No abstract

Objective: Excess body weight is related to significant morbidity and mortality. However, less is known about the relationship of body weight to health-related quality of life (HRQOL), especially for Asian populations. We examined the relationship of excess weight and HRQOL in a general population sample from Taiwan. Research methods and procedures: This cross-sectional study used a national representative sample (n ¼ 14 221) from the 2001 Taiwan National Health Interview Survey. Body weight was categorized using body mass index (BMI in kg/m 2 ) as normal (18.5-24.9), overweight (25-29.9), and obese (X30). HRQOL was measured using the Taiwan version of the SF-36. We compared the body weight-HRQOL relationships by age, gender, and status of chronic condition, respectively. We especially used the Generalized Estimating Equations (GEE) to examine the relationships of BMI and HRQOL by taking into account the correlations of HRQOL within households. Four models were developed to adjust sequentially for sets of covariates: Model 1 with no adjustment; Model 2 adjusting for sociodemographic variables; Model 3 adding chronic conditions; Model 4 further adding smoking status. Results: Unadjusted physical HRQOL was best for normal weight, worse for overweight, and worst for obese individuals. For unadjusted mental HRQOL, overweight subjects had at least as good mental domain scores of HRQOL as those with normal weight or obesity, depending on the subscales. As age increased, excess weight was associated with worse physical, but not mental HRQOL. Compared to men, women with excess weight showed a greater deficit in physical HRQOL. Multivariable analyses suggested that obesity was associated with worse physical HRQOL compared to overweight, which, in turn, was worse or comparable to normal weight. Specifically, in the model adjusting for demographic variables, the deficit in physical functioning and physical component scores for the obese vs normal weight were statistical significant (Po0.05) and clinically important difference (effect size X0.3). Both obesity and overweight were associated with higher mental component scores than normal weight, but the effect size was o0.3. Conclusion: In Taiwan, excess weight was related to worse physical, but not mental HRQOL. The lack of impact of increased body weight on mental health status presents a potential challenge to preventing the increases in obesity. More research is needed to elucidate the mechanisms by which excess weight affects specific domains of HRQOL, and to develop effective prevention strategies.

S65pre-(baseline) and 12-month post-(follow-up) index hospitalization were included. Patients who had previous evidence of ACS or prescription of antiplatelet agents during baseline period or had major adverse cardiovascular events within the initial 30 days after discharge were excluded. Patients who had a ≥ 80% proportion of days covered (PDC) were considered adherent, while patients who had no gaps of ≥ 30 days in antiplatelet therapy were considered persistent. Logistic and Cox models were used to explore the associated factors for adherence and persistence, respectively. ReSultS: 5,486 patients (63.2±10.8 years; 60.2% male) were identified. Only 10.9% (N= 600) of them were adherent to antiplatelet agents during follow-up, and the mean PDC was 0.39±0.29 for the total cohort. 90.1% (N= 4,942) patients discontinued antiplatelet agents during follow-up and the average time to discontinuation was 103.89±110.27 days. Male, patients who received percutaneous coronary intervention (PCI) or those who had longer stay during index hospitalization had better adherence (Odds ratio [95%