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体质指数与健康相关生命质量关联性

泰然健康网
2024-12-02 18:48

摘要:

目的研究湖北省≥18岁居民体质指数（BMI）与健康相关生命质量（HRQOL）的关系。

方法于2013年运用多阶段分层整群随机抽样方法，在湖北省共纳入研究对象27 814人。采用欧洲5维健康量表（EQ-5D）对居民HRQOL进行评价；分析不同BMI分组与HRQOL得分以及EQ-5D各维度之间的关系。

结果不同性别低体重人群EQ-5D和EQ-VAS得分均低于正常体重人群，而超重或肥胖人群EQ-5D和EQ-VAS得分与正常体重人群没有明显差异。相对于正常体重者，不同性别低体重人群在EQ-5D各维度出现问题的风险均增加；超重男性出现“焦虑或抑郁”问题的风险降低（OR = 0.776，95 % CI = 0.626～0.961），超重女性出现“疼痛或不适”的风险升高（OR = 1.150，95 % CI = 1.105～1.303）；不同性别肥胖人群出现“行动能力”和“自我照顾能力”方面问题的风险较大，且肥胖女性更容易出现“焦虑或抑郁”问题（OR = 1.381，95 % CI = 1.028～1.856）。

结论低体重人群HRQOL较差，超重和肥胖人群也存在一定的影响其生命质量的生理和心理问题。

Abstract:

Objective To study the association between body mass index (BMI) and the health-related quality of life (HRQOL) among adult residents in Hubei province.

Methods We conducted a survey among 27 814 ≥ 18 years old residents recruited using stratified multistage cluster sampling across Hubei province in 2013. The Euro-Quality of Life-5 Dimension (EQ-5D) was adopted to assess the HRQOL of the participants. The relationship between categorized BMI and the scores of HRQOL and each dimension of EQ-5D were analyzed.

Results The scores of EQ-5D and EuroQol Visual Analogue Scale (EQ-VAS) were lower in both underweight male and female participants than in the participants with normal weight but there was no statistical difference in the scores between the overweight or obese participants and the normal weight participants. Both the male and female underweight participants had higher risks of health problems than the normal weight participants in the five dimensions of EQ-5D. Overweight male participants had a lower risk of anxiety/depression than the normal weight participants (odds ratio [OR] = 0.776, 95% confidence interval [95% CI]: 0.626 – 0.961); overweight female participants had a higher risk of pain/discomfort than the normal weight female participants (OR = 1.150, 95% CI: 1.105 – 1.303); obese male and female participants had greater risks of mobility and self-care than normal weight participants and obese female participants were more likely to suffer from anxiety/depression than the normal weight female participants (OR = 1.381, 95% CI: 1.028 – 1.856).

Conclusion The HRQOL of underweight residents is relatively poor and the HRQOL is influenced by some physical or psychological problems among overweight or obese residents in Hubei province.

表 1 不同BMI分组人群HRQOL得分

BMI分组男性女性 EQ-5D EQ-VAS EQ-5D EQ-VAS 低体重 0.910 ± 0.192 c 75.32 ± 16.68 c 0.931 ± 0.168 c 77.04 ± 16.70 c 正常 0.964 ± 0.113 81.84 ± 13.24 0.963 ± 0.112 80.91 ± 13.49 超重 0.968 ± 0.110 82.00 ± 13.26 0.950 ± 0.121 c 78.52 ± 14.22 c 肥胖 0.953 ± 0.129 a 80.28 ± 15.26 0.934 ± 0.140 c 76.92 ± 14.88 c　　注：正常体重组分别与低体重组、超重组和肥胖组比较；Kruskal-Wallis检验：a P < 0.05，c P < 0.001。

表 2 不同BMI分组人群EQ-5D各维度出现问题状况（%）

维度男性女性低体重正常超重肥胖低体重正常超重肥胖 MO 13.98 bcd 4.95 a 3.91 ad 7.29 ac 9.75 bc 4.52 acd 6.24 abd 10.57 bc SC 9.07 bcd 2.88 a 2.51 a 4.38 a 6.87 bc 2.84 ad 3.25 ad 6.23 bc UA 12.04 bcd 4.72 a 3.73 a 4.58 a 9.75 bc 4.23 acd 5.55 ab 7.92 b PD 22.69 bcd 11.08 a 10.11 a 13.96 a 19.73 b 12.99 acd 17.99 b 20.19 b AD 12.31 bcd 5.60 ac 4.15 ab 5.42 a 11.04 bc 6.16 acd 7.61 abd 11.32 bc　　注：a与低体重组比较，P < 0.05；b与正常体重组比较，P < 0.05；c与超重组比较，P < 0.05；d与肥胖组比较P < 0.05。

表 3 BMI与HRQOL关系的多元线性回归模型分析

特征低体重vs正常超重vs正常肥胖vs正常 β 95 % CI β 95 % CI β 95 % CI 男性　EQ-5D – 0.030 – 0.037～0.023 a 0.002 – 0.003～0.007 – 0.009 – 0.020～0.001 　EQ-VAS – 3.314 – 4.061～2.566 a 0.258 – 0.241～0.757 – 0.888 – 1.967～0.191 女性　EQ-5D – 0.023 – 0.029～0.017 a 0.000 – 0.005～0.004 – 0.008 – 0.018～0.002 　EQ-VAS – 2.699 – 3.290～– 2.049 a – 0.100 – 0.611～0.412 – 0.355 – 1.405～0.696　　注：a P < 0.001；模型中BMI分组以正常体重组为参照。

表 4 BMI与EQ-5D各维度关系的logistic回归模型分析

特征低体重vs正常超重vs正常肥胖vs正常 OR值 95 % CI OR值 95 % CI OR值 95 % CI 男性　MO 1.784 1.426～2.231 c 0.931 0.740～1.172 1.764 1.183～2.630 b 　SC 1.914 1.456～2.515 c 1.055 0.792～1.406 1.701 1.030～2.808 a 　UA 1.573 1.238～2.000 c 0.900 0.709～1.142 0.980 0.603～1.590 　PD 1.565 1.313～1.866 c 0.945 0.813～1.098 1.303 0.976～1.741 　AD 1.511 1.213～1.882 c 0.776 0.626～0.961 a 0.947 0.619～1.449 女性　MO 1.506 1.214～1.867 c 1.185 0.970～1.448 1.788 1.285～2.488 c 　SC 1.602 1.245～2.061 c 0.948 0.729～1.231 1.599 1.062～2.406 a 　UA 1.706 1.376～2.116 c 1.094 0.888～1.348 1.336 0.930～1.920 　PD 1.403 1.206～1.632 c 1.150 1.015～1.303 a 1.084 0.851～1.380 　AD 1.611 1.339～1.939 c 1.010 0.851～1.198 1.381 1.028～1.856 a　　注：a P < 0.05，b P < 0.01，c P < 0.001；模型中BMI分组以正常体重组为参照。 [1]

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