Zanganeh Mandana, Adab Peymané, Li Bai, Pallan Miranda, Liu Wei J, Rong Lin, Liu Wei, Martin James, Cheng Kar K, Frew Emma
Centre for Health Economics, Warwick Medical School, University of Warwick.
Institute of Applied Health Research, University of Birmingham.
J Health Econ Outcomes Res. 2022 Mar 7;9(1):75-81. doi: 10.36469/jheor.2022.32414. eCollection 2022.
Some studies from high-income countries suggest that overweight and/or obesity in children are negatively associated with health-related quality of life (HRQOL). However, the relationship between weight status and HRQOL is not well established in China, where obesity trends follow a different pattern compared with high-income countries. The risk of obesity is greater in children from higher socioeconomic backgrounds and higher in boys compared with girls. The aim of this study was to examine the relationship between weight status and HRQOL in children between 6 and 7 years old in this unique country context. Baseline HRQOL and demographic data were collected from children recruited to the CHIRPY DRAGON obesity prevention trial in China. HRQOL was measured using the Chinese version of the Child Health Utility-9D (CHU-9D-CHN) and the Pediatric Quality of Life Inventory™ (PedsQL™) instruments. CHU-9D-CHN utility scores were generated using 2 scoring algorithms (UK and Chinese tariffs). Height and weight measures were taken at school by trained researchers using standardized methods, and BMI scores were calculated using the World Health Organization 2007 growth charts. The relationship between HRQOL and weight status was examined using multivariable analyses, adjusting for age, gender, and socioeconomic status. Full data were available for 1539 children (mean age, 6 years). In both unadjusted and adjusted analyses, HRQOL, using both the CHU-9D-CHN and the PedsQL™, was marginally higher in children who were overweight or living with obesity compared with children with healthy weight, although this difference did not reach statistical significance. Separate analyses and models by gender showed that the relationship between weight status and HRQOL scores was similar in boys and girls. Our results suggest no statistically significant difference in HRQOL between children with overweight/obesity compared with those with healthy weight. These results have implications for the methods of economic evaluation for obesity treatment and prevention interventions within this population cohort and country setting, as there appears to be no discernible consequences on children's HRQOL from living with overweight and obesity.
一些来自高收入国家的研究表明，儿童超重和/或肥胖与健康相关生活质量（HRQOL）呈负相关。然而，在中国，体重状况与健康相关生活质量之间的关系尚未明确，与高收入国家相比，中国的肥胖趋势呈现出不同的模式。社会经济背景较高家庭的儿童肥胖风险更大，男孩的肥胖风险高于女孩。本研究的目的是在这个独特的国家背景下，探讨6至7岁儿童体重状况与健康相关生活质量之间的关系。从参与中国“ Chirpy Dragon”肥胖预防试验招募的儿童中收集了基线健康相关生活质量和人口统计学数据。使用中文版儿童健康效用9维度量表（CHU-9D-CHN）和儿童生活质量量表（PedsQL™）来测量健康相关生活质量。CHU-9D-CHN效用得分是使用两种评分算法（英国和中国费率）生成的。经过培训的研究人员在学校采用标准化方法测量身高和体重，并使用世界卫生组织2007年生长图表计算体重指数（BMI）得分。使用多变量分析来研究健康相关生活质量与体重状况之间的关系，并对年龄、性别和社会经济地位进行了调整。共有1539名儿童（平均年龄6岁）获得了完整数据。在未调整和调整后的分析中，使用CHU-9D-CHN和PedsQL™测量的健康相关生活质量，超重或肥胖儿童略高于体重正常的儿童，尽管这种差异未达到统计学显著性。按性别进行的单独分析和建模表明，男孩和女孩的体重状况与健康相关生活质量得分之间的关系相似。我们的结果表明，超重/肥胖儿童与体重正常儿童在健康相关生活质量方面没有统计学上的显著差异。这些结果对于该人群队列和国家背景下肥胖治疗和预防干预措施的经济评估方法具有启示意义，因为超重和肥胖似乎对儿童的健康相关生活质量没有明显影响。
