Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstaedter Landstrasse 1, Munich, 85764, Neuherberg, Germany.
Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany.
Health Qual Life Outcomes. 2020 Mar 5;18(1):58. doi: 10.1186/s12955-020-01309-z.
Obesity can significantly reduce health-related quality of life (HRQoL) and may lead to numerous health problems even in youths. This study aimed to investigate whether HRQoL varies among youths with obesity depending on grade of obesity and other factors.
For the Youths with Extreme obesity Study (YES) (2012-2014), a prospective multicenter cohort study, a baseline sample of 431 obese and extremely obese adolescents and young adults (age 14 to 24 years, BMI ≥30 kg/m) was recruited at four German university medical centers and one job center. Obesity grade groups (OGG) were defined according to BMI (OGG I: 30-34.9 kg/m, OGG II: 35-39.9 kg/m, OGG III (extreme obesity): ≥40 kg/m). HRQoL was measured with the Euroqol-5D-3 L (EQ-5D-3 L), DISABKIDS chronic generic (DCGM-31) and the KINDL obesity module. Differences between OGGs were assessed with logistic and linear regression models, adjusting for age, sex, and study center in the base model. In a second regression analysis, we included other characteristics to identify possible determinants of HRQoL.
Three hundred fifty-two adolescents (mean age: 16.6 (±2.4), mean BMI: 39.1 (±7.5) kg/ m) with available HRQoL data were analysed. HRQoL of youths in all OGGs was markedly lower than reference values of non-obese adolescents. Adjusting for age and sex, HRQoL of youths in OGG III significantly impaired compared to OGG I. Youths in OGG III were 2.15 times more likely to report problems with mobility in the EQ-5D-3 L than youths in OGG I. A mean difference of 9.7 and 6.6 points between OGG III and I were found for DCGM-31 and KINDL respectively and 5.1 points between OGG II and I for DCGM-31. Including further variables into the regression models, showed that HRQoL measured by DCGM-31 was significantly different between OGGs. Otherwise, female sex and having more than 4 h of daily screen time were also associated with lower HRQoL measured by DCGM-31 and KINDL.
HRQoL of adolescents with obesity is reduced, but HRQoL of adolescents with extreme obesity is particularly affected. Larger and longitudinal studies are necessary to understand the relation of extreme obesity and HRQoL, and the impact of other lifestyle or socioeconomic factors.
Clinicaltrials.gov NCT01625325; German Clinical Trials Register (DRKS) DRKS00004172.
肥胖会显著降低健康相关生活质量（HRQoL），并可能导致许多健康问题，即使是在年轻人中。本研究旨在调查肥胖青少年的 HRQoL 是否因肥胖程度和其他因素而异。
对于极端肥胖青少年研究（YES）（2012-2014 年），这是一项前瞻性多中心队列研究，在德国的四个大学医学中心和一个就业中心招募了一个基线样本，共 431 名肥胖和极度肥胖的青少年和年轻人（年龄 14 至 24 岁，BMI≥30kg/m）。肥胖等级组（OGG）根据 BMI 定义（OGG I：30-34.9kg/m，OGG II：35-39.9kg/m，OGG III（极度肥胖）：≥40kg/m）。使用欧洲五维健康量表 3 级简表（EQ-5D-3L）、残疾儿童慢性通用量表 31 级（DCGM-31）和 KINDL 肥胖模块测量 HRQoL。使用逻辑回归和线性回归模型评估 OGG 之间的差异，在基础模型中调整年龄、性别和研究中心。在第二个回归分析中，我们纳入了其他特征，以确定 HRQoL 的可能决定因素。
对 352 名有可用 HRQoL 数据的青少年（平均年龄：16.6（±2.4），平均 BMI：39.1（±7.5）kg/m）进行了分析。所有 OGG 青少年的 HRQoL 明显低于非肥胖青少年的参考值。在调整年龄和性别后，OGG III 青少年的 HRQoL 明显比 OGG I 青少年差。与 OGG I 青少年相比，OGG III 青少年在 EQ-5D-3L 中报告移动问题的可能性高 2.15 倍。OGG III 和 I 之间的 DCGM-31 平均差异为 9.7 分，KINDL 为 6.6 分，OGG II 和 I 之间的 DCGM-31 为 5.1 分。将其他变量纳入回归模型后，显示 DCGM-31 测量的 HRQoL 在 OGG 之间存在显著差异。此外，女性和每天屏幕时间超过 4 小时也与 DCGM-31 和 KINDL 测量的 HRQoL 较低相关。
肥胖青少年的 HRQoL 降低，但极度肥胖青少年的 HRQoL 尤其受到影响。需要更大规模和纵向研究来了解极度肥胖与 HRQoL 的关系，以及其他生活方式或社会经济因素的影响。
Clinicaltrials.gov NCT01625325；德国临床试验注册（DRKS）DRKS00004172。
