Indriyati Titi, Adisasmita Asri C, Nadjib Mardiati, Subekti Imam, Hatma Ratna Djuwita, Kosen Soewarta, Riyadina Woro, Purnamasari Telly
Faculty of Health, Universitas Mohammad Husni Thamrin Jakarta, Indonesia.
Faculty of Public Health, Universitas Indonesia, Indonesia.
Belitung Nurs J. 2025 Apr 19;11(2):172-185. doi: 10.33546/bnj.3543. eCollection 2025.
Metabolic syndrome (MetS) is a cluster of chronic conditions, including central obesity, hypertension, impaired glucose metabolism, and dyslipidemia (low HDL, high LDL, and triglycerides). A diagnosis of MetS is made when three or more of these symptoms are present. If left unmanaged, MetS can lead to serious health complications such as cardiovascular disease and type 2 diabetes. Over time, individuals with MetS may experience a decline in their health-related quality of life (HRQoL), especially due to its chronic nature.
This study aimed to evaluate the effects of changes in MetS status on HRQoL.
This study employed a cross-sectional design. Secondary data from the cohort study of Non-Communicable Disease (NCD) risk factors, conducted by the Health Research and Development Agency of the Ministry of Health of the Republic of Indonesia in Bogor City, was used. Data from four follow-up periods (2011/2012 to 2017/2018) were analyzed. A total of 874 respondents were selected via total sampling based on inclusion and exclusion criteria. Data were collected in 2021, which included measures of knowledge, health check-ups, and HRQoL using the SF-36 questionnaire. Statistical analyses, including chi-square tests, t-tests, and multiple regression analyses, were conducted to examine the associations between MetS status and HRQoL.
Descriptive analysis revealed that 19% (171 participants) had worsened MetS status, while 80.4% (703 participants) showed improvement. Chi-Square analysis found that respondents with worsening MetS status were 1.6 times more likely to experience poor HRQoL in the physical dimension (95% CI = 1.1-2.3), but no significant effect was found for the mental dimension (PR = 1.1, 95% CI = 0.8-1.6). Multiple logistic regression analysis revealed that comorbidities interacted with worsening MetS status to significantly affect HRQoL in the physical dimension. The adjusted prevalence ratios (PR) were 27.5 (95% CI = 10.3-73.2) for those with comorbidities and 9.2 (95% CI = 5.7-15.0) for those without comorbidities, after controlling for age, mental health, BMI changes, routine health checks, and knowledge.
Changes in MetS status towards worsening have a significant negative effect on HRQoL, particularly in the physical dimension. The presence of comorbidities in individuals with worsening MetS status greatly increases the risk of poor HRQoL. Healthcare professionals and nurses should consider the interaction between MetS and comorbidities in patient management. Nurses are encouraged to monitor HRQoL in patients with MetS, promote education on managing comorbidities, and collaborate across disciplines to enhance patient care and intervention programs aimed at improving HRQoL.
代谢综合征（MetS）是一组慢性病症，包括中心性肥胖、高血压、糖代谢受损和血脂异常（低高密度脂蛋白、高低密度脂蛋白和甘油三酯）。当出现三种或更多这些症状时，即可诊断为代谢综合征。如果不加以控制，代谢综合征可能导致严重的健康并发症，如心血管疾病和2型糖尿病。随着时间的推移，代谢综合征患者的健康相关生活质量（HRQoL）可能会下降，尤其是由于其慢性性质。
本研究旨在评估代谢综合征状态变化对健康相关生活质量的影响。
本研究采用横断面设计。使用了印度尼西亚共和国卫生部卫生研究与发展局在茂物市进行的非传染性疾病（NCD）危险因素队列研究的二手数据。分析了四个随访期（2011/2012至2017/2018）的数据。根据纳入和排除标准，通过全样本抽样共选取了874名受访者。数据于2021年收集，包括知识测量、健康检查以及使用SF - 36问卷进行的健康相关生活质量测量。进行了统计分析，包括卡方检验、t检验和多元回归分析，以检验代谢综合征状态与健康相关生活质量之间的关联。
描述性分析显示，19%（171名参与者）的代谢综合征状态恶化，而80.4%（703名参与者）有所改善。卡方分析发现，代谢综合征状态恶化的受访者在身体维度上健康相关生活质量较差的可能性高1.6倍（95%置信区间 = 1.1 - 2.3），但在心理维度上未发现显著影响（PR = 1.1，95%置信区间 = 0.8 - 1.6）。多元逻辑回归分析显示，合并症与代谢综合征状态恶化相互作用，显著影响身体维度的健康相关生活质量。在控制年龄、心理健康、体重指数变化、常规健康检查和知识后，有合并症者的调整患病率比（PR）为27.5（95%置信区间 = 10.3 - 73.2），无合并症者为9.2（95%置信区间 = 5.7 - 15.0）。
代谢综合征状态向恶化方向的变化对健康相关生活质量有显著负面影响，尤其是在身体维度。代谢综合征状态恶化的个体中合并症的存在大大增加了健康相关生活质量差的风险。医疗保健专业人员和护士在患者管理中应考虑代谢综合征与合并症之间的相互作用。鼓励护士监测代谢综合征患者的健康相关生活质量，促进合并症管理的教育，并跨学科合作以加强患者护理和旨在改善健康相关生活质量的干预项目。
