Associations of gastrointestinal, sleep, and affective symptom combinations with cardiometabolic conditions: a cross-sectional study

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.