies, use of unadjusted baseline data, and substantial heterogeneity in some analyses.