Research On The Relationship Between Different Indicators Of Obesity Diagnosis Of Obesity And Health-related Quality Of Life

Objective:Overweight/obesity is closely associated with a variety of chronic diseases. However, in recent years, some studies have found that overweight/obesity have positive impact on HRQoL, especially the mental component score of HRQoL, which is different from the general findings that obesity will cause negative impact on HRQoL. Additionally, compared with the normal weight population, overweight/obesity people have better clinical outcomes, namely "obesity paradox". So this study takes different obesity indicators (body mass index, waist circumference, waist-hip ratio, waist to height ratio) to evaluate the relationship between obesity and HRQoL and to analyze whether obese people have a better HRQoL. Then apply the research conclusion to health evaluation and provide guidance for the public health and scientific weight management.Methods:A sample of639subjects>=18years was selected from physical examination population that had been conducted in Beijing Tongren hospital affiliated to Capital Medical University. Chi-square test (Fisher exact probability method) and multiple regression analysis (confounders:sociodemographic factors, behavioral lifestyle factors, chronic disease factors) were used to explore the relationship between obesity and health-related quality of life.Results:(1) BMI indicator and confounders as independent variables were introduced in the multiple regression model showed:Compared to the normal weight group, the overweight had higher scores in physical component summary (PCS), mental component summary(MCS) and its various dimensions. But there was no statistically significant difference; the damage of obesity on HRQoL were mainly expressed in PCS (Beta=-0.089, P=0.026), physical functioning (PF)(Beta=-0.116, P=0.003), bodily pain (BP)(Beta=-0.08, P=0.049), not MCS. Adversely affect the physical HRQoL mainly were chronic diseases (PCS:Beta=-0.227, P<0.001), low-level motion (PCS:Beta=-0.213, P<0.001) and old (PCS:Beta=-0.181, P<0.001). Adversely affect the mental HRQoL mainly were low-level motion (MCS: Beta=-0.254, P<0.001), chronic diseases(MCS:Beta=-0.149, P=0.001) and unmarried (MCS:Beta=-0.111, P=0.008).(2) WC indicator and confounders as independent variables were introduced in the multiple regression model displayed:The effect of obesity on PCS and MCS had no statistically significant difference. Adversely affect the physical HRQoL mainly were chronic diseases (PCS:Beta=-0.235, P<0.001), low-level motion (PCS Beta=-0.221, P<0.001) and old (PCS:Beta=-0.169, P<0.001). Adversely affect the mental HRQoL mainly were the low-level motion (MCS:Beta=-0.258, P<0.001), chronic diseases (MCS:Beta=-0.152, P=0.001) and unmarried (MCS:Beta=-0.118, P=0.004).(3) WHR indicator and confounders as independent variables were introduced in the multiple regression model showed:The damage of obesity on physical HRQoL were only expressed in PCS (Beta =-0.089, P=0.039). The effect of obesity on MCS had no statistically significant difference. Adversely affect the physical HRQoL mainly were chronic diseases (PCS:Beta=-0.240, P <0.001), low-level motion (PCS:Beta=-0.216, P<0.001) and old (PCS:Beta=-0.173, P <0.001). Adversely affect the mental HRQoL mainly were the low-level motion (MCS:Beta=-0.255, P<0.001), chronic diseases (MCS:Beta=-0.155, P<0.001) and unmarried (mental (MCS) areas:Beta=-0.119, P=0.004).(4)WHtR indicator and confounders as independent variables were introduced in the multiple regression model showed:The damage of obesity on physical HRQoL were only expressed in PF (Beta=-0.107, P=0.009). The effect of obesity on MCS had no statistically significant difference. Adversely affect the physical HRQoL mainly were chronic diseases (PCS:Beta=-0.226, P<0.001), low-level motion (PCS:Beta=-0.219, P<0.001) and old (PCS:Beta=-0.167, P<0.001). Adversely affect the mental HRQoL mainly were the low-level motion (MCS:Beta=-0.257, P<0.001), chronic diseases (MCS:Beta=-0.153, P=0.001) and unmarried (MCS:Beta=-0.117, P=0.005).Conclusion:The impact of obese diagnosed by four different indicators (BMI, WC, WHR, WHtR) on HRQoL are similar. This similarity is mainly reflected that obesity negative impact on quality of life is weaker, and showed only in the field of physiology. The most two important factors on the HRQoL field of physiological and psychological are the chronic diseases and low-level motion. Therefore, to the overweight and obese health people’s management, we need to develop a reasonable exercise program and lifestyle risk factors for chronic bad behavior intervention programs to reduce the adverse effects of lack of exercise and chronic disease on quality of life, improve quality of life of overweight and obese.