Abstract
BackgroundHealth-related quality of life (HR-QoL) may be compromised in obese individuals, depending on the presence of other complications. The aim of this study is to assess the effect of obesity-related conditions on HR-QoL. These conditions are i) grade of obesity with and without type 2 diabetes (T2D), ii) metabolic syndrome (MetS), and iii) level of inflammation.MethodsFrom the Dutch LifeLines Cohort Study we included 13,686 obese individuals, aged 18–80 years. HR-QoL was measured with the RAND 36-Item Health Survey which encompasses eight health domains. We calculated the percentage of obese individuals with poor HR-QoL, i.e. those scoring below the domain and sex specific cut-off value derived from the normal weight population. Logistic regression analysis was used to calculate the probability of having poor domain scores according to the conditions under study.ResultsHigher grades of obesity and the additional presence of T2D were associated with lower HR-QoL, particularly in the domains physical functioning (men: odds ratios (ORs) 1.48–11.34, P<0.005, and women: ORs 1.66–5.05, P<0.001) and general health (men: ORs 1.44–3.07, P<0.005, and women: ORs 1.36–3.73, P<0.001). A higher percentage of obese individuals with MetS had a poor HR-QoL than those without MetS. Furthermore, we observed a linear trend between inflammation and the percentage of obese individuals with poor scores on the HR-QoL domains. Individuals with MetS were more likely to have poor scores in the domains general health, vitality, social functioning and role limitations due to emotional problems. Obese women with increased inflammation levels were more likely to have poor scores on all domains except role limitations due to emotional problems and mental health.ConclusionsThe impact of obesity on an individual’s quality of life is enhanced by grade of obesity, T2D, MetS and inflammation and are mainly related to reduced physical health. The mental well-being is less often impaired.
Highlights
A recent study across seven European countries estimated that obesity prevalence varies between 12% and 26% [1], confirming that obesity has become an epidemic [2]
Higher grades of obesity and the additional presence of type 2 diabetes (T2D) were associated with lower health-related quality of life (HR-QoL), in the domains physical functioning (men: odds ratios (ORs) 1.48– 11.34, P
We observed a linear trend between inflammation and the percentage of obese individuals with poor scores on the HR-QoL domains
Summary
A recent study across seven European countries estimated that obesity prevalence varies between 12% and 26% [1], confirming that obesity has become an epidemic [2]. Obesity often coincides with metabolic syndrome (MetS), type 2 diabetes (T2D) and chronic inflammation in varying degrees. It remains unclear whether the presence of MetS, a cluster of inter-related risk factors for future cardiovascular diseases (CVD) and T2D, is affecting HR-QoL. Some studies suggest that the inflammatory state of a person may be related to HR-QoL [15,16,17] This relationship has only been studied in elderly men [18] and in patient settings, e.g. among patients with chronic kidney disease or diabetes [15, 16, 19]. We are unaware of any evidence linking HR-QoL to the inflammatory state of individuals with obesity
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