Association of sleep quality and body mass index (BMI) with metabolic syndrome risk factors among medical students
Abstract
Sleep quality reflects an individual’s satisfaction with the sleep process, which is essential for cognitive, psychological, metabolic, and cardiovascular health. Poor sleep quality is prevalent among medical students and may elevate their risk of metabolic syndrome. This study investigated the association between sleep quality and body mass index (BMI) with metabolic syndrome risk factors in medical students. This was a cross-sectional study involving 98 first- to third-year preclinical medical students. Sleep quality was assessed by using the Pittsburgh sleep quality index (PSQI) questionnaire, BMI was measured from body weight and height, and metabolic syndrome risk factors were evaluated through waist circumference, blood pressure, fasting blood glucose, and high-density lipoprotein (HDL) cholesterol levels. Data was analyzed using Chi square and Fisher’s exact test. Results showed that 54.08% of students had good sleep quality and 42.86% had a normal BMI. However, 59.18% of students exhibited at least one metabolic syndrome risk factor, including central obesity (51.02%), hypertension (20.41%), dyslipidemia (13.27%), and high fasting blood glucose (1.02%). There was no association between sleep quality and metabolic syndrome risk factors. The BMI showed no association with fasting blood glucose and HDL cholesterol level. However, BMI showed a significant association with waist circumference (p<0.001) and blood pressure (p = 0.005). These findings emphasize the importance of addressing the MBI in mitigating metabolic syndrome risks among medical students.
References
Csipo T, Lipecz A, Owens C, Mukli P, Perry JW, Tarantini S, et al. Sleep deprivation impairs cognitive performance, alters task-associated cerebral blood flow and decreases cortical neurovascular coupling-related hemodynamic responses. Sci Rep, 2021; 11(1):20994.
https://doi.org/10.1038/s41598-021-00188-8
Linh TTD, Ho DKN, Nguyen NN, Hu CJ, Yang CH, Wu D. Global prevalence of post-COVID-19 sleep disturbances in adults at different follow-up time points: a systematic review and meta-analysis. Sleep Med Rev, 2023; 71:101833.
https://doi.org/10.1016/j.smrv.2023.101833
Briançon-Marjollet A, Weiszenstein M, Henri M, Thomas A, Godin-Ribuot D, Polak J. The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms. Diabetol Metab Syndr, 2015; 7:25.
https://doi.org/10.1186/s13098-015-0018-3
Abro SU, Khalid G, Saleem Q, Khan M, Ahmed S, Fatima. Association of body mass index and gender with sleep quality in medical students: a survey. Prof Med J, 2020; 27(11):2511-6.
https://doi.org/doi.org/10.29309/TPMJ/2020.27.11.4717
Yeboah K, Dodam KK, Agyekum JA, Oblitey JN. Association between poor quality of sleep and metabolic syndrome in Ghanaian university students: a cross-sectional study. Sleep Disord, 2022; 2022:8802757.
https://doi.org/10.1155/2022/8802757
Ahmed MS, Khan S, Hsan K, Sen L, Yunus FM, Griffiths MD, et al. Factors affecting sleep quality among the university students in bangladesh: a cross-sectional structured interview study. Sleep Vigilance, 2020; 4(2):177-84
https://doi.org/10.1007/s41782-020-00106-4
Mahfouz MS, Ali SA, Bahari AY, Ajeebi RE, Sabei HJ, Somaily SY, et al. Association between sleep quality and physical activity in Saudi Arabian university students. Nat Sci Sleep, 2020; 12:775-82.
https://doi.org/10.2147/NSS.S267996
Lavalle FJ, Villarreal JZ, Montes J, Mancillas LG, Rodríguez SE, González P, et al. Change in the prevalence of metabolic syndrome in a population of medical students: 6-year follow-up. J Diabetes Metab Disord, 2015; 14(1):85.
https://doi.org/10.1186/s40200-015-0216-4
Welty FK. How do elevated triglycerides and low HDL-cholesterol affect inflammation and atherothrombosis? Curr Cardiol Rep 2013; 15(9):400.
https://doi.org/10.1007/s11886-013-0400-4
Ying M, Hu X, Li Q, Dong H, Zhou Y, Chen Z. Long-term trajectories of BMI and cumulative incident metabolic syndrome: a cohort study. Front Endocrinol, 2022; 13:915394.
https://doi.org/doi.org/10.3389/fendo.2022.915394
Marcus Y, Segev E, Shefer G, Eilam D, Shenkerman G, Buch A, et al. Metabolically healthy obesity is a misnomer: components of the metabolic syndrome linearly increase with bmi as a function of age and gender. Biology (Basel), 2023; 12(5):719.
https://doi.org/10.3390/biology12050719
Amin Y, Mushtaq S, Taj R, Sachdev S, Magray SM. Perceived stress and sleep quality among medical students and their relationship with body mass index and body fat: a cross-sectional study. J Clin Diagn Res, 2023; 17(10):17-20.
https://doi.org/10.7860/JCDR/2023/63254.18603
Warrier V, Krishan K, Shedge R, et al. Height Assessment. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
https://www.ncbi.nlm.nih.gov/books/NBK551524/
Freitag E, Edgecombe G, Baldwin I, Cottier B, Heland M. Determination of body weight and height measurement for critically ill patients admitted to the intensive care unit: A quality improvement project. Aust Crit Care, 2010; 23(4):197-207.
https://doi.org/10.1016/j.aucc.2010.04.003
NHLBI Obesity Education Initiative. The practical guide to the identification, evaluation and treatment of overweight and obesity in adults. National Institutes of Health, National Heart, Lung, and Blood Institute, North American Association for the Study of Obesity, 2000.
Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120(16):1640-5.
https://doi.org/10.1161/CIRCULATIONAHA.109.192644
The Pittsburgh sleep quality index (PSQI) [Internet]. [Cited 2025 April 15].
https://guides.library.uq.edu.au/referencing/vancouver/webpages.
Phaneendra DJ, Arige G, Sirivelu B, Lakshmi GS. Prevalence of metabolic syndrome amongst undergraduate medical students: a cross-sectional study. Natl J Lab Med, 2024; 13(2):5-9.
https://doi.org/10.7860/NJLM/2024/66548.2828
Raouf N, Mahfouz E, Seedhom A, Ghazawy E, Abdelrehim M. The risk of obesity in relation to dietary habits among medical students at Minia University, Faculty of Medicine, Minia, Egypt. Minia J Med Res, 2022; 33(4):105-14.
https://doi.org/10.21608/mjmr.2022.166298.1195
Haider M, Abbas U, Arif HE, Uqaili AA, Khowaja MA, Hussain N, et al. From plate to profile: investigating the influence of dietary habits and inactive lifestyle on lipid profile in medical students at clerkship. BMC Nutr, 2024; 10(1):71.
https://doi.org/10.1186/s40795-024-00871-9
Jha RK, Yadav AK, Shrestha S, Shrestha PR, Shrestha S, Jha M, et al. Study of body mass index among medical students of a medical college in nepal: a descriptive cross-sectional study. JNMA J Nepal Med Assoc, 2021; 59(235):280-3.
https://doi.org/10.31729/jnma.6282
Peltzer K, Pengpid S. Sleep duration, sleep quality, body mass index, and waist circumference among young adults from 24 low- and middle-income and two high-income countries. Int J Environ Res Public Health, 2017; 14(6):566.
https://doi.org/10.3390/ijerph14060566
Putri LEW, Amalia E, Anggoro J. Hubungan antara tingkat stres, kualitas tidur dan tekanan darah pada mahasiswa Pendidikan Dokter Fakultas Kedokteran Universitas Mataram. J Kedokt, 2023; 12(4):351-7.
https://doi.org/10.29303/jk.v12i4.4562
Aulia DR, Goviana NR, Isnanta R. The relationship between sleep quality and blood pressure in students of the Faculty of Medicine, Universitas Prima Indonesia. Eureka Herba Indones, 2023; 4(1):190-3.
https://doi.org/10.37275/ehi.v4i2.65
Wikanendra GB, Suhadi R, Setiawan CH, Virginia DM, Hendra P, Fenty F. Correlation among sleep duration, blood pressure, and blood glucose level of Morangan people, Sindumartani, Ngemplak, Sleman. J Pharm Sci Comm, 2020; 17(2):86-91.
http://dx.doi.org/10.24071/jpsc.002404
Mahadarmika DGAA, Dinata IMK, Wahyuni N. Hubungan kualitas tidur terhadap intoleransi glukosa pada mahasiswa pendidikan dokter fakultas kedokteran universitas udayana. Intisari Sains Medis, 2023; 14(1):275-9.
https://doi.org/10.15562/ism.v14i1.1627
AL-Musharaf S, AlAjllan L, Aljuraiban G, AlSuhaibani M, Alafif N, Hussain SD. Nutritional biomarkers and factors correlated with poor sleep status among young females: a case-control study. Nutrients, 2022; 14(14):2898.
https://doi.org/10.3390/nu14142898
Hariri M, Shamshirgaran SM, Aminisani N, Abasi H, Gholami A. Is poor sleep quality associated with lipid profile in elderly population? Finding from Iranian longitudinal study on ageing. Ir J Med Sci, 2023; 193(Suppl 9):123-9.
https://doi.org/10.1007/s11845-023-03449-9
Castañeda RBQ, Turpo-Chaparro J, Torres JH, Saintila J, Mamani PGR. Overweight and obesity, body fat, waist circumference, and anemia in Peruvian University students: a cross-sectional study. J Nutr Metab, 2021; 2021:5049037.
https://doi.org/10.1155/2021/5049037
Song L, Li J, Yu S, Cai Y, He H, Lun J, et al. Body Mass Index is associated with blood pressure and vital capacity in medical students. Lipids Health Dis, 2023; 22(1):174.
https://doi.org/10.1186/s12944-023-01920-1
do Vale Moreira NC, Hussain A, Bhowmik B, Mdala I, Siddiquee T, Fernandes VO, et al. Prevalence of metabolic syndrome by different definitions, and its association with type 2 diabetes, pre-diabetes, and cardiovascular disease risk in Brazil. Diabetes Metab Syndr, 2020; 14(5):1217-24.
https://doi.org/10.1016/j.dsx.2020.05.043
Yusni Y, Rahman S, Naufal I. Positive correlation between body weight and body mass index with blood pressure in young adults. Narra J, 2024; 4(1):e533.
https://doi.org/10.52225/narra.v4i1.533
Setyawati T, Adawiyah R, Khumairah H. The relationship between body weight and fasting blood glucose levels in students of the Faculty of Medicine, Tadulako University, Class of 2022. Int J Health Econ Soc Sci (IJHESS), 2023; 5(3):265-9.
https://doi.org/10.56338/ijhess.v5i3.3675
Swathi M, Paul GRR, Dharahasa KD, Kumar TD, Priyanka P. Study of body mass index (bmi) and its association with lipid profile among medical students in Nizambad. Int J Acad Med Pharm, 2023; 5(5):152-5.
https://doi.org/10.47009/jamp.2023.5.5.32
Mishra S, Murry B, Devi NK, Tripathi S, Suokhire S. Obesity in dyslipidemia and hypertension: a study among young adults of Delhi/NCR. Clin Epidemiol Glob Health, 2023; 22:101335.



