Gender-specific associations between metabolic syndrome components and electrocardiographic abnormalities: evidence from Birjand University of medical sciences employee health study (BUMS EHCS)

Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide. Metabolic syndrome (MetS), which consists of a group of metabolic risk factors, greatly elevates the risk of CVD. This study aimed to examine gender-specific associations between MetS components and electrocardiographic (ECG) abnormalities. This cross-sectional study included 617 staff members aged > 30 years from Birjand University of Medical Sciences. Data were collected through standardized questionnaires, clinical examinations, laboratory tests, and ECG recordings. MetS is defined based on the ATP III criteria as the presence of at least three risk factors. Data were entered into SPSS, and analyses were conducted at a significance level of P ≤ 0.05 to compare MetS scores and associated CVD risk factors between genders. Of the 617 participants studied, 261 (42%) were male and 356 (58%) were female (mean age 39 ± 7.6 years). Among these, 536 individuals (87%) did not have MetS, while 81 individuals (13%) had MetS. Individuals with MetS showed significantly higher WC, BP, FBS, and TG, but lower HDL, age, and education levels compared to participants without MetS. In women with MetS, heart rate, PR interval, and prolonged QRS duration were significantly higher, while QT interval was lower; no significant ECG differences were found in men. Findings suggest that ECG parameters remain relatively stable across increasing MetS scores, with heart rate being the only parameter showing a score-related association (p < 0.05). This study highlights potential gender-specific cardiodynamic variations in relation to metabolic syndrome components. While certain distinct associations were observed between MetS components and ECG parameters in women, these differences were modest, suggesting that gender-specific screening could be considered alongside general metabolic risk evaluations. Although ECG, as a simple and noninvasive tool, represents a valuable window into the complex interplay between metabolic and electrophysiological health.