Background: Social trust, assessed by the trustworthiness of one another in a community, is known to have beneficial effects on health outcomes. However, the impact of social trust on metabolic syndrome (MetS) is unclear. Methods: The study subjects were extracted from the Korean National Health Insurance Service, and social trust was obtained from the Korean Community Health Survey (KCHS). Previously healthy participants were followed up from 1 January 2010 to 31 December 2011, and again from 1 January 2012 to 31 December 2013 for waist circumference, blood pressure, fasting blood glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C). Multivariate logistic regression was used to calculate the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for newly developed MetS according to social trust quintiles. Stratified analyses were performed to determine the relationship between lifestyle behaviors and social trust. Results: Compared to the participants within the first quintile of social trust, those in the remaining quintiles had lower risks of developing MetS. The aOR with the 95% CI was 0.88 (0.79–0.98) in the 5th quintile group of social trust. Among the diagnostic criteria for MetS, waist circumference and HDL-C were statistically significant with aORs of 0.91 (0.84–0.99) and 0.88 (0.80–0.95) in the 5th quintile group. The stratified analyses showed protective effects of positive lifestyle behaviors. The aORs with 95% CIs were 0.85 (0.74–0.99) in never smokers, 0.82 (0.70–0.95) in non-drinkers and 0.87 (0.76–1.00) in the physically active in the highest level of social trust. Conclusions: Higher social trust was associated with a lower incidence of MetS. Therefore, building community with psychosocial support may be helpful in improving public health.
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