Abstract
ObjectiveHealth-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.DesignSecondary 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.MethodsHRQoL 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.ResultsOf 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 (β [95% CI] per 1 kg/m2: −0.36 [−0.41; −0.30] and −0.05 [−0.11; −0.00], respectively). A significant association between the change in BMI and physical SF-12 summary scores over time was only present in women (−0.18 [−0.27; −0.09]) and only in obese participants (−0.19 [−0.29; −0.10]). A change in BMI was directly associated with mental SF-12 summary scores (0.12 [0.06; 0.19]) in the total population.ConclusionIncreases 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.Trial RegistrationClinicalTrials.gov NCT00379249
Highlights
The obesity epidemic is a major public health challenge in an increasing number of countries worldwide [1]
Increases in body mass index (BMI) were associated with decreases in physical Health-related quality of life (HRQoL), in obese individuals and in women
The mental HRQoL seemed to increase with increasing BMI over time
Summary
The obesity epidemic is a major public health challenge in an increasing number of countries worldwide [1]. The major consequences of obesity include an increased risk of both all-cause and, in particular, cardiovascular mortality [2,3,4]. Obesity is a risk factor for several morbidities, such as type 2 diabetes mellitus [5,6], and it is associated with psychological disorders, such as depression, and social discrimination [5,6,7]. It has been shown to predict premature mortality [38,39,40,41,42,43] and morbidities such as type 2 diabetes mellitus and cardiovascular events [42,44,45]. HRQoL as an outcome is especially relevant for individuals with chronic diseases who spend an increasing amount of time living with their disease due to improved survival
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