Keramat Syed Afroz, Alam Khorshed, Keating Byron, Ahinkorah Bright Opoku, Gyan Aboagye Richard, Seidu Abdul-Aziz, Samad Nandeeta, Saha Monidipa, Gow Jeff, Biddle Stuart J H, Comans Tracy
Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
School of Business, University of Southern Queensland, Australia.
Prev Med Rep. 2022 May 12;28:101823. doi: 10.1016/j.pmedr.2022.101823. eCollection 2022 Aug.
This study aims to investigate the impact of morbid obesity and multiple long-term conditions (MLTCs) on health-related quality of life (HRQoL). Data for this study were sourced from three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The paper analyses 37,887 person-year observations from 19,387 individuals during the period 2009-2017. The longitudinal random-effects Tobit model was fitted to examine the association between morbid obesity, MLTCs and HRQoL. This study found that morbid obesity and MLTCs were both negatively associated with HRQoL as measured through physical component summary (PCS), mental component summary (MCS), and the short-form six-dimension utility index (SF-6D) of the 36-item Short-Form Health Survey (SF-36). Morbidly obese scored lower points on the PCS (β = -5.05, 95% CI: -5.73, -4.37), MCS (β = -1.03, 95% CI: -1.84, -0.23), and in the SF-6D utility index (β = -0.045, 95% CI: -0.054, -0.036) compared to their healthy weight counterparts. Similar findings were observed for individuals with MLTCs, with lower scores for the PCS (β = -4.79, 95% CI: -5.20, -4.38), MCS (β = -4.95, 95% CI: -5.43, -4.48), and SF-6D utility (β = -0.071, 95% CI: -0.076, -0.066). Additionally, multiplicative interaction between morbid obesity and MLTCs was observed to modestly exacerbated the negative effect of morbid obesity on PCS scores (β = -1.69, 95% CI: -2.74, -0.64). The interaction effect, on the other hand, significantly lessen the unfavourable effect of morbid obesity on the MCS score (β = 1.34, 95% CI: 0.10, 2.58). The findings of this study will be useful for future cost-effectiveness analyses and measuring the burden of diseases since it provides information on the disutility associated with morbid obesity and MLTCs.
本研究旨在调查病态肥胖和多种长期疾病（MLTCs）对健康相关生活质量（HRQoL）的影响。本研究的数据来自澳大利亚家庭、收入和劳动力动态调查（HILDA）的三个波次（第9波、第13波和第17波）。本文分析了2009年至2017年期间19387名个体的37887人年观察数据。采用纵向随机效应 Tobit 模型来检验病态肥胖、MLTCs与HRQoL之间的关联。本研究发现，通过36项简短健康调查（SF-36）的身体成分汇总（PCS）、心理成分汇总（MCS）和简短六维度效用指数（SF-6D）来衡量，病态肥胖和MLTCs均与HRQoL呈负相关。与健康体重的同龄人相比，病态肥胖者在PCS（β = -5.05，95%置信区间：-5.73，-4.37）、MCS（β = -1.03，95%置信区间：-1.84，-0.23）以及SF-6D效用指数（β = -0.045，95%置信区间：-0.054，-0.036）上得分较低。MLTCs患者也有类似的发现，其在PCS（β = -4.79，95%置信区间：-5.20，-4.38）、MCS（β = -4.95，95%置信区间：-5.43，-4.48）和SF-6D效用（β = -0.071，95%置信区间：-0.076，-0.066）上得分较低。此外，观察到病态肥胖与MLTCs之间的相乘交互作用适度加剧了病态肥胖对PCS得分的负面影响（β = -1.69，95%置信区间：-2.74，-0.64）。另一方面，交互作用显著减轻了病态肥胖对MCS得分的不利影响（β = 1.34，95%置信区间：0.10，2.58）。本研究的结果将有助于未来的成本效益分析和疾病负担测量，因为它提供了与病态肥胖和MLTCs相关的负效用信息。
