Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Int J Obes (Lond). 2011 Aug;35(8):1087-94. doi: 10.1038/ijo.2010.230. Epub 2010 Nov 2.
Metabolic syndrome has been associated with impaired health-related quality of life (HRQoL) in several studies. Many studies used only one HRQoL measure and failed to adjust for important confounding variables, including obesity, depression and comorbid conditions.
To investigate the relationship between metabolic syndrome and HRQoL using multiple measures. We also sought to determine whether increasing body mass index or diabetes status further modified this relationship.
This cross-sectional study included 390 obese participants with elevated waist circumference and at least one other criterion for metabolic syndrome. Of these 390 participants, 269 had metabolic syndrome (that is, they met 3 out of the 5 criteria specified by the NCEP (National Cholesterol Education Program)) and 121 did not. Participants were enrolled in a primary care-based weight-reduction trial. HRQoL was assessed using two generic instruments, the Medical Outcomes Study Short-Form 12 and the EuroQol-5D, as well as an obesity-specific measure, the Impact of Weight on Quality of Life. Differences in HRQoL were compared among participants with and without metabolic syndrome. Multivariable linear regression was used to determine how HRQoL varied according to metabolic syndrome status, and whether factors including weight, depression and burden of comorbid disease modified this relationship.
Metabolic syndrome was not associated with HRQoL as assessed by any of the measures. In univariable analysis, depression, disease burden and employment status were significantly associated with worse HRQoL on all instruments. In multivariable models, only depression remained significantly associated with reduced HRQoL on all measures. Increasing obesity and diabetes status did not modify the relationship between metabolic syndrome and HRQoL.
In contrast to previous studies, metabolic syndrome was not associated with impaired HRQoL as assessed by multiple measures. This suggests that metabolic syndrome in itself is not associated with decreased HRQoL, but other factors such as obesity, depression and greater disease burden may significantly influence the quality of life in this population.
多项研究表明，代谢综合征与健康相关生活质量（HRQoL）受损有关。许多研究仅使用一种 HRQoL 测量方法，并且未能调整重要的混杂变量，包括肥胖、抑郁和合并症。
使用多种测量方法研究代谢综合征与 HRQoL 的关系。我们还试图确定体重指数增加或糖尿病状态是否进一步改变了这种关系。
这项横断面研究纳入了 390 名腰围升高且至少符合代谢综合征其他一项标准的肥胖参与者。在这 390 名参与者中，269 名患有代谢综合征（即符合 NCEP（国家胆固醇教育计划）规定的 5 项标准中的 3 项），121 名没有。参与者参加了一项基于初级保健的减肥试验。使用两种通用工具（医疗结果研究短式健康调查 12 项和欧洲五维健康量表）以及一种肥胖特异性测量工具（体重对生活质量的影响）评估 HRQoL。比较代谢综合征患者和非代谢综合征患者的 HRQoL 差异。多变量线性回归用于确定 HRQoL 根据代谢综合征状态的变化情况，以及包括体重、抑郁和合并症负担在内的因素是否改变了这种关系。
代谢综合征与任何测量方法评估的 HRQoL 均无关。在单变量分析中，抑郁、疾病负担和就业状况与所有工具的 HRQoL 显著相关。在多变量模型中，只有抑郁与所有测量方法的 HRQoL 显著相关。肥胖和糖尿病状态的增加并未改变代谢综合征与 HRQoL 之间的关系。
与以往的研究相比，代谢综合征与多种测量方法评估的 HRQoL 受损无关。这表明代谢综合征本身与 HRQoL 降低无关，但肥胖、抑郁和更大的疾病负担等其他因素可能会显著影响该人群的生活质量。
