Evangelista Lorraine S, Moser Debra K, Westlake Cheryl, Hamilton Michele A, Fonarow Gregg C, Dracup Kathleen
School of Nursing, University of California, Los Angeles, 700 Tiverton, Factor Building, Los Angeles, CA 90095-6918, USA.
Eur J Heart Fail. 2006 Nov;8(7):750-5. doi: 10.1016/j.ejheart.2006.02.004. Epub 2006 Mar 10.
The effect of obesity on health related quality of life (HRQOL) and depression in a number of disease states is well documented, but its impact in heart failure (HF) patients remains speculative. We therefore examined the relationship between obesity, HRQOL, and depression in 358 patients with HF.
Comparative analyses were conducted to determine if body mass index (BMI) was associated with HRQOL and depression in three groups of patients with HF-normal weight (BMI 18.5-24.9 kg/m2, n = 100), overweight (BMI 25-29.9 kg/m2, n = 141), and obese (BMI > or = 30 kg/m2, n = 117). Obese patients were younger than normal and overweight participants; all other demographic and clinical characteristics were similar. HRQOL and depression scores were significantly higher (worse) for obese patients. Body mass index was significantly correlated with all 3 scales of HRQOL (overall, r2 = .160; physical, r2 = .162; and mental, r2 = .217) as well as with depression (r2 = .166).
Obese patients with HF are more likely to have poorer HRQOL, physical health, emotional well-being and depressive symptoms. Poorer HRQOL is predictive of worse outcomes in patients with HF; however, given the apparent obesity paradox in HF, further investigation of the impact of obesity in HF is urgently required.
肥胖对多种疾病状态下与健康相关的生活质量（HRQOL）及抑郁的影响已有充分记录，但其对心力衰竭（HF）患者的影响仍存在争议。因此，我们研究了358例HF患者中肥胖、HRQOL和抑郁之间的关系。
对三组HF患者进行比较分析，以确定体重指数（BMI）是否与HRQOL及抑郁相关，这三组患者分别为体重正常（BMI 18.5 - 24.9 kg/m²，n = 100）、超重（BMI 25 - 29.9 kg/m²，n = 141）和肥胖（BMI≥30 kg/m²，n = 117）。肥胖患者比体重正常和超重的参与者年轻；所有其他人口统计学和临床特征相似。肥胖患者的HRQOL和抑郁评分显著更高（更差）。BMI与HRQOL的所有3个量表（总体，r² = 0.160；生理，r² = 0.162；心理，r² = 0.217）以及抑郁（r² = 0.166）均显著相关。
肥胖的HF患者更有可能具有较差的HRQOL、身体健康、情绪健康和抑郁症状。较差的HRQOL预示着HF患者的预后更差；然而，鉴于HF中明显的肥胖悖论，迫切需要进一步研究肥胖对HF的影响。
