Longitudinal Association Between Body Mass Index and Health-Related Quality of Life.

Abstract

Objective: Health-related quality of life (HRQoL) is an important outcome in individuals with a high risk for cardiovascular diseases. We investigated the association of HRQoL and body mass index (BMI) as an indicator for obesity.Design: Secondary longitudinal analysis of the ORBITAL study, an intervention study which included high-risk cardiovascular primary care patients with hypercholesterolemia and an indication for statin therapy.Methods: HRQoL was determined with the generic Short Form (SF)-12 health status instrument. Body weight and height were assessed at baseline and at months 6, 12, 18, 24, 30, and 36. We used a linear and a linear mixed-effects regression model to investigate the association between BMI and SF-12 summary scores at baseline as well as between change in BMI and SF-12 summary scores over 3 years. We adjusted for age, sex, smoking status, and in the longitudinal analysis also for the study arm and its interaction term with time.Results: Of the 7640 participants who completed the baseline questionnaire, 6726 participants (mean age: 61 years) were analyzed. The baseline BMI was inversely associated with physical and mental SF-12 summary scores (b [95% CI] per 1 kg/ m 2 : 20. 36 [20.41; 20.30] and 20.05 [20.11; 20.00], respectively). A significant association between the change in BMI and physical SF-12 summary scores over time was only present in women (20.18 [20.27; 20.09]) and only in obese participants (20.19 [20.29; 20.10]). A change in BMI was directly associated with mental SF-12 summary scores (0.12 [0.06; 0.19]) in the total population. Conclusion:Increases in BMI were associated with decreases in physical HRQoL, particularly in obese individuals and in women. In contrast, the mental HRQoL seemed to increase with increasing BMI over time. Thus, body weight management with respect to the HRQoL should be evaluated differentially by sex and body weight status.

The longitudinal association between weight change and health‐related quality of life in adults and children: a systematic review

“…Previous systematic reviews and meta‐analyses of cross‐sectional studies have similarly demonstrated a strong dose‐responsive inverse relationship between weight and physical HRQOL in both adults and children . Secondary analyses of longitudinal intervention studies further show that weight gain is associated with reduced physical HRQOL . The mechanism of this association is unknown.…”

“…In children, one review showed an inverse relationship between weight and overall mental HRQOL, while three reviews found that only one PedsQL mental subscale was consistently lower at higher weights . Longitudinal intervention studies found weight gain to be variably associated with improved and reduced mental HRQOL. It is possible that weight and mental HRQOL are unrelated or only weakly related, with mental HRQOL only affected at extremes of weight change.…”

Main predictors in health-related quality of life in Chinese patients with type 2 diabetes mellitus

“…A study reported that higher HbA1c was associated with lower HRQOL [12], but other studies showed no association between HbA1c and HRQOL over time [13][14][15]. Inconsistent relationships between BMI and HRQOL over time were found in previous studies [15][16][17]. Hence, further study is needed to provide more evidence on the predictors for HRQOL among type 2 diabetic patients.…”