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Luah XW, Holst-Hansen T, Lübker C. The association between body mass index and health-related quality of life in the 2017 and 2018 health survey of England data: A cross-sectional observational analysis. Diabetes Obes Metab 2024; 26:2318-2328. [PMID: 38499493 DOI: 10.1111/dom.15546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/20/2024]
Abstract
AIM To provide an updated estimate of the association between body mass index (BMI) and health-related quality of life (HRQoL) among the general population in England and to identify population subgroups with the highest potential utility gains from obesity interventions. MATERIALS AND METHODS The sample included 12 158 adults with valid HRQoL and BMI data from the 2017 and 2018 Health Survey for England. Robust standard error linear regression, controlling for demographic and socioeconomic characteristics, lifestyle behaviours and obesity-related comorbidities, was used for the baseline analysis. Robustness checks assessed the impact of (a) estimator selection; (b) model specifications; (c) statistical outliers at high BMI; (d) potential BMI measurement error; and (e) data pooling. RESULTS The study found a significant association between HRQoL and BMI, which exhibited an inverted U-shaped relationship. The mean HRQoL peaked at 25.7 kg/m2 in men and 22.6 kg/m2 in women and was reduced in the underweight, overweight and obesity BMI ranges. Sensitivity analyses reported similar coefficients, suggesting a robust model specification. CONCLUSIONS Reduced HRQoL beyond optimal BMI underlines the importance of maintaining a normal BMI range for overall health. The rising prevalence of class III obesity is a major public health concern given its disproportionate impact on health, health care utilization and costs. Obesity management is key to preventing the reduction in HRQoL associated with obesity-related comorbidities, and this analysis supports the development of targeted policies and population health initiatives for people with class III obesity.
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Affiliation(s)
- Xiao Wen Luah
- Department of Economics and Related Studies, University of York, York, UK
- Novo Nordisk A/S, Søborg, Denmark
| | | | - Christopher Lübker
- Novo Nordisk A/S, Søborg, Denmark
- Department of Health Sciences, University of York, York, UK
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Bernardelli LV, Kortt MA, Charles MB. The association between BMI and self-reported health among a Brazilian sample: a cross-sectional study. Qual Life Res 2024; 33:1041-1050. [PMID: 38217772 DOI: 10.1007/s11136-023-03583-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE To examine the association between Body Mass Index (BMI) and self-rated health status among a representative sample of the Brazilian population. METHODS This study consists of a secondary analysis of the existing 2019 Brazilian National Health Survey (PNS). Logistic regression models were then used to examine the association between self-reported health status and BMI, while controlling for obesity-related medical conditions and socio-demographic characteristics. RESULTS The representative sample included 34,021 men and 34,430 women, comprising a total sample of 68,451. Men living with obesity (BMI ≥ 30 kg/m2) had, on average, a lower self-reported health status score (OR = 0.69, p < 0.01) compared to men within a healthy weight BMI range (18.5-25 kg/m2). Women living with obesity had, on average, a lower self-reported health status score (OR = 0.56, p < 0.01) compared to women within a healthy weight BMI range (18.5-25 kg/m2). There was also a statistically significant negative association (p < 0.01) between our obesity-related medical conditions and self-reported health for men and women. We also find some evidence of a non-linear association between BMI and health status for men. CONCLUSIONS The findings indicate that there is a statistically significant negative association between BMI and self-reported health for Brazilian men and women living with obesity. These findings reinforce the importance of addressing this growing public health challenge and the value of preventive measures and effective public health programs that focus on improving overall health and quality of life for individuals living with obesity.
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Affiliation(s)
- Luan Vinicius Bernardelli
- Federal University of Goiás, Câmpus Goiás, Bom Pastor Avenue, Setor Areião, Goiás, GO, 76600-000, Brazil.
| | - Michael A Kortt
- Faculty of Business, Law and Arts, Southern Cross University, Gold Coast, Australia
| | - Michael B Charles
- Faculty of Business, Law and Arts, Southern Cross University, Gold Coast, Australia
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Reinbacher P, Draschl A, Smolle MA, Hecker A, Gaderer F, Lanner KB, Ruckenstuhl P, Sadoghi P, Leithner A, Nehrer S, Klestil T, Brunnader K, Bernhardt GA. The Impact of Obesity on the Health of the Older Population: A Cross-Sectional Study on the Relationship between Health-Related Quality of Life and Body Mass Index across Different Age Groups. Nutrients 2023; 16:51. [PMID: 38201881 PMCID: PMC10780898 DOI: 10.3390/nu16010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Obesity is strongly associated with mortality and morbidity, but there is a lack of data on its impact on health-related quality of life (HRQoL) across different age groups. Therefore, this study's objective was to determine the association between body mass index (BMI) and HRQoL in the Austrian adult population based on age groups using the 36-Item Short Form (SF-36) survey. METHODS The SF-36 survey was sent to 500 randomly assigned Austrian adults (response rate: 80.6%). This study assessed HRQoL subscale and component scores based on gender, level of education, smoking status, and alcohol consumption in 403 participants. RESULTS Increasing BMI is associated with a negative impact on all domains of physical health and social function. The study uncovered substantial variations in the impact of increasing BMI on HRQoL across different age groups, with a pronounced effect observed in the physical components, particularly among individuals aged 65-74. CONCLUSIONS BMI is negatively associated with the physical aspects of HRQoL and social function, affecting various adult age groups differently. Consequently, our results emphasize assessing different age groups and possible influencing factors on HRQoL, such as BMI, for further optimization in designing prevention programs against obesity.
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Affiliation(s)
- Patrick Reinbacher
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
| | - Alexander Draschl
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
- COREMED-Centre for Regenerative and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria
| | - Maria Anna Smolle
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Andrzej Hecker
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
- COREMED-Centre for Regenerative and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria
| | - Franz Gaderer
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Kay-Bernd Lanner
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
| | - Paul Ruckenstuhl
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Patrick Sadoghi
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Andreas Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Stefan Nehrer
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
| | - Thomas Klestil
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Landesklinikum Baden-Mödling, 2340 Mödling, Austria
| | - Kevin Brunnader
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Gerwin A. Bernhardt
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
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Lindner H, Gimotty PA, Bilker WB. The diagnostic likelihood ratio function and modified test for trend: Identifying, evaluating, and validating nontraditional biomarkers in case-control studies. Stat Med 2023; 42:5313-5337. [PMID: 37735925 PMCID: PMC11073617 DOI: 10.1002/sim.9912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/05/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
The ROC curve and its associated summary statistic, the AUC, are used to identify informative diagnostic biomarkers under the assumption that risk of disease is a monotone function of the biomarker. We refer to biomarkers that meet this assumption as traditional, and those that do not as nontraditional. Nontraditional biomarkers most often arise when both low and high biomarker values are associated with an outcome of interest, such as blood pressure with medical complications or leukocyte count with ICU prognosis. Since nontraditional biomarkers do not meet the assumptions for ROC-based analyses, we propose using the discrete diagnostic likelihood ratio (DLR) function to evaluate a wider class of informative biomarkers. We obtain the DLR function using the multinomial logistic regression (MLR) model to improve upon existing estimation techniques, and implement a likelihood ratio test to identify candidate informative traditional and nontraditional biomarkers. We propose a modification of the Cochran-Armitage test for trend that separates biomarkers deemed informative into traditional and nontraditional categories. The statistical properties of the likelihood ratio test and modified test for trend are explored under simulation. Together, these methods achieve the identification, evaluation, and validation of biomarkers from early discovery research. Finally, we show that incorporating covariates into the MLR model results in a covariate-adjusted DLR function that is useful for integrating multiple sources of information in clinical decision making. The methods are applied to gene expression data from subjects with high grade serous ovarian cancer, where stage, early stage vs late stage, is the outcome of interest.
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Affiliation(s)
- Hanna Lindner
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Phyllis A. Gimotty
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
- Authors contributed equally as senior co-authors
| | - Warren B. Bilker
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
- Authors contributed equally as senior co-authors
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Çevik R, Em S, Nas K, Toprak M, Cengiz G, Çalış M, Sezer İ, Ünal Enginar A, Bora Karslı P, Sağ S, Sargın B, Alkan Melikoğlu M, Aydın Y, Tuncay Duruöz M, Hande Gezer H, Ecesoy H. Association of pain and clinical factors on disability and quality of life in systemic sclerosis: A cross-sectional study from Turkish League Against Rheumatism Network. Arch Rheumatol 2023; 38:9-21. [DOI: 10.46497/archrheumatol.2023.9243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/21/2021] [Indexed: 03/18/2023] Open
Abstract
Objectives: In this study, we aimed to evaluate the factors associated with disability and quality of life (QoL) in Turkish patients with systemic sclerosis (SSc).
Patients and methods: Between January 2018 and January 2019, a total of 256 SSc patients (20 males, 236 females; mean age: 50.9±12.4 years; range, 19 to 87 years) who were diagnosed with SSc were included in the study. Disability and health-related QoL (HRQoL) were evaluated by the Health Assessment Questionnaire (HAQ), scleroderma HAQ (SHAQ), Duruöz Hand Index (DHI), and Short Form-36 (SF-36). Linear regression analysis methods were used to describe factors associated with disability and QoL of the patients.
Results: All disability scores were higher and HRQoL scores were lower in diffuse cutaneous SSc patients compared limited cutaneous SSc, and differentiations were significant (p=0.001 and p=0.007). In multiple regression, pain (VAS) was the strongest predictor for high disability and low QoL scores (p<0.001) as HAQ (β=0.397, 0.386, 0.452), SHAQ (β=0.397, 0.448, 0.372), DHI (β=0.446, 0.536, 0.389), PCS (β=-0.417,-0.499, -0.408) and MCS (β=-0.478, -0.441, -0.370) in combined, lcSSc and dcSSc patients respectively. The factors associated with high disability and low QoL scores were forced vital capacity for HAQ (β=-0.172, p=0.002) and SF-36 PCS (β=0.187, p=0.001); disease duration for HAQ (β=0.208, p<0.001), DHI (β=0.147, p=0.006), and SF-36 PCS (β=-0.134, p=0.014); 6-minute walk test for HAQ (β=-0.161, p=0.005) and SF-36 PCS (β=0.153, p=0.009); and modified Rodnan skin score for SHAQ (β=0.250, p<0.001) and DHI (β=0.233, p<0.001) in SSc patients. Diffusing capacity of the lungs for carbon monoxide for HAQ (β=-0.189, p=0.010) and SHAQ (β=-0.247, p=0.002); erythrocyte sedimentation rate for DHI (β=0.322, p<0.001); age for SF-36 PCS (β=-0.221, p=0.003) and body mass index for SF-36 PCS (β=-0.200, p=0.008) and MCS (β=-0.175, p=0.034) were the other variables associated with high disability or low QoL scores in SSc subsets.
Conclusion: Clinicians should consider the management of the pain and its sources as a key to improve better functional state and quality of daily life in SSc.
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Bouzgarrou L, Merchaoui I, Omrane A, Ameur N, Kammoun S, Chaari N. Health-related Quality of Life and Determinants of the Mental Dimension Among Tunisian Nurses in Public Hospitals. LA MEDICINA DEL LAVORO 2023; 114:e2023002. [PMID: 36790411 PMCID: PMC9987467 DOI: 10.23749/mdl.v114i1.13029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 11/14/2022] [Indexed: 02/16/2023]
Abstract
BACKGROUND The health-related quality of life (HR-QoL) has been in-creasingly investigated in health sciences. The Objectives of this study are to evaluate the HR-QoL among nurses in Tunisian public hospitals and to identify the determinants of its mental dimension. METHODS A cross-sectional, bi-centric study was conducted within a representative sample of the 1,179 nurses assigned to 28 departments of two Tunisian public hospitals. A structured inquiry (socio-professional characteristics, occupational perceived workload) and validated questionnaires (SF12, Job Content Questionnaire of Karasek, Work Ability Index) have been completed. RESULTS Response rate was equal to 97.34%. The mean age of nurses was 42.60 ± 21 years. Nearly half of caregivers (49.07%) had a poor mental quality of life. The multivariate analysis concluded that mental HR-QoL was correlated with the female gender (0.010), obesity and the non-practice of regular physical activity (0.027), musculoskeletal diseases (<10-3), the low ability to work (<10-3). This deterioration of the mental HR-QoL dimension was also associated with the job tenure (0.002), the perceived workload (0.015), and conflictual relationships with colleagues (0.006) the feeling of insecurity at work (0.034), and the intention to leave the profession early (0.007) Conclusion: The results of this study showed that a considerable number of nurses had a poor mental quality of life. This study also identified factors associated with this deterioration. Acting on these determining factors may improve the well-being and global health of nurses, as well as their work performance and quality of care provided.
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Affiliation(s)
- Lamia Bouzgarrou
- Occupational Medicine and Ergonomics Department, Faculty of Medicine, University of Monastir, Tunisia.
| | - Irtyah Merchaoui
- Occupational Medicine and Ergonomics Department, Faculty of Medicine, University of Monastir, Tunisia.
| | - Amira Omrane
- Occupational Medicine and Ergonomics Department, Faculty of Medicine, University of Monastir, Tunisia.
| | - Nada Ameur
- Occupational Medicine and Ergonomics Department, Faculty of Medicine, University of Monastir, Tunisia.
| | - Salma Kammoun
- Occupational Medicine and Ergonomics Department, Faculty of Medicine, University of Monastir, Tunisia.
| | - Neila Chaari
- Occupational Medicine and Ergonomics Department, Faculty of Medicine, University of Monastir, Tunisia.
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Hoque MM, Datta PK, Basu KC, Rahman MF, Khan MMH, Kamal MM, Mahmud R, Aftab KA, Khan EA, Mahmud I, Sharmin R, Khan MAS, Hasan MJ, Amin MR, Miah MT, Rahman MM. Post-discharge quality of life of COVID-19 patients at 1-month follow-up: A cross-sectional study in the largest tertiary care hospital of Bangladesh. PLoS One 2023; 18:e0280882. [PMID: 36719890 PMCID: PMC9888719 DOI: 10.1371/journal.pone.0280882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/10/2023] [Indexed: 02/01/2023] Open
Abstract
There is increasing evidence of the post-COVID-19 suffering and decreased quality of life in the COVID-19 patients. This study aimed to assess the quality of life and associated factors of COVID-19 patients at one month after discharge from the hospital. This was a cross-sectional study that was conducted at the post-covid clinic of Dhaka Medical College Hospital (DMCH) where RT-PCR-confirmed adult COVID-19 recovered patients were enrolled one month after discharge from the same hospital. They were consecutively selected from January 01 to May 30. A pretested semi-structured questionnaire was used for the data collection for clinical variables. The generic multi-attributable utility instrument EQ-5D-5L was used for assessing health-related quality of life (HRQoL). A total of 563 patients were enrolled in the study. The patients had a mean age with standard deviation (±SD) of 51.18 (±13.49) years and 55.95% were male. The mean (SD) EQ-5D-5L index score and EQ-VAS scores were 0.78 (±0.19) and 70.26 (±11.13), respectively. Overall, 45.77%, 50.99%, 52.79%, 55.14% and 62.16% had problems (slight to extreme) in the mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions, respectively. Patients aged ≥60 years had significant problem in mobility (odds ratio [OR] 3.24, 95% confidence interval [CI]: 1.07-9.77). Female participants were 5.50 times (95% CI: 2.22-13.62) more likely to have problems in their usual activities. In comparison to urban area, living in a peri-urban setting was significantly associated with problems in mobility (OR 1.89, 95% CI: 1.13-3.20), pain/discomfort (OR 1.82, 95% CI: 1.04-3.12) and anxiety/depression (OR 2.16, 95% CI: 1.22-3.84). Comorbid patients were 1.75 times (95% CI: 1.07-2.85) more likely to report problems in the pain/discomfort dimension. Presence of symptom(s) was associated with problems in self-care (OR 3.27, 95%CI: 1.31-8.18), usual-activity (OR 3.08, 95%CI: 1.21-7.87), pain/discomfort dimensions (OR 2.75, 95%CI: 1.09-6.96) and anxiety/depression (OR 3.35, 95%CI: 1.35-8.30). Specific management strategies should be planned to address the factors associated with low health-related quality of life in post-acute care of COVID-19 patients.
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Affiliation(s)
| | | | | | | | | | | | - Reaz Mahmud
- Department of Neurology, Dhaka Medical College, Dhaka, Bangladesh
| | - Kazi Ali Aftab
- Department of Endocrinology, Dhaka Medical College, Dhaka, Bangladesh
| | | | - Imran Mahmud
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Rumana Sharmin
- Department of Pathology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | | | | | - Md. Robed Amin
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md. Titu Miah
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
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Capuno J, Kraft A, Calicdan KG, O’Donnell O. Associations between health-related quality of life and measures of adiposity among Filipino adults. PLoS One 2022; 17:e0275798. [PMID: 36288388 PMCID: PMC9605333 DOI: 10.1371/journal.pone.0275798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/23/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Estimate associations between the health-related quality of life (HRQoL) and adiposity in a low-income population. METHODS In a cluster random sample of 3796 Filipinos aged 40-70 years in Nueva Ecija province, we measured body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and six dimensions of HRQoL using the 20-item Short Form Health Survey. We stratified by sex and used nonparametric regression to graph mean HRQoL in each dimension by BMI, WC, and WHR. We used ordinary least squares regression to estimate differences in each HRQoL dimension by categories of BMI, WC, and WHR adjusted for sociodemographic characteristics and smoking. RESULTS Mean HRQoL was lowest for health perception (Males: 67.5 (SD = 15.9); Females: 66.7 (15.8)) and highest for role functioning (Males: 97.5 (12.9); Females: 97.4 (13.3)). Mean (SD) values of BMI, WC, and WHR were 22.1 (3.6), 84.8 cm (9.5), and 0.9 (0.1), respectively for males, and 23.7 (4.2), 86.5 cm (10.2), and 0.9 (0.1), respectively, for females. There was no evidence that higher BMI was associated with lower HRQoL. Adjusted mean social functioning was 4.92 (p = 0.076) higher for males with high BMI risk (8.6% prevalence) compared with acceptable BMI risk (50.3%). Mean social functioning was 3.61 (p = 0.012) and 5.48 (p = 0.017) lower for females with high WC (44.7%) and WHR (83.1%), respectively, compared with those with low WC (23.8%) and WHR (3.6%). Mean physical functioning was lower by 2.70 (p = 0.204) and 1.07 (p = 0.198) for males and females, respectively, with high compared with low WC. Mean physical functioning was 3.93 (p = 0.037) lower for males with high (7.6%) compared with low (38.8%) WHR. Mean role functioning was 1.09 (p = 0.124) and 2.46 (p = 0.158) lower for males with borderline and high WHR, respectively. CONCLUSIONS There is discordance between future adiposity-related health risk and current experience of HRQoL.
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Affiliation(s)
- Joseph Capuno
- School of Economics, University of the Philippines, Diliman, Quezon City, Philippines
| | - Aleli Kraft
- School of Economics, University of the Philippines, Diliman, Quezon City, Philippines
| | - Kayleen Gene Calicdan
- School of Economics, University of the Philippines, Diliman, Quezon City, Philippines
| | - Owen O’Donnell
- Department of Applied Economics, Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, Netherlands
- Tinbergen Institute, Amsterdam, Netherlands
- University of Lausanne, Lausanne, Switzerland
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Mitu I, Preda C, Dimitriu CD, Mitu O, Costache II, Ciocoiu M. Metabolic Phenotypes—The Game Changer in Quality of Life of Obese Patients? Healthcare (Basel) 2022; 10:healthcare10040617. [PMID: 35455798 PMCID: PMC9025564 DOI: 10.3390/healthcare10040617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The present study aimed to investigate the association of obesity phenotypes and quality of life (QoL) scales and their relationship with fat mass (FM) parameters. Methods: This study categorized 104 subjects into 4 obesity phenotypes based on BMI and metabolic syndrome status: metabolically healthy obese (MHO), metabolically unhealthy obese (MUO), metabolically healthy non-obese (MHNO), and metabolically unhealthy non-obese (MUNO). Body composition was measured by dual-energy X-ray absorptiometry (DEXA) and metabolic profile was characterized by blood samples. All subjects completed the SF-36 item Short Form Health Survey Questionnaire. Results: Comparing the four obesity phenotypes, significant results were reported for Bodily Pain between MHNO/MUNO (p = 0.034), for Vitality between MHO/MUO (p = 0.024), and for Mental Component Score between MHO/MUO (p = 0.026) and MUO/MUNO (p = 0.003). A more thorough inside-groups analysis yielded a positive and moderate to high correlation between FM parameters and QoL scales in MHO and MHNO, while a negative and weak to moderate correlation was observed in MUO and MUNO. Conclusion: This study reported an inverse U-shaped relationship between FM and QoL in obesity phenotypes, suggesting that metabolic status is a key factor involved in modulating QoL and therefore challenging the idea of obesity as a main driver of low QoL. We recommend the inclusion of FM percentage in the definition of obesity phenotypes in future research, to better evaluate QoL of obesity phenotypes.
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Affiliation(s)
- Ivona Mitu
- Department of Morpho-Functional Sciences II, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (I.M.); (C.D.D.); (M.C.)
| | - Cristina Preda
- Department of Endocrinology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Cristina Daniela Dimitriu
- Department of Morpho-Functional Sciences II, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (I.M.); (C.D.D.); (M.C.)
| | - Ovidiu Mitu
- 1st Medical Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
- Correspondence: ; Tel.: +40-7452-79714
| | - Irina Iuliana Costache
- 1st Medical Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Manuela Ciocoiu
- Department of Morpho-Functional Sciences II, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (I.M.); (C.D.D.); (M.C.)
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Physical activity and health-related quality of life among high-risk women for type 2 diabetes in the early years after pregnancy. BMC Womens Health 2022; 22:84. [PMID: 35313870 PMCID: PMC8939162 DOI: 10.1186/s12905-022-01664-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background Previous studies have shown that physical activity (PA) correlates positively with health-related quality of life (HRQoL) in the general population. Few studies have investigated associations between device-measured PA and HRQoL among premenopausal women at risk for type 2 diabetes (T2D). In addition to physical well-being, general well-being improved by PA has been suggested to strengthen PA’s benefits in reducing metabolic diseases. The aim of this study was to examine the associations between PA and HRQoL (general and dimensions) among high-risk women in the early post-pregnancy years when T2D risk is highest and to estimate whether current obesity or prior gestational diabetes (GDM) modified these associations. Methods This cross-sectional study of high-risk women [body mass index (BMI) ≥ 30 kg/m2 and/or prior GDM)]4–6 years after delivery measured sleep, sedentary time, daily steps, and light (LPA), moderate-to-vigorous (MVPA), and vigorous PA (VPA) with the SenseWear ArmbandTM accelerometer for seven days and HRQoL with the 15D instrument. Results The analyses included 204 women with a median (IQR) age of 39 (6.0) years and a median BMI of 31.1 kg/m2 (10.9). 54% were currently obese (BMI ≥ 30 kg/m2), and 70% had prior gestational diabetes (GDM+). Women with obesity had lower PA levels than women with normal weight or overweight (p < 0.001) but there was no difference between the GDM+ or GDM− women. Women with both current obesity and GDM+ had highest sedentary time and lowest PA levels. The whole sample’s median 15D score was 0.934 (IQR 0.092), lower among women with obesity compared to the others (p < 0.001), but not different between GDM+ or GDM−. There was a positive correlation between VPA (adjusted rs = 0.262 p = 0.001) and the 15D score. After grouping according to BMI (< and ≥ 30 kg/m2), the associations remained significant only in women without obesity. Among them, sleep, total steps, MVPA, and VPA were positively associated with 15D. Conclusions Higher PA levels are associated with better HRQoL among high-risk women with normal weight and overweight but no differences were found among women affected by obesity in the early years after pregnancy. Trial registration Ethics committees of Helsinki University Hospital (Dnro 300/e9/06) and South Karelian Central Hospital (Dnro 06/08).
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11
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Cardiometabolic Health Status, Ethnicity and Health-Related Quality of Life (HRQoL) Disparities in an Adult Population: NutrIMDEA Observational Web-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052948. [PMID: 35270641 PMCID: PMC8910247 DOI: 10.3390/ijerph19052948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 12/24/2022]
Abstract
Precision public health supported on online tools is increasingly emerging as a potential strategy to achieve health promotion and disease prevention. Our aim was to assess the relationships of sociodemographic variables, anthropometric data, dietary habits and lifestyle factors with health-related quality of life (HRQoL), cardiometabolic health status and ethnicity in an online recruited adult population (NutrIMDEA Study). NutrIMDEA Study is a web-based cross-sectional survey that included 17,333 adults. Self-reported sociodemographic characteristics, anthropometric data, clinical and family history of cardiometabolic illnesses, dietary habits, lifestyle factors and HRQoL features were collected. Diseased individuals showed significative poorer MedDiet and worse HRQoL than those in the healthy cardiometabolic status group (p < 0.05). In comparison, European/Caucasian individuals reported a significantly better HRQoL, higher MedDiet and HRQoL values compared with those of other ethnicities (p < 0.05). We obtained a total of 16.8% who reported poor/fair, 56.5% good and 26.6% very good/excellent HRQoL. Respondents with very good/excellent HRQoL showed lower BMI, greater adherence to a Mediterranean diet (MedDiet) and higher physical activity. The results suggest the presence of interactions between the mental and physical components of HRQoL with obesity, sedentarism and dietary intake, which were dependent on disease status and ethnicity. Online HRQoL assessment could contribute to wider implementation of precision public health strategies to promote health targeted interventions with policy implications to community health promotion.
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12
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Gąsecka A, Rzepa B, Skwarek A, Ćwiek A, Pluta K, Szarpak Ł, Jaguszewski MJ, Mazurek T, Kochman J, Opolski G, Filipiak KJ, Gąsecki K. Health-related Quality of Life Increases After First-time Acute Myocardial Infarction: a Population-based Study. Zdr Varst 2022; 61:24-31. [PMID: 35111263 PMCID: PMC8776287 DOI: 10.2478/sjph-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 11/04/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Acute myocardial infarction (AMI) affects patients' health-related quality of life (HRQOL). AMI may decrease HRQOL, thus negatively affecting QOL. However, the improvements in interventional treatment and early rehabilitation after AMI may have a positive effect on HRQOL. AIM We evaluated HRQOL in patients after the first AMI treated in a reference cardiology centre in Poland and assessed which clinical variables affect HRQOL after AMI. MATERIAL AND METHODS We prospectively evaluated HRQOL in 60 consecutive patients suffering after their first AMI during the index hospitalisation and again after 6 months, using: (i) MacNew, (ii) World Health Organization Quality of Life (WHOQOL) BREF, and (iii) Short Form (SF) 36. RESULTS As measured by the MacNew questionnaire, global, social, and physical functioning did not change (p≥0.063), whereas emotional functioning improved 6 months after AMI, compared to index hospitalisation (p=0.002). As measured by WHOQOL BREF, physical health, psychological health, and environmental functioning did not change (p≥0.321), whereas social relationships improved 6 months after AMI (p=0.042). As assessed by SF-36, the global HRQOL improved after AMI (p=0.044). Patients with improved HRQOL in SF-36 often had a higher baseline body mass index (p=0.046), dyslipidaemia (p=0.046), and lower left ventricle ejection fraction (LVEF; p=0.013). LVEF<50% was the only variable associated with improved HRQOL in multivariate analysis (OR 4.463, 95% CI 1.045 - 19.059, p=0.043). CONCLUSIONS HRQOL increased 6 months after the first AMI, especially in terms of emotional functioning and social relationships. Patients with LVEF<50% were likely to have improved HRQOL.
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Affiliation(s)
- Aleksandra Gąsecka
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | | | - Aleksandra Skwarek
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | - Agata Ćwiek
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | - Kinga Pluta
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | - Łukasz Szarpak
- Bialystok Oncology Center, Bialystok, Poland
- Polish Society of Disaster Medicine, Warsaw, Poland
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
| | - Miłosz J. Jaguszewski
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | - Tomasz Mazurek
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | - Janusz Kochman
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | - Grzegorz Opolski
- Medical University of Warsaw, 1st Chair and Department of Cardiology, Stefana Banacha 1a, Warsaw, Masovian, Poland
| | | | - Krzysztof Gąsecki
- University of Warmia and Mazury, Faculty of Social Sciences, Chair of Social Pedagogy and Educational Research Methodology, Olsztyn, Poland
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13
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Gribsholt SB, Farkas DK, Thomsen RW, Richelsen B, Sørensen HT. Mortality Among Danish Patients with a Hospital Diagnosis of Overweight or Obesity Over a 40-Year Period. Clin Epidemiol 2022; 14:309-325. [PMID: 35313653 PMCID: PMC8933862 DOI: 10.2147/clep.s350459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Sigrid Bjerge Gribsholt
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center, Aarhus University Hospital, Aarhus, Denmark
- Correspondence: Sigrid Bjerge Gribsholt, Tel +4561651148, Email
| | - Dóra Körmendiné Farkas
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Reimar Wernich Thomsen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Bjørn Richelsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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14
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Abdul Manaf MR, Mohammed Nawi A, Mohd Tauhid N, Othman H, Abdul Rahman MR, Mohd Yusoff H, Safian N, Ng PY, Abdul Manaf Z, Abdul Kadir NB, Yanasegaran K, Abdul Basir SM, Ramakrishnappa S, Ariff MI, Ganasegeran K. Factors Associated with Health-Related Quality of Life amongst Employees in a Malaysian Public University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010903. [PMID: 34682645 PMCID: PMC8535262 DOI: 10.3390/ijerph182010903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/26/2022]
Abstract
The current academic landscape has overwhelmed faculties and with demands to adopt tech-savvy teaching modes and accelerate scholarly works, administrative duties, and outreach programs. Such demands have deteriorated the health-related quality of life (HRQoL) among university employees. This study aimed to determine the factors associated with HRQoL among university employees in a Malaysian public university. This cross-sectional study was conducted among 397 employees from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. A self-administered questionnaire that consisted of socio-demographic items, risky health behaviors, health-related information, and validated scales for measuring employees’ physical inactivity, psychological states, and HRQoL was utilized. Descriptive and inferential statistics were calculated using SPSS version 23.0. Hierarchical multiple linear regression models were yielded to determine the factors associated with different domains of HRQoL. Mediation analysis was conducted using PROCESS MACRO (Model 4). Statistical significance was set to p < 0.05. Physical HRQoL scored the highest, while environmental HRQoL had the lowest score among the employees. Physical HRQoL was influenced by age, service duration, comorbid conditions, BMI, chronic diseases, and anxiety. Factors associated with psychological HRQoL were age, service duration, depression, and stress. Age, service duration, and chronic diseases affected employees’ social relationship HRQoL, while environmental HRQoL was associated with age, occupation type, chronic diseases, and depression. Socio-demographics, risky health behaviors, health profiles, and psychological attributes were significantly associated with employees’ HRQoL. Age was the only positively correlated factor across all HRQoL domains, while other factors deteriorated employees’ HRQoL.
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Affiliation(s)
- Mohd Rizal Abdul Manaf
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.M.N.); (M.R.A.R.); (H.M.Y.); (N.S.); (S.R.)
- Correspondence:
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.M.N.); (M.R.A.R.); (H.M.Y.); (N.S.); (S.R.)
| | - Noorlaili Mohd Tauhid
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Hanita Othman
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Mohd Rizam Abdul Rahman
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.M.N.); (M.R.A.R.); (H.M.Y.); (N.S.); (S.R.)
| | - Hanizah Mohd Yusoff
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.M.N.); (M.R.A.R.); (H.M.Y.); (N.S.); (S.R.)
| | - Nazarudin Safian
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.M.N.); (M.R.A.R.); (H.M.Y.); (N.S.); (S.R.)
| | - Pei Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (P.Y.N.); (K.Y.)
| | - Zahara Abdul Manaf
- Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (Z.A.M.); (S.M.A.B.)
| | - Nor Ba’yah Abdul Kadir
- Centre for Research in Psychology and Human Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia;
| | - Kevina Yanasegaran
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (P.Y.N.); (K.Y.)
| | - Siti Munirah Abdul Basir
- Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (Z.A.M.); (S.M.A.B.)
| | - Sowmya Ramakrishnappa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.M.N.); (M.R.A.R.); (H.M.Y.); (N.S.); (S.R.)
| | - Mohd Izhar Ariff
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Kurubaran Ganasegeran
- Clinical Research Center, Seberang Jaya Hospital, Ministry of Health Malaysia, Penang 13700, Malaysia;
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15
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Herold T, Kothe R, Siepe CJ, Heese O, Hitzl W, Korge A, Wuertz-Kozak K. Effect of BMI on the clinical outcome following microsurgical decompression in over-the-top technique: bi-centric study with an analysis of 744 patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:936-945. [PMID: 33638720 DOI: 10.1007/s00586-021-06765-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/28/2020] [Accepted: 12/08/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE Decompression is one of the most common interventions in spinal surgery. Obesity has become an increasing issue in surgical patients. Therefore, the aim of this study was to analyze the clinical outcome following lumbar microsurgical decompression in correlation with the patient's body mass index (BMI). MATERIALS AND METHODS A toal of 744 patients with spinal claudication that were seen at two specialized spine centers were included in this study. All patients underwent a bilateral microsurgical decompression in over-the-top technique. Patients were allocated in 4 groups based in their BMI category: 18.5-24.9 (n = 204), 25.0-29.9 (n = 318), 30.0-34.9 (n = 164) and ≥ 35 (n = 58). Clinical outcome data were recorded at baseline as well as 3, 12 and 24 months thereafter within a prospective study framework. The minimum follow-up was 12 months. For statistical analysis, data were adjusted for age, length of surgery and ASA and were analyzed by generalized linear gamma-based models. RESULTS Postoperative changes in all outcome parameters were clearly dependent on BMI. Patients with higher BMI were characterized by inferior baseline values for VAS Back (p < 0.05). Over the follow-up period, the groups with BMI 30-34.9 and BMI ≥ 35 benefitted significantly less from the surgery than the two slimmer groups (p < 0.05). CONCLUSION The data obtained from this large, homogenous cohort demonstrate that the quality of life improved substantially in all patients that were treated microsurgically for spinal stenosis. However, a BMI ≥ 30 may be considered as a negative predictor for a significantly inferior clinical outcome.
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Affiliation(s)
- Tamara Herold
- Schön Klinik München Harlaching, Spine Center, Harlachinger Str. 51, 81547, Munich, Germany. .,Academic Teaching Hospital and Spine Research Institute, Paracelsus Medical University, Salzburg, Austria. .,ZFOS, Zentrum für Orthopädie und Sportmedizin, Nymphenburger Str. 110, Munich, Germany.
| | - Ralph Kothe
- Schön Klinik Eilbek, Clinic for Spinal Surgery, Hamburg, Germany.,Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph J Siepe
- Schön Klinik München Harlaching, Spine Center, Harlachinger Str. 51, 81547, Munich, Germany.,Academic Teaching Hospital and Spine Research Institute, Paracelsus Medical University, Salzburg, Austria
| | - Oliver Heese
- Schön Klinik München Harlaching, Spine Center, Harlachinger Str. 51, 81547, Munich, Germany.,Academic Teaching Hospital and Spine Research Institute, Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Hitzl
- Research Office - Biostatistics, Paracelsus Medical University, Salzburg, Austria.,Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Salzburg, Austria
| | - Andreas Korge
- Schön Klinik München Harlaching, Spine Center, Harlachinger Str. 51, 81547, Munich, Germany.,Academic Teaching Hospital and Spine Research Institute, Paracelsus Medical University, Salzburg, Austria
| | - Karin Wuertz-Kozak
- Schön Klinik München Harlaching, Spine Center, Harlachinger Str. 51, 81547, Munich, Germany.,Academic Teaching Hospital and Spine Research Institute, Paracelsus Medical University, Salzburg, Austria.,Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, NY, USA
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16
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Smith BP, Cardoso-Mendoza E, Flaws JA, Madak-Erdogan Z, Smith RL. Racial differences in lifestyle, demographic, and health factors associated with quality of life (QoL) in midlife women. Womens Midlife Health 2021; 7:2. [PMID: 33407936 PMCID: PMC7788772 DOI: 10.1186/s40695-020-00060-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/02/2020] [Indexed: 11/10/2022] Open
Abstract
Previously, quality of life (Qol) has been defined as an individual's evaluation of a satisfactory life as a whole (i.e. physically, mentally, psychologically, and socially). Only a few studies have examined the racial differences between QoL and risk factors associated with health, demographics, and lifestyle in midlife women. Thus, the purpose of our study was to determine racial differences in QoL in menopausal women due to lifestyle, demographic, and health related risk factors. A stratified ordinal logistic regression model was applied to self-reported questionnaire data from the Midlife Women's Health Study (MWHS) to determine risk factors associated with QoL differences between White and Black women during the menopausal transition. In multivariable models, our results showed Black women who had 3 or 4 comorbidities were about 4 times as likely to have higher QoL compared to women who had 0 to 2 comorbidities (95% CI: 1.65,10.78). However, the number of comorbidities was not significantly associated with QoL in White women in univariate or multiple regression. Further, body mass index and income were not significant factors in QoL in Black women but were in White women. Overall, our results illustrate that differences in health, demographic, and lifestyle factors are associated with QoL during menopause. Also, we suggest that future studies evaluate stratified models between racial groups to determine race-specific risk factors related to quality of life.
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Affiliation(s)
- Brandi Patrice Smith
- Illinois Informatics, University of Illinois, Urbana-Champaign, Champaign, IL, USA
| | | | - Jodi A Flaws
- Department of Comparative Biosciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA.,Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Zeynep Madak-Erdogan
- Illinois Informatics, University of Illinois, Urbana-Champaign, Champaign, IL, USA.,Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana-Champaign, Urbana, IL, USA.,Food Science and Human Nutrition Department, University of Illinois, Urbana-Champaign, Urbana, IL, USA.,Carle Illinois College of Medicine, University of Illinois, Urbana-Champaign, Urbana, IL, USA.,Cancer Center at Illinois, University of Illinois, Urbana-Champaign, Urbana, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana-Champaign, Urbana, IL, USA.,National Center for Supercomputing Applications, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Rebecca L Smith
- Illinois Informatics, University of Illinois, Urbana-Champaign, Champaign, IL, USA. .,Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana-Champaign, Urbana, IL, USA. .,National Center for Supercomputing Applications, University of Illinois, Urbana-Champaign, Urbana, IL, USA. .,Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, 2001 S. Lincoln Ave, Urbana, IL, USA.
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17
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Bao C, Yang R, Pedersen NL, Xu W, Xu H, Song R, Qi X, Xu W. Overweight in midlife and risk of cancer in late life: A nationwide Swedish twin study. Int J Cancer 2019; 144:2128-2134. [PMID: 30565668 DOI: 10.1002/ijc.32005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/08/2018] [Indexed: 12/11/2022]
Abstract
Our study examined whether midlife overweight (body mass index [BMI] ≥25) is associated with late-life cancer risk and explored the role of genetic and early-life environmental factors in this association. The study included 14,766 individuals from the Swedish Twin Registry, whose midlife (30-50 years) height and weight were recorded. Information on cancer diagnoses in late life (>65 years) was derived from the National Patient Registry and Cancer Registry. Generalized estimating equation (GEE) models were used to analyze unmatched case-control data (controlled for the clustering of twins within a pair). A co-twin matched case-control analysis used conditional logistic regression to compare cancer-discordant twins. Of all participants, 3968 (26.9%) were overweight and 4253 (28.8%) had cancer. In multi-adjusted GEE models using normal-weight (BMI 18.5-24.9) participants as the reference group, overweight was related to higher risk of colon cancer (OR 1.36, 95% CI: 1.00-1.84, p = 0.049), liver cancer (OR 2.00, 95% CI: 1.11-3.62), cervix uteri cancer (OR 2.86, 95% CI: 1.19-6.91) and corpus uteri cancer (OR 1.78, 95% CI: 1.14-2.78) but lower risk of nonmelanoma skin cancer (OR 0.77, 95% CI: 0.66-0.90). In conditional logistic regression analysis, these associations were attenuated becoming nonsignificance. The difference in ORs from the unmatched and matched analyses was not significant. In conclusion, midlife overweight is associated with increased risk of late-life colon, liver and uterine cancer but reduced risk of late-life nonmelanoma skin cancer. Further investigations are warranted to explore the role of genetic and early-life environmental factors in these associations.
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Affiliation(s)
- Cuiping Bao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China.,Department of Radiology, Tianjin Union Medical Centre, Tianjin, China
| | - Rongrong Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Weige Xu
- Department of Radiology, Tianjin Gongan Hospital, Tianjin, China
| | - Hui Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China
| | - Ruixue Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
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