健康相关生活质量与可调胃束带术后体重的关系：一种非线性方法。

Association between health-related quality of life and body mass after adjustable gastric banding: a nonlinear approach.

机构信息

Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, WA 98195, USA.

出版信息

Value Health. 2013 Jul-Aug;16(5):823-9. doi: 10.1016/j.jval.2013.05.001. Epub 2013 Jul 9.

DOI:10.1016/j.jval.2013.05.001

PMID:23947976

Abstract

OBJECTIVE

To estimate the relationship between health utilities and body mass index (BMI) among a cohort of obese patients who underwent laparoscopic adjustable gastric banding (LAGB).

METHODS

We used a cross-sectional survey to ascertain demographic, clinical, and health utility data from patients who had undergone LAGB in Washington State from 2004 to 2010. The EuroQol five-dimensional (EQ-5D) questionnaire was used for health utility estimation. We calculated adjusted EQ-5D questionnaire indices across BMI categories by using a two-part model. We also used logistic regression to examine the relationship between BMI and the likelihood of reporting problems on each of the EQ-5D questionnaire dimension.

RESULTS

Data were obtained from 790 subjects. The mean adjusted EQ-5D questionnaire indices for all obese BMI categories were significantly lower than those in the normal weight category. The relationship between BMI and EQ-5D questionnaire indices was nonlinear. Respondents classified as morbidly obese II (BMI > 50 kg/m(2)) had the greatest decrement (-0.15, 95% confidence interval -0.28 to -0.01) in EQ-5D questionnaire indices. The association between EQ-5D questionnaire indices and BMI at the time of the survey was weaker after adjusting for weight loss after LAGB. Respondents with higher BMI were more likely to report having problems in the mobility, usual/activity, pain/discomfort, and anxiety/depression dimensions (trend test, P < 0.05), but not for the self-care dimension (trend test, P = 0.08).

CONCLUSIONS

The EQ-5D questionnaire has a negative and nonlinear relationship with BMI for obese patients who had LAGB. The relationship is confounded by weight loss. Within the EQ-5D questionnaire dimensions, patients are more likely to report having problems in the mobility, usual/activity, pain/discomfort, and anxiety/depression dimensions in higher BMI categories, but not in the self-care dimension.

摘要

目的

评估队列肥胖患者腹腔镜可调节胃束带术（LAGB）后健康效用与体重指数（BMI）之间的关系。

方法

我们采用横断面调查，从 2004 年至 2010 年在华盛顿州接受 LAGB 的患者中确定人口统计学、临床和健康效用数据。使用欧洲五维健康量表（EQ-5D）问卷进行健康效用评估。我们使用两部分模型计算 BMI 分类的调整后 EQ-5D 问卷指数。我们还使用逻辑回归检验 BMI 与 EQ-5D 问卷各维度报告问题的可能性之间的关系。

结果

共获得 790 例患者的数据。所有肥胖 BMI 分类的平均调整后 EQ-5D 问卷指数均显著低于正常体重分类。BMI 与 EQ-5D 问卷指数之间的关系是非线性的。BMI 分类为病态肥胖 II（BMI>50kg/m2）的患者 EQ-5D 问卷指数下降幅度最大（-0.15，95%置信区间-0.28 至-0.01）。调整 LAGB 后体重减轻后，EQ-5D 问卷指数与 BMI 之间的关联减弱。BMI 较高的患者更有可能报告在移动、日常活动、疼痛/不适、焦虑/抑郁维度存在问题（趋势检验，P<0.05），但在自我保健维度不存在问题（趋势检验，P=0.08）。