Department of Pharmacy, National University of Singapore, Singapore.
Int J Obes (Lond). 2010 Jun;34(6):1034-43. doi: 10.1038/ijo.2010.24. Epub 2010 Feb 9.
To investigate the association between body mass index (BMI) and physical and mental health-related quality of life (HRQoL) in a multiethnic Asian population in Singapore, and explore whether there were gender and ethnic differences in this association.
We conducted cross-sectional analyses using data from 5027 Chinese, Malay and Indian participants (2403 men and 2624 women) aged 24-95 years. These subjects were from four previous cross-sectional surveys carried out in Singapore (from 1982 to 1998) who attended a follow-up examination (including both a questionnaire and a clinic examination) between 2004 and 2007, during which HRQoL was assessed. Participants were classified as underweight (<18.5 kg m(-2)), normal weight (18.5 to <23 kg m(-2)), overweight (23 to <25 kg m(-2)), moderate obese (25 to <30 kg m(-2)) and severe obese (>or=30 kg m(-2)). HRQoL was measured using the Short-Form 36-item questionnaire (SF-36) physical component summary score (PCS) and mental component summary score (MCS). Linear regressions with and without adjusting for other covariates were used to evaluate the association between BMI and SF-36 PCS and MCS.
Compared with participants with normal weight, moderate or severe obesity was associated with 0.8 points (95% confidence interval (CI): -1.5 to -0.1, P=0.03) and 2.1 points lower PCS (95% CI: -3.1 to -0.1, P<0.001), respectively, after adjustment for sociodemographic variables, family functioning measure scores and the presence of chronic diseases. These associations were greater in women than in men. In contrast, being underweight was associated with 1.3 points lower MCS (95% CI: -2.3 to -0.3, P=0.014).
In this study (one of few studies in the Asia-Pacific region), obesity was associated with lower PCS and the effect was modified by gender but not ethnicity, such that the association was greater in women than in men. However, obesity was not associated with MCS. Underweight was associated with reduced MCS but not PCS.
在新加坡的一个多民族亚洲人群中，研究体重指数（BMI）与身心健康相关生活质量（HRQoL）之间的关系，并探讨这种关联是否存在性别和种族差异。
我们使用来自新加坡四项之前的横断面调查（1982 年至 1998 年）的 5027 名中国、马来和印度参与者（2403 名男性和 2624 名女性）的数据进行了横断面分析。这些参与者在 2004 年至 2007 年间参加了随访检查（包括问卷调查和临床检查），在此期间评估了 HRQoL。参与者被分为体重不足（<18.5 kg/m²）、正常体重（18.5 至<23 kg/m²）、超重（23 至<25 kg/m²）、中度肥胖（25 至<30 kg/m²）和重度肥胖（≥30 kg/m²）。使用 36 项简短健康调查问卷（SF-36）的身体成分综合评分（PCS）和心理成分综合评分（MCS）来衡量 HRQoL。使用线性回归，无论是否调整其他协变量，评估 BMI 与 SF-36 PCS 和 MCS 之间的关系。
与正常体重的参与者相比，中度或重度肥胖与 PCS 分别低 0.8 分（95%置信区间[CI]：-1.5 至 -0.1，P=0.03）和 2.1 分（95% CI：-3.1 至 -0.1，P<0.001），调整社会人口统计学变量、家庭功能测量评分和慢性病存在后。这些关联在女性中比男性更明显。相比之下，体重不足与 MCS 低 1.3 分相关（95% CI：-2.3 至 -0.3，P=0.014）。
在这项研究（亚太地区为数不多的研究之一）中，肥胖与较低的 PCS 相关，这种关联受到性别而非种族的影响，因此女性比男性更为明显。然而，肥胖与 MCS 无关。体重不足与 MCS 降低有关，但与 PCS 无关。
