Cui Wanjun, Zack Matthew M, Wethington Holly
Division of Population Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS F-78, Atlanta, GA, 30341, USA,
Qual Life Res. 2014 Sep;23(7):2139-50. doi: 10.1007/s11136-014-0646-3. Epub 2014 Feb 14.
To examine the magnitude of differences in health-related quality of life (HRQOL) by body mass index (BMI) in a population-based sample of United States adolescents overall and by sex, and to provide national prevalence estimates of reported HRQOL outcomes for not only obese and overweight but also underweight adolescents.
From the 2001 through 2010 cross-sectional National Health and Nutrition Examination Surveys, we estimated the percentages of four HRQOL outcomes-self-rated health, physically unhealthy days, mentally unhealthy days, and activity limitation days-in four BMI categories-obese, overweight, normal weight, and underweight-of approximately 6,000 US adolescents aged 12-17 years. We also estimated the percentages for boys and girls separately.
Substantial gaps in self-rated health exist between normal-weight adolescents and those who are obese and overweight, but not underweight. Eighteen percent (95% CI 15-22) of obese adolescents reported fair or poor health compared to only 5% (95% CI 4-7) of normal-weight adolescents. Thirty-seven percent (95% CI 33-42) of obese adolescents reported excellent or very good health, compared to 65% (94% CI 63-67) of normal-weight adolescents. However, all BMI groups reported similar percentages of physically unhealthy days, mentally unhealthy days, and activity limitation days. The associations between HRQOL and BMI groups did not vary by sex. Boys generally reported significantly better self-rated health and mental health than girls. Specifically, obese boys reported better self-rated health, mental health, and fewer activity limitation days than obese girls.
Substantially, significant differences in some domains of HRQOL are found between above normal-weight and normal-weight US adolescents. This relationship between BMI and HRQOL is robust and observed among both boys and girls.
在一个基于美国青少年人群的样本中，总体上以及按性别考察健康相关生活质量（HRQOL）因体重指数（BMI）不同而产生的差异程度，并提供不仅针对肥胖和超重青少年，还针对体重过轻青少年所报告的HRQOL结果的全国患病率估计。
从2001年至2010年的横断面全国健康与营养检查调查中，我们估计了约6000名12 - 17岁美国青少年在四个BMI类别（肥胖、超重、正常体重和体重过轻）中四项HRQOL结果（自我评定健康状况、身体不健康天数、精神不健康天数和活动受限天数）的百分比。我们还分别估计了男孩和女孩的百分比。
正常体重青少年与肥胖和超重青少年（而非体重过轻青少年）在自我评定健康状况方面存在显著差距。18%（95%置信区间15 - 22）的肥胖青少年报告健康状况一般或较差，而正常体重青少年中这一比例仅为5%（95%置信区间4 - 7）。37%（95%置信区间33 - 42）的肥胖青少年报告健康状况极佳或非常好，而正常体重青少年中这一比例为65%（94%置信区间63 - 67）。然而，所有BMI组在身体不健康天数、精神不健康天数和活动受限天数方面报告的百分比相似。HRQOL与BMI组之间的关联不因性别而异。男孩总体上报告的自我评定健康状况和心理健康状况明显优于女孩。具体而言，肥胖男孩报告的自我评定健康状况、心理健康状况更好，活动受限天数比肥胖女孩更少。
在美国，超重及以上体重青少年与正常体重青少年在HRQOL的某些领域存在显著差异。BMI与HRQOL之间的这种关系很稳固，在男孩和女孩中均有观察到。
