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[中国中老年人群体重指数与健康相关生活质量的关系研究]

[Study on the relationship between body mass index and health-related quality of life in middle-aged or older Chinese adults].

作者信息

Zhu Yan-Bo, Luo Xiao-Xia, Wang Qi

机构信息

School of Administration, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Jul;30(7):687-91.

Abstract

OBJECTIVE

To study the association between body mass index (BMI) and the health-related quality of life (HRQOL) in the middle-aged and older Chinese people.

METHODS

Data of 9539 middle-aged and older adults was collected from a cross-sectional survey performed in 9 provinces of China (Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and Henan province). MOS SF-36 was used to measure HRQOL. BMI classification was in accordance with the criteria recommended by the Ministry of Health of China. Rank sum test was used to compare HRQOL between subjects with normal weight and those with different BMI classification. Multiple logistic regression analysis was used to assess the association of HRQOL with BMI after adjusted for sex, age, marital, education, physical activity status and chronic diseases.

RESULTS

When compared with middle-aged and older adults at normal weight range (18.5< or =BMI<24), data on physical domain (P<0.001), mental domain (P< 0.01) and 8 dimensions of HRQOL (physical functioning, mental health, P<0.05; role-physical, bodily pain, general health, vitality, social functioning, role-emotional, P<0.01) among subjects with underweight (BMI<18.5) were significantly lower while mental component summary (P<0.05) of overweight subjects (24< or =BMI<28) was significantly higher. Obese subjects (BMI> or =28) had worse physical function (physical functioning, P<0.01) but better mental health (mental health, P<0.01; mental component summary, P<0.05). After adjusting for other factors, and compared to middle aged and older adults with normal weight, data on odds ratios (ORs) of impaired HRQOL in physical domain (OR=1.67, 95% CI: 1.35-2.06), mental domain (OR=1.39, 95% CI: 1.13-1.70) and 8 dimensions increased among underweight subjects while ORs of impaired HRQOL in mental domain (OR=0.86, 95% CI: 0.78-0.95) and role-physical, vitality, social functioning, role-emotional and mental health dimensions decreased among overweight subjects. ORs increased (OR= 1.51, 95% CI: 1.27-1.80) in impaired HRQOL in physical functioning dimension but decreased in mental domain (OR=0.71, 95% CI: 0.60-0.85) as well as vitality, role-emotional and mental health dimensions among obese subjects.

CONCLUSION

HRQOL of each domain were different among middle aged and older adults with different BMI classification. Underweight people had poor HRQOL in both physical domain and psychological domain, and obese people had poor physical function but good mental health condition.

摘要

目的

研究中国中老年人身体质量指数(BMI)与健康相关生活质量(HRQOL)之间的关联。

方法

从在中国9个省份(江苏、安徽、甘肃、青海、福建、北京、吉林、江西和河南省)进行的一项横断面调查中收集了9539名中老年人的数据。采用MOS SF-36量表测量HRQOL。BMI分类按照中国卫生部推荐的标准进行。采用秩和检验比较体重正常者与不同BMI分类者的HRQOL。在对性别、年龄、婚姻状况、教育程度、身体活动状况和慢性病进行校正后,采用多因素logistic回归分析评估HRQOL与BMI的关联。

结果

与体重正常范围(18.5≤BMI<24)的中老年人相比,体重过低(BMI<18.5)者在身体领域(P<0.001)、心理领域(P<0.01)以及HRQOL的8个维度(生理功能、心理健康,P<0.05;生理角色、身体疼痛、总体健康、活力、社会功能、情感角色,P<0.01)的数据显著更低,而超重者(24≤BMI<28)的心理综合得分(P<0.05)显著更高。肥胖者(BMI≥28)的身体功能较差(生理功能,P<0.01),但心理健康状况较好(心理健康,P<0.01;心理综合得分,P<0.05)。在对其他因素进行校正后,与体重正常的中老年人相比,体重过低者在身体领域(OR=1.67,95%CI:1.35-2.06)、心理领域(OR=1.39,95%CI:1.13-1.70)以及8个维度的HRQOL受损的比值比(OR)升高,而超重者在心理领域(OR=0.86,95%CI:0.78-0.95)以及生理角色、活力、社会功能、情感角色和心理健康维度的HRQOL受损的OR降低。肥胖者在生理功能维度的HRQOL受损的OR升高(OR=1.51,95%CI:1.27-1.80),但在心理领域(OR=0.71,95%CI:0.60-0.85)以及活力、情感角色和心理健康维度的OR降低。

结论

不同BMI分类的中老年人各领域的HRQOL存在差异。体重过低者在身体和心理领域的HRQOL较差,肥胖者身体功能较差但心理健康状况良好。

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