Zhao Jingyu, Kuang Zhexiang, Xu Jing, Yu Xiao, Dong Jin, Li Juan, Li Liyun, Liu Yanjie, He Xintong, Xu Chun, Li Xia, Shi Jun
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China.
Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
Qual Life Res. 2023 Apr;32(4):1119-1131. doi: 10.1007/s11136-023-03343-y. Epub 2023 Jan 18.
Health-related quality of life (HRQoL) is a multi-dimensional construct used to assess the impact of health status on quality of life, and it is known to be affected by lifestyle behaviors. This study focused on multiple lifestyle behaviors among patients with hematologic diseases, including physical activity, dietary intake, sleep quality, occupational exposure, alcohol consumption and smoking. The main objective was to investigate the association of both individual and clustering of health behaviors with HRQoL among the population with hematologic diseases based on a comprehensive lifestyle survey.
A total of 539 patients with hematologic diseases aged over 18 years were enrolled in this cross-sectional study. Latent class analysis was used to identify homogeneous, mutually exclusive lifestyle classes, and multinomial logistic regression was then performed to explore the association of lifestyle classes membership with HRQoL. Meanwhile, multiple linear regression and quantile regression were used to identify the relationship between individual lifestyle behaviors and HRQoL.
A three-class model was selected based on conceptual interpretation and model fit. We found no association between multiple lifestyle behaviors and HRQoL in the 3-class model, either in the whole patients or in subgroups stratified by hematological malignancies. Further research on each lifestyle found that physical activity, dietary intake, occupational exposure, alcohol consumption or smoking were independent of HRQoL. Sleep quality was positively associated with HRQoL.
Our findings suggested that clustering of lifestyle behaviors may not be an indicator to reflect the health quality of patients with hematologic diseases. Sleep represents a viable intervention target that can confer health benefits on the hematologic patients.
健康相关生活质量（HRQoL）是一个用于评估健康状况对生活质量影响的多维度概念，且已知其受生活方式行为的影响。本研究聚焦于血液系统疾病患者的多种生活方式行为，包括身体活动、饮食摄入、睡眠质量、职业暴露、饮酒和吸烟。主要目的是基于全面的生活方式调查，研究血液系统疾病患者中个体健康行为及其聚类与HRQoL之间的关联。
本横断面研究共纳入539名年龄超过18岁的血液系统疾病患者。采用潜在类别分析来识别同质且相互排斥的生活方式类别，然后进行多项逻辑回归以探讨生活方式类别归属与HRQoL之间的关联。同时，使用多元线性回归和分位数回归来确定个体生活方式行为与HRQoL之间的关系。
基于概念解释和模型拟合选择了一个三类模型。我们发现在这个三类模型中，无论是在全体患者还是按血液系统恶性肿瘤分层的亚组中，多种生活方式行为与HRQoL之间均无关联。对每种生活方式的进一步研究发现，身体活动、饮食摄入、职业暴露、饮酒或吸烟与HRQoL无关。睡眠质量与HRQoL呈正相关。
我们的研究结果表明，生活方式行为的聚类可能不是反映血液系统疾病患者健康质量的指标。睡眠是一个可行的干预靶点，可为血液系统疾病患者带来健康益处。
