The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.
The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.
Qual Life Res. 2018 Nov;27(11):2851-2858. doi: 10.1007/s11136-018-1932-2. Epub 2018 Jul 10.
Few studies focus on the health-related quality of life (HRQoL) of preschool children with overweight or obesity. This is relevant for evaluation of obesity prevention trials using a quality-adjusted life year (QALY) framework. This study examined the association between weight status in the preschool years and HRQoL at age 5 years, using a preference-based instrument.
HRQoL [based on parent proxy version of the Health Utilities Index Mark 3 (HUI3)] and weight status were measured in children born in Australia between 2007 and 2009. Children's health status was scored across eight attributes of the HUI3-vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain, and these were used to calculate a multi-attribute utility score. Ordinary least squares (OLS), Tobit and two-part regressions were used to model the association between weight status and multi-attribute utility.
Of the 368 children for whom weight status and HUI3 data were available, around 40% had overweight/obesity. After adjusting for child's sex, maternal education, marital status and household income, no significant association between weight status in the preschool years and multi-attribute utility scores at 5 years was found.
Alternative approaches for capturing the effects of weight status in the preschool years on preference-based HRQoL outcomes should be tested. The application of the QALY framework to economic evaluations of obesity-related interventions in young children should also consider longitudinal effects over the life-course. Clinical Trial Registration The Healthy Beginnings Trial was registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).
很少有研究关注超重或肥胖学龄前儿童的健康相关生活质量（HRQoL）。这对于使用质量调整生命年（QALY）框架评估肥胖预防试验是相关的。本研究使用偏好加权工具，考察了学龄前体重状况与 5 岁时 HRQoL 的关系。
在澳大利亚出生的 2007 年至 2009 年期间，对儿童的 HRQoL（基于健康效用指数标记 3 版的父母代理版（HUI3））和体重状况进行了测量。儿童的健康状况在 HUI3 的八个属性（视力、听力、言语、行动、灵巧、情绪、认知和疼痛）上进行评分，并用于计算多属性效用评分。使用普通最小二乘法（OLS）、Tobit 和两部分回归来对体重状况与多属性效用之间的关系进行建模。
在有体重状况和 HUI3 数据的 368 名儿童中，约有 40%超重/肥胖。在调整了儿童性别、母亲教育程度、婚姻状况和家庭收入后，学龄前体重状况与 5 岁时的多属性效用评分之间没有显著关联。
应测试替代方法，以捕捉学龄前体重状况对偏好加权 HRQoL 结果的影响。在评估儿童肥胖相关干预措施的经济学效果时，QALY 框架的应用还应考虑整个生命周期的纵向影响。临床试验注册健康开端试验在澳大利亚临床试验注册处（ACTRNO12607000168459）进行了注册。
