Metabolic syndrome and risk of suicide death in South Korea: a nationwide cohort study

Kim, Jin Hwa; Lyu, Young Sang; Kim, Mee Kyoung; Kim, Sang Yong; Baek, Ki-Hyun; Song, Ki-Ho; Han, Kyungdo; Kwon, Hyuk-Sang

doi:2026.41.6.1114

Korean J Intern Med > Volume 41(6); 2026 > Article

ORIGINAL ARTICLE

Endocrinology-metabolism

Korean J Intern Med. 2026;41(6):1114-1125. doi: https://doi.org/10.3904/kjim.2025.371

Metabolic syndrome and risk of suicide death in South Korea: a nationwide cohort study

Jin Hwa Kim¹, Young Sang Lyu¹, Mee Kyoung Kim², Sang Yong Kim¹, Ki-Hyun Baek², Ki-Ho Song², Kyungdo Han³

, and Hyuk-Sang Kwon²

¹Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
²Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
³Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea

Corresponding Author: Kyungdo Han , Tel: +82-2-820-7025, Fax: +82-2-823-1746, Email: hkd917@naver.com
Hyuk-Sang Kwon , Tel: +82-2-3799-1039, Fax: +82-2-786-1479, Email: drkwon@catholic.ac.kr

Received: October 28, 2025; Revised: April 22, 2026; Accepted: May 28, 2026.

Abstract

Background/Aims: South Korea has one of the highest suicide rates worldwide. This study examined the association between metabolic syndrome (MetS) and suicide death using nationwide data.
Methods: The study used the National Health Insurance Service database in South Korea. A total of 3,951,398 individuals were followed for up to 11 years. The risk of suicide death was analyzed in those with and without MetS and its components. Kaplan–Meier analysis was conducted to assess the incidence of suicide death, and Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: During 10,657,552.48 person-years, the incidence of suicide death was higher in individuals with MetS than in those without MetS (0.35 vs. 0.26 per 1,000 person-years). In adjusted analyses, MetS was associated with suicide death (HR: 1.135; 95% CI: 1.088–1.185). Compared with individuals without any metabolic components, those with one to five components showed HRs of 1.09 (1.032–1.151), 1.223 (1.155–1.295), 1.232 (1.154–1.314), 1.358 (1.258–1.466), and 1.434 (1.277–1.609), respectively.
Conclusions: MetS showed a possible association with suicide death. Further studies are needed to confirm these findings.

Keywords: Suicide ; Metabolic syndrome ; Cohort studies