Donini Lorenzo Maria, Rosano Aldo, Di Lazzaro Luca, Lubrano Carla, Carbonelli Mariagrazia, Pinto Alessandro, Giusti Anna Maria, Lenzi Andrea, Siervo Mario
Medical Pathophysiology, Food Science and Endocrinology Section, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy,
Italian National Agency for Regional Healthcare Services (AGENAS), Rome, Italy.
Obes Facts. 2020;13(2):191-200. doi: 10.1159/000506079. Epub 2020 Mar 24.
Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide and creating substantial financial and health burdens. Obesity has a negative impact on health-related quality of life (HRQoL) with reference to physical and mental health status, social relationships, and economic factors. The aim of the present study is to investigate the association of number of comorbidities, psychological status, and disability level with HRQoL in a sample of subjects with obesity.
A total of 273 subjects with obesity (199 women and 74 men) were recruited. Medical history and anthropometric measurements were carried out. The Italian version of the Laval questionnaire, the TSD-OC (SIO test for obesity-related disabilities), and SCL-90 (Symptom Checklist-90) tests were administered. The association between HRQoL (global and different domains scores of the Laval questionnaire - dependent variable) and age, body mass index (BMI), comorbidity, TSD-OC, and SCL-90 was analysed using a stepwise linear regression model.
BMI, disability (TSD-OC global score), and psychological symptoms (SCL-90 global severity index) were found to be the main determinants of HRQoL. Single domains of HRQoL (symptoms, activity/mobility, personal hygiene/clothing, emotions, social interaction, and sexual life) showed different patterns of associations with each domain of the Laval questionnaire. BMI, pain, and social life disruptions were found to be significantly associated with most of the HRQoL domains while age, comorbidities, psychological problems (depression, interpersonal symptoms, somatization), and disability were associated with only some domains of the Laval questionnaire. Education, psychological symptoms (obsessive-compulsive, anxiety, hostility, phobic anxiety, paranoid ideation), and disability domains (stiffness, housework, outdoor activities, occupational activities) were not associated with any of the dimensions of the Laval questionnaire.
DISCUSSION/CONCLUSION: The present study identified key determinants of QoL in subjects with obesity, which could help in refining the multidimensional diagnostic assessment of obesity as well as designing more effective interventions to improve HRQoL in these patients.
肥胖是一个迅速发展的公共卫生问题,影响着全球越来越多的国家,并造成巨大的经济和健康负担。肥胖对与健康相关的生活质量(HRQoL)在身体和心理健康状况、社会关系以及经济因素方面产生负面影响。本研究的目的是在一组肥胖受试者样本中,调查合并症数量、心理状态和残疾水平与HRQoL之间的关联。
共招募了273名肥胖受试者(199名女性和74名男性)。进行了病史采集和人体测量。使用了意大利版的拉瓦尔问卷、TSD - OC(肥胖相关残疾的SIO测试)和SCL - 90(症状自评量表90项)测试。使用逐步线性回归模型分析HRQoL(拉瓦尔问卷的总体得分和不同领域得分 - 因变量)与年龄、体重指数(BMI)、合并症、TSD - OC和SCL - 90之间的关联。
发现BMI、残疾(TSD - OC总体得分)和心理症状(SCL - 90总体严重程度指数)是HRQoL的主要决定因素。HRQoL的各个单一领域(症状、活动/ mobility、个人卫生/服装、情绪、社会交往和性生活)与拉瓦尔问卷的各个领域呈现出不同的关联模式。发现BMI、疼痛和社会生活干扰与大多数HRQoL领域显著相关,而年龄、合并症、心理问题(抑郁、人际症状、躯体化)和残疾仅与拉瓦尔问卷的某些领域相关。教育程度、心理症状(强迫、焦虑、敌对、恐惧焦虑、偏执观念)和残疾领域(僵硬、家务、户外活动、职业活动)与拉瓦尔问卷的任何维度均无关联。
讨论/结论:本研究确定了肥胖受试者生活质量的关键决定因素,这有助于完善肥胖的多维诊断评估,并设计更有效的干预措施以改善这些患者的HRQoL。