Banegas José R, López-García Esther, Graciani Auxiliadora, Guallar-Castillón Pilar, Gutierrez-Fisac Juan L, Alonso Jordi, Rodríguez-Artalejo Fernando
Department of Preventive Medicine and Public Health, Universidad Autónomous Universidad of Madrid, Barcelona, Spain.
Eur J Cardiovasc Prev Rehabil. 2007 Jun;14(3):456-62. doi: 10.1097/HJR.0b013e3280803f29.
The purpose of this study was to study the cumulative effects of cardiovascular risk factors on all the health-related quality of life dimensions among the elderly in this era of epidemic obesity and diabetes.
The population-based study covered 3567 participants, representative of the Spanish non-institutionalized population aged 60 years and above. Data were gathered from home-based interviews and from the measurements of blood pressure and other anthropometric variables. Multiple linear regression was used to examine the relationships between health-related quality of life, on each scale of the SF-36 questionnaire, and obesity (waist circumference >102 cm in men and >88 cm in women), hypertension (blood pressure >/=140/90 mmHg), and known diabetes, after adjusting for sociodemographic and lifestyle factors.
Patients with obesity, hypertension, and diabetes, or a combination of these factors were, in general, associated with a worse health-related quality of life, on both the physical and the mental scales, than those without these factors, though statistical significance (P<0.05) was only attained for some relationships. Obesity in women (-2.9 to -6.7 points, according to the scale) and diabetes in men (-6.1 to -16.4 points, according to the scale) were the factors most closely and significantly associated with diminished health-related quality of life. Women who had all three factors showed the maximum decline in health-related quality of life (-10.2 to -17.7 points, according to the scale).
Obesity in old women and diabetes in old men are the most decisive factors adversely affecting the health-related quality of life. The association with worse health-related quality of life is especially marked (greater than additive) in women with all three factors, thereby rendering them a group that calls for special study and attention.
本研究旨在探讨在肥胖和糖尿病流行的时代，心血管危险因素对老年人所有健康相关生活质量维度的累积影响。
这项基于人群的研究涵盖了3567名参与者，他们代表了西班牙60岁及以上的非机构化人群。数据通过家庭访谈以及血压和其他人体测量变量的测量收集。在调整了社会人口统计学和生活方式因素后，使用多元线性回归来检验SF-36问卷各量表上的健康相关生活质量与肥胖（男性腰围>102厘米，女性腰围>88厘米）、高血压（血压≥140/90毫米汞柱）和已知糖尿病之间的关系。
一般来说，患有肥胖、高血压和糖尿病或这些因素组合的患者，在身体和心理量表上的健康相关生活质量都比没有这些因素的患者差，不过只有部分关系达到了统计学显著性（P<0.05）。女性肥胖（根据量表为-2.9至-6.7分）和男性糖尿病（根据量表为-6.1至-16.4分）是与健康相关生活质量下降最密切且显著相关的因素。具有所有三个因素的女性健康相关生活质量下降幅度最大（根据量表为-10.2至-17.7分）。
老年女性肥胖和老年男性糖尿病是对健康相关生活质量产生不利影响的最决定性因素。对于具有所有三个因素的女性，与较差的健康相关生活质量的关联尤为明显（大于相加效应），因此这一群体需要特别研究和关注。
