Riedel Oliver, Braitmaier M, Dankhoff Mark, Hornschuch Michel, Klein Melanie, Zachariassen Wiebke, Hoyer Jana
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Obes Res Clin Pract. 2023 Jul-Aug;17(4):353-360. doi: 10.1016/j.orcp.2023.08.001. Epub 2023 Aug 15.
Bariatric interventions (BI, including surgical interventions) are effective in patients with massive obesity, i.e., a body mass index (BMI) > 40, and their number has steadily increased during the past decade. Yet, the stability of improvements in quality of life (QoL) in post-interventional patients is understudied and restricted to studies with small samples and short follow-ups.
Patients with BI between 2004 and 2018 were identified in a health claims database and invited to fill in a survey, comprising sociodemographic and lifestyle information and psychometric scales. QoL was assessed with the Bariatric QoL (BQL) scale with lower scores denoting worse QoL. BMI and excess weight loss (EWL) were calculated for the time soon after intervention (EWL-T1) and when filling the survey (EWL-T2).
The majority of n = 2151 patients were female (80.7 %), had a mean age of 54.5 years and a mean BMI of 34.8. The mean EWL-T1 was 79 % (EWL-T2: 64.6 %). The mean BQL score was 47.6 and decreased with BMI (18.5-24.9: 52.6 vs. >40: 38.7), EWL-T2 (>66 %: 51.3 vs. <65 %: 42.1) and years since intervention (3-4: 48.2 vs >8: 45.1, each p < .001). For EWL-T1, the association between higher EWLs and higher BQL scores was stronger in females than in males (p < .005); for EWL at T2, both sexes did not differ in this regard (p = .848). Among normal-weight persons, males scored significantly lower on the BQL than females (44.9 vs. 54.9).
Post-interventional QoL improvements diminish over time and depend on the weight loss, with significant differences between men and women.
减肥干预措施（BI，包括手术干预）对重度肥胖患者（即体重指数（BMI）>40）有效，在过去十年中，接受这类干预的患者数量稳步增加。然而，干预后患者生活质量（QoL）改善的稳定性研究不足，且仅限于小样本和短期随访的研究。
在一个健康保险理赔数据库中识别出2004年至2018年间接受减肥干预的患者，并邀请他们填写一份调查问卷，内容包括社会人口统计学和生活方式信息以及心理测量量表。使用减肥生活质量（BQL）量表评估生活质量，得分越低表明生活质量越差。计算干预后不久（EWL-T1）和填写调查问卷时（EWL-T2）的BMI和超重减轻（EWL）情况。
n = 2151名患者中大多数为女性（80.7%），平均年龄为54.5岁，平均BMI为34.8。平均EWL-T1为79%（EWL-T2：64.6%）。平均BQL得分为47.6，且随BMI（18.5 - 24.9：52.6 vs.>40：38.7）、EWL-T2（>66%：51.3 vs.<65%：42.1）以及干预后的年份（3 - 4：48.2 vs>8：45.1，各p <.001）而降低。对于EWL-T1，女性中较高的EWL与较高的BQL得分之间的关联比男性更强（p <.005）；对于T2时的EWL，在这方面两性无差异（p = 0.848）。在体重正常的人群中，男性的BQL得分显著低于女性（44.9 vs. 54.9）。
干预后生活质量的改善会随着时间推移而减弱，且取决于体重减轻情况，男女之间存在显著差异。
