体重指数与健康相关生活质量之间的纵向关联。
Longitudinal association between body mass index and health-related quality of life.
作者信息
Müller-Nordhorn Jacqueline, Muckelbauer Rebecca, Englert Heike, Grittner Ulrike, Berger Hendrike, Sonntag Frank, Völler Heinz, Prugger Christof, Wegscheider Karl, Katus Hugo A, Willich Stefan N
机构信息
Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Berlin School of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
出版信息
PLoS One. 2014 Mar 26;9(3):e93071. doi: 10.1371/journal.pone.0093071. eCollection 2014.
OBJECTIVE
Health-related quality of life (HRQoL) is an important outcome in individuals with a high risk for cardiovascular diseases. We investigated the association of HRQoL and body mass index (BMI) as an indicator for obesity.
DESIGN
Secondary longitudinal analysis of the ORBITAL study, an intervention study which included high-risk cardiovascular primary care patients with hypercholesterolemia and an indication for statin therapy.
METHODS
HRQoL was determined with the generic Short Form (SF)-12 health status instrument. Body weight and height were assessed at baseline and at months 6, 12, 18, 24, 30, and 36. We used a linear and a linear mixed-effects regression model to investigate the association between BMI and SF-12 summary scores at baseline as well as between change in BMI and SF-12 summary scores over 3 years. We adjusted for age, sex, smoking status, and in the longitudinal analysis also for the study arm and its interaction term with time.
RESULTS
Of the 7640 participants who completed the baseline questionnaire, 6726 participants (mean age: 61 years) were analyzed. The baseline BMI was inversely associated with physical and mental SF-12 summary scores (β [95% CI] per 1 kg/m2: -0.36 [-0.41; -0.30] and -0.05 [-0.11; -0.00], respectively). A significant association between the change in BMI and physical SF-12 summary scores over time was only present in women (-0.18 [-0.27; -0.09]) and only in obese participants (-0.19 [-0.29; -0.10]). A change in BMI was directly associated with mental SF-12 summary scores (0.12 [0.06; 0.19]) in the total population.
CONCLUSION
Increases in BMI were associated with decreases in physical HRQoL, particularly in obese individuals and in women. In contrast, the mental HRQoL seemed to increase with increasing BMI over time. Thus, body weight management with respect to the HRQoL should be evaluated differentially by sex and body weight status.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00379249.
目的
健康相关生活质量（HRQoL）是心血管疾病高危个体的一项重要预后指标。我们研究了HRQoL与作为肥胖指标的体重指数（BMI）之间的关联。
设计
对ORBITAL研究进行二次纵向分析，该研究为一项干预性研究，纳入了患有高胆固醇血症且有他汀类药物治疗指征的心血管疾病高危初级护理患者。
方法
采用通用的简短健康调查问卷（SF）-12健康状况量表来测定HRQoL。在基线以及第6、12、18、24、30和36个月时评估体重和身高。我们使用线性和线性混合效应回归模型来研究基线时BMI与SF-12汇总评分之间的关联，以及3年内BMI变化与SF-12汇总评分之间的关联。我们对年龄、性别、吸烟状况进行了校正，在纵向分析中还对研究组及其与时间的交互项进行了校正。
结果
在完成基线调查问卷的7640名参与者中，对6726名参与者（平均年龄：61岁）进行了分析。基线BMI与身体和心理SF-12汇总评分呈负相关（每1kg/m²的β[95%CI]分别为：-0.36[-0.41；-0.30]和-0.05[-0.11；-0.00]）。BMI变化与身体SF-12汇总评分随时间的显著关联仅在女性中存在（-0.18[-0.27；-0.09]），且仅在肥胖参与者中存在（-0.19[-0.29；-0.10]）。BMI变化与总体人群的心理SF-12汇总评分呈正相关（0.12[0.06；0.19]）。
结论
BMI增加与身体HRQoL下降相关，尤其是在肥胖个体和女性中。相比之下，随着时间推移，心理HRQoL似乎随BMI增加而升高。因此，应根据性别和体重状况对HRQoL方面的体重管理进行差异化评估。
试验注册
ClinicalTrials.gov NCT00379249。
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