Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Korea.
Department of Internal Medicine, Gil Hospital, Gachon University, Inchon, Korea.
Qual Life Res. 2019 Apr;28(4):1075-1083. doi: 10.1007/s11136-018-2084-0. Epub 2018 Dec 7.
Obesity is linked to poor health-related quality of life (HRQOL) in the general population, but its role in chronic kidney disease (CKD) is uncertain.
We conducted a cross-sectional study that investigated 1880 participants from the KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD) who underwent complete baseline laboratory tests, health questionnaires, and HRQOL. HRQOL was assessed by physical component summary (PCS) and mental component summary (MCS) of the SF-36 questionnaire. We used multivariable linear regression models to examine the relationship between Body Mass Index (BMI) and sex-specific waist circumference (WC) with HRQOL.
Adults with higher BMI and greater WC showed lower PCS. After adjusting for age, sex, socioeconomic state, comorbidities, and laboratory findings, we found that WC, but not BMI, was associated with PCS. Greater WC quintiles were associated with lower PCS [WC-4th quintile (β, - 2.63, 95% CI - 5.19 to - 0.06) and WC-5th quintile (β, - 3.71, 95% CI - 6.28 to - 1.15)]. The association between WC and PCS was more pronounced in older adults, woman, patients with diabetes, cardiovascular disease, or lower eGFR. The relationship between BMI and WC with MCS was not significant.
In adults with CKD, WC is a better indicator of poor physical HRQOL than BMI. The association between WC and physical HRQOL is modified by age, sex, eGFR, and comorbidities such as diabetes and cardiovascular disease.
肥胖与普通人群健康相关生活质量（HRQOL）较差有关，但在慢性肾脏病（CKD）中的作用尚不确定。
我们进行了一项横断面研究，调查了接受完整基线实验室检查、健康问卷和 HRQOL 的韩国肾病患者结局研究（KNOW-CKD）的 1880 名参与者。HRQOL 通过 SF-36 问卷的身体成分综合评分（PCS）和心理成分综合评分（MCS）进行评估。我们使用多变量线性回归模型来检查体重指数（BMI）和性别特异性腰围（WC）与 HRQOL 之间的关系。
BMI 和 WC 较高的成年人 PCS 较低。在调整年龄、性别、社会经济状况、合并症和实验室发现后，我们发现 WC 而不是 BMI 与 PCS 相关。较大的 WC 五分位数与较低的 PCS 相关[WC-4 分位数（β，-2.63，95%CI-5.19 至-0.06）和 WC-5 分位数（β，-3.71，95%CI-6.28 至-1.15)]。WC 与 PCS 的关系在老年人、女性、患有糖尿病、心血管疾病或 eGFR 较低的患者中更为明显。BMI 和 WC 与 MCS 的关系不显著。
在 CKD 成人中，WC 是比 BMI 更能反映身体 HRQOL 较差的指标。WC 与身体 HRQOL 的关系受年龄、性别、eGFR 以及合并症（如糖尿病和心血管疾病）的影响。
