School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
Qual Life Res. 2022 Nov;31(11):3283-3292. doi: 10.1007/s11136-022-03178-z. Epub 2022 Jul 7.
To estimate the association between changes in BMI and changes in Health-Related Quality of Life (EQ-5D-3L).
The WRAP trial was a multicentre, randomised controlled trial with parallel design and recruited 1267 adults (BMI ≥ 28 kg/m). Participants were allocated to Brief Intervention, a Commercial weight management Programme (WW, formerly Weight Watchers) for 12 weeks, or the same Programme for 52 weeks. Participants were assessed at 0, 3, 12, 24, and 60 months. We analysed the relationship between BMI and EQ-5D-3L, adjusting for age and comorbidities, using a fixed effects model. Test for attrition, model specification and missing data were conducted. Secondary analyses investigated a non-symmetric gradient for weight loss vs. regain.
A unit increase in BMI was associated with a - 0.011 (95% CI - 0.01546, - 0.00877) change in EQ-5D-3L. A unit change in BMI between periods of observation was associated with - 0.016 017 (95% CI - 0.0077009, - 0.025086) change in EQ-5D-3L. The negative association was reduced during weight loss, as opposed to weight gain, but the difference was not statistically significant.
We have identified a strong and statistically significant negative relationship between BMI changes and HRQoL. These estimates could be used in economic evaluations of weight loss interventions to inform policymaking.
This trial was registered with Current Controlled Trials, number ISRCTN82857232.
评估 BMI 变化与健康相关生活质量（EQ-5D-3L）变化之间的关系。
WRAP 试验是一项多中心、随机对照试验，采用平行设计，招募了 1267 名成年人（BMI≥28kg/m²）。参与者被分配到简短干预组、商业体重管理计划（WW，前身为 Weight Watchers）12 周组或相同计划 52 周组。参与者在 0、3、12、24 和 60 个月时进行评估。我们使用固定效应模型，在调整年龄和合并症后，分析 BMI 与 EQ-5D-3L 之间的关系。进行了损耗检验、模型规范和缺失数据分析。次要分析研究了体重减轻与反弹之间的非对称梯度。
BMI 增加一个单位与 EQ-5D-3L 变化-0.011（95%CI-0.01546，-0.00877）相关。在观察期内 BMI 的单位变化与 EQ-5D-3L 变化-0.016017（95%CI-0.0077009，-0.025086）相关。与体重增加相比，体重减轻期间的负相关关系减弱，但差异无统计学意义。
我们已经确定了 BMI 变化与 HRQoL 之间存在强烈且具有统计学意义的负相关关系。这些估计值可用于体重减轻干预措施的经济评估，为决策提供信息。
该试验在 Current Controlled Trials 上注册，编号为 ISRCTN82857232。
