Flinders Health Economics Group, and.
Pediatrics. 2014 Apr;133(4):e868-74. doi: 10.1542/peds.2013-0622. Epub 2014 Mar 3.
To explore the relationship between weight status (BMI) and health-related quality of life in children and adolescents through application of the Child Health Utility 9D, a new generic preference-based instrument.
Data were collected from primary and high school students in rural and metropolitan regions of South Australia. Consenting participants (2588 in grades 4-6 and 765 in grades 9-10) were weighed and measured and categorized as underweight, healthy weight, overweight, or obese according to International Obesity Taskforce BMI cutoff points (primary outcome). Participants also completed a questionnaire including the Child Health Utility 9D and standardized measures of physical activity, sedentary behavior, sleep patterns, and eating behavior (secondary outcomes). Descriptive and multivariate linear regression analyses were undertaken to calculate mean utility differences.
In comparison with healthy-weight primary school students, adjusted mean utilities were lower for overweight (-0.016, P = .02) or obese (-0.039, P = .001) students. For high school students, the adjusted mean utilities were also lower for overweight and obese students but were nonsignificant (-0.018, P > .10). Physical activity, sedentary behavior, sleep patterns, and eating behavior were all found to be significantly associated with utilities.
Irrespective of BMI, young people engaging in more physical activities or less sedentary behavior, and having healthier sleep patterns or eating behavior exhibited higher utilities. Associations between utilities and sleep patterns or eating behavior were stronger than the associations with BMI. Future economic evaluations for obesity interventions should more formally investigate the relationship between changes over time in weight status and health-related quality of life for children and adolescents.
通过应用新的通用偏好量表儿童健康效用 9D，探索儿童和青少年体重状况（BMI）与健康相关生活质量之间的关系。
数据来自南澳大利亚农村和城市地区的小学和高中学生。同意参与的学生（4-6 年级 2588 人，9-10 年级 765 人）进行称重和测量，并根据国际肥胖工作组 BMI 切点分为体重不足、健康体重、超重或肥胖（主要结局）。参与者还完成了一份问卷，包括儿童健康效用 9D 以及身体活动、久坐行为、睡眠模式和饮食行为的标准化测量（次要结局）。进行描述性和多元线性回归分析以计算平均效用差异。
与健康体重的小学生相比，超重（-0.016，P =.02）或肥胖（-0.039，P =.001）学生的调整后平均效用较低。对于高中生，超重和肥胖学生的调整后平均效用也较低，但无统计学意义（-0.018，P >.10）。身体活动、久坐行为、睡眠模式和饮食行为均与效用显著相关。
无论 BMI 如何，参与更多身体活动或更少久坐行为、拥有更健康睡眠模式或饮食习惯的年轻人表现出更高的效用。效用与睡眠模式或饮食行为之间的关联强于与 BMI 的关联。未来针对肥胖干预的经济评估应更正式地调查儿童和青少年体重状况随时间变化与健康相关生活质量之间的关系。
