Loh D A, Moy F M, Zaharan N L, Mohamed Z
Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Child Care Health Dev. 2015 Nov;41(6):1216-26. doi: 10.1111/cch.12252. Epub 2015 Apr 15.
Physical functioning and psychological resilience in adulthood is shaped during adolescence. Self-reported health-related quality of life (HRQoL) assessments during this life phase are important first-hand accounts of their well-being. This study aimed, firstly, to identify differences in HRQoL according to gender, ethnicity, socio-economic status and weight status; and secondly, to examine associations between weight status and HRQoL among an urban sample of multi-ethnic adolescents in Kuala Lumpur, Malaysia.
A cross-sectional study involving 652 adolescents (aged 13 years) was conducted in Kuala Lumpur. Weight and height were measured. Body mass index z-scores were categorized according to the International Obesity Task Force criteria. HRQoL was assessed using the Malay version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Univariate analyses of differences in HRQoL according to gender, ethnicity (Malays, Chinese and Indians), maternal education level and weight status were performed. Complex samples general linear model was used to examine the associations between HRQoL and weight status, adjusted for confounders.
Female adolescents reported significantly lower emotional functioning scores (mean, 95% confidence interval: 59.25, 57.33-61.17). When the three main ethnic groups were studied, Malay adolescents scored significantly lower emotional functioning scores (59.00, 57.13-60.87) compared with their Chinese peers. Adolescents with tertiary-educated mothers reported lower emotional functioning scores (57.45, 53.85-61.06) compared with those with primary-educated mothers. Obese adolescents reported poorer HRQoL scores with significantly impaired physical and social functioning after controlling for confounders.
These findings detected disparities in HRQoL among the adolescents when gender, ethnicity, maternal education level and weight status were considered. Further studies should address these health inequalities by implementing gender-specific and culturally appropriate measures to attain optimal well-being and avoid potential burden of disease.
成年期的身体机能和心理适应能力在青春期就已形成。在这一人生阶段，自我报告的健康相关生活质量（HRQoL）评估是其幸福感的重要第一手资料。本研究旨在，首先，根据性别、种族、社会经济地位和体重状况确定HRQoL的差异；其次，在马来西亚吉隆坡的一个多民族青少年城市样本中，研究体重状况与HRQoL之间的关联。
在吉隆坡进行了一项涉及652名青少年（13岁）的横断面研究。测量了体重和身高。根据国际肥胖特别工作组的标准对体重指数z评分进行分类。使用马来语版的儿童生活质量量表4.0通用核心量表评估HRQoL。对根据性别、种族（马来人、华人、印度人）、母亲教育水平和体重状况划分的HRQoL差异进行单因素分析。使用复杂样本一般线性模型来研究HRQoL与体重状况之间的关联，并对混杂因素进行了调整。
女性青少年报告的情绪功能得分显著较低（均值，95%置信区间：59.25，57.33 - 61.17）。在研究三个主要种族群体时，马来青少年的情绪功能得分（59.00，57.13 - 60.87）显著低于华人同龄人。母亲受过高等教育的青少年报告的情绪功能得分（57.45，53.85 - 61.06）低于母亲受过小学教育的青少年。在控制混杂因素后，肥胖青少年报告的HRQoL得分较差，身体和社会功能显著受损。
当考虑性别、种族、母亲教育水平和体重状况时，这些发现揭示了青少年中HRQoL的差异。进一步的研究应通过实施针对性别和文化适宜的措施来解决这些健康不平等问题，以实现最佳的幸福感并避免潜在的疾病负担。
