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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research

Exploring the nonlinear relationship between body mass index and health-related quality of life among adults: a cross-sectional study in Shaanxi Province, China

Authors: Yongjian Xu, Zhongliang Zhou, Yanli Li, Jinjuan Yang, Xiaoyuan Guo, Jianmin Gao, Ju’e Yan, Gang Chen

Published in: Health and Quality of Life Outcomes | Issue 1/2015

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Abstract

Introduction

China is a country facing the “double burden” of both obesity and underweight. The objective of this study was to explore the relationship between body mass index (BMI) and health-related quality of life (HRQOL) in adults from Shaanxi Province.

Methods

The data were derived from the fifth Health Service Survey of Shaanxi Province, which was part of China’s National Health Service Survey (NHSS), conducted in 2013. The HRQOL was assessed using the three-level EQ-5D questionnaire and scored based on a recently developed Chinese-specific tariff. Semiparametric regression models were adopted to explore the non-linear relationship between continuous BMI and overall HRQOL scores. Logistic regression models were further undertaken to assess the relationship between categorized BMI and five dimensions of HRQOL.

Results

Among the study sample (n = 37,902), 77 % of men and 75 % of women were assigned to normal weight, according to the WHO International classification. There were statistical significant nonlinear relationships between BMI and HRQOL, with optimal HRQOL achieved at a BMI of near 23 kg/m2 for men and 24 kg/m2 for women. Before BMI reached optimal HRQOL, the EQ-5D utility scores were increasing faster among men than the women, whilst after the BMI value reached the optimal utility scores, women showed a faster decline in utility scores than men. With adjustments for socio-demographic, physical activity and co-morbidities, obese respondents were more likely to suffer from physical rather than mental problems. Underweight respondents were significantly more likely to report having any problems in all five dimensions of the EQ-5D, whilst the magnitudes of odds ratios were consistently larger for men than women.

Conclusion

There was an inverse U-shaped association between continuous BMI and overall HRQOL scores, meaning that both underweight and obesity were associated with lower HRQOL. The relationship between BMI and HRQOL varied between sexes. Underweight respondents had a higher risk of suffering from both physical and mental problems. Interventions aimed to tackle the prevalence of underweight should be put into action in Shaanxi Province.
Literature
1.
Silventoinen K, Sans S, Tolonen H, Monterde D, Kuulasmaa K, Kesteloot H, et al. Trends in obesity and energy supply in the WHO MONICA Project. Int J Obesity. 2004;28(5):710–8.CrossRef
2.
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81.CrossRefPubMed
3.
Huang IC, Frangakis C, Wu AW. The relationship of excess body weight and health-related quality of life: evidence from a population study in Taiwan. Int J Obes (Lond). 2006;30(8):1250–9.CrossRef
4.
5.
6.
7.
Soltoft F, Hammer M, Kragh N. The association of body mass index and health-related quality of life in the general population: data from the 2003 Health Survey of England. Qual Life Res. 2009;18(10):1293–9.PubMedCentralCrossRefPubMed
8.
Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol. 2006;26(5):968–76.CrossRefPubMed
9.
Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA. 2007;298(17):2028–37.CrossRefPubMed
10.
Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293(15):1861–7.CrossRefPubMed
11.
Davalos ME, French MT. This recession is wearing me out! Health-related quality of life and economic downturns. J Ment Health Policy Econ. 2011;14(2):61–72.PubMed
12.
Riazi A, Shakoor S, Dundas I, Eiser C, McKenzie SA. Health-related quality of life in a clinical sample of obese children and adolescents. Health Qual Life Outcomes. 2010;8:134.PubMedCentralCrossRefPubMed
13.
Chen G, Ratcliffe J, Olds T, Magarey A, Jones M, Leslie E. BMI, health behaviors, and quality of life in children and adolescents: a school-based study. Pediatrics. 2014;133(4):e868–74.CrossRefPubMed
14.
15.
Larsson U, Karlsson J, Sullivan M. Impact of overweight and obesity on health-related quality of life--a Swedish population study. Int J Obes Relat Metab Disord. 2002;26(3):417–24.CrossRefPubMed
16.
Ul-Haq Z, Mackay DF, Fenwick E, Pell JP. Meta-analysis of the association between body mass index and health-related quality of life among children and adolescents, assessed using the pediatric quality of life inventory index. J Pediatr. 2013;162(2):280–6.CrossRefPubMed
17.
Renzaho A, Wooden M, Houng B. Associations between body mass index and health-related quality of life among Australian adults. Qual Life Res. 2010;19(4):515–20.CrossRefPubMed
18.
Wee HL, Cheung YB, Loke WC, Tan CB, Chow MH, Li SC, et al. The association of body mass index with health-related quality of life: an exploratory study in a multiethnic Asian population. Value Health. 2008;11 Suppl 1:S105–14.CrossRefPubMed
19.
Takahashi Y, Sakai M, Tokuda Y, Takahashi O, Ohde S, Nakayama T, et al. The relation between self-reported body weight and health-related quality of life: a cross-sectional study in Japan. J Public Health (Oxf). 2011;33(4):518–26.CrossRef
20.
Jia H, Lubetkin EI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf). 2005;27(2):156–64.CrossRef
21.
Wang R, Wu MJ, Ma XQ, Zhao YF, Yan XY, Gao QB, et al. Body mass index and health-related quality of life in adults: a population based study in five cities of China. Eur J Public Health. 2012;22(4):497–502.CrossRefPubMed
22.
Zhu YB, Luo XX, Wang Q. Study on the relationship between body mass index and health-related quality of life in middle-aged or older Chinese adults. Zhonghua Liu Xing Bing Xue Za Zhi. 2009;30(7):687–91.PubMed
23.
Xu Y, Gao J, Zhou Z, Xue Q, Yang J, Luo H, et al. Measurement and explanation of socioeconomic inequality in catastrophic health care expenditure: evidence from the rural areas of Shaanxi Province. BMC Health Serv Res. 2015;15:256.PubMedCentralCrossRefPubMed
24.
25.
WHO. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO consultation on Obesity. Geneva: WHO; 2001.
26.
27.
Liu GG, Wu H, Li M, Gao C, Luo N. Chinese time trade-off values for EQ-5D health states. Value Health. 2014;17(5):597–604.CrossRefPubMed
28.
Chen G, Yan X. Demand for voluntary basic medical insurance in urban China: panel evidence from the Urban Resident Basic Medical Insurance scheme. Health Policy Plan. 2012;27(8):658–68.CrossRefPubMed
29.
Hunger M, Schunk M, Meisinger C, Peters A, Holle R. Estimation of the relationship between body mass index and EQ-5D health utilities in individuals with type 2 diabetes: evidence from the population-based KORA studies. J Diabetes Complications. 2012;26(5):413–8.CrossRefPubMed
30.
Tan Z, Liang Y, Liu S, Cao W, Tu H, Guo L, et al. Health-related quality of life as measured with EQ-5D among populations with and without specific chronic conditions: a population-based survey in Shaanxi Province. China Plos One. 2013;8(7):e65958.CrossRefPubMed
31.
Heo M, Allison DB, Faith MS, Zhu S, Fontaine KR. Obesity and quality of life: mediating effects of pain and comorbidities. Obes Res. 2003;11(2):209–16.CrossRefPubMed
32.
Bin Li Z, Yin Ho S, Man Chan W, Sang Ho K, Pik Li M, Leung GM, et al. Obesity and depressive symptoms in Chinese elderly. Int J Geriatr Psych. 2004;19(1):68–74.CrossRef
33.
Wiesenfeld-Hallin Z. Sex differences in pain perception. Gender Med. 2005;2(3):137–45.CrossRef
34.
Hongo M, Miwa H, Kusano M. Symptoms and quality of life in underweight gastroesophageal reflux disease patients and therapeutic responses to proton pump inhibitors. J Gastroenterol Hepatol. 2012;27(5):913–8.CrossRefPubMed
35.
Suastika K, Dwipayana P, Saraswati MR, Gotera W, Budhiarta AA, Sutanegara ND, et al. Underweight is an important risk factor for coronary heart disease in the population of Ceningan Island. Bali Diab Vasc Dis Res. 2012;9(1):75–7.CrossRefPubMed
36.
Sach TH, Barton GR, Doherty M, Muir KR, Jenkinson C, Avery AJ. The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D. Int J Obes (Lond). 2007;31(1):189–96.CrossRef
37.
Krul AJ, Daanen HA, Choi H. Self-reported and measured weight, height and body mass index (BMI) in Italy, the Netherlands and North America. Eur J Public Health. 2011;21(4):414–9.CrossRefPubMed
38.
Dekkers JC, van Wier MF, Hendriksen IJ, Twisk JW, van Mechelen W. Accuracy of self-reported body weight, height and waist circumference in a Dutch overweight working population. BMC Med Res Methodol. 2008;8:69.PubMedCentralCrossRefPubMed
39.
Lucca A, Moura EC. Validity and reliability of self-reported weight, height and body mass index from telephone interviews. Cad Saude Publica. 2010;26(1):110–22.CrossRefPubMed
40.
Lv S, Su JX, Quan Y, Wu M. Analysis on the knowing rates and accuracies of self-reported height, weight and waist circumstance data of adults. Jiangsu J Prev Med. 2012;23(5):13–5.
Metadata
Title
Exploring the nonlinear relationship between body mass index and health-related quality of life among adults: a cross-sectional study in Shaanxi Province, China
Authors
Yongjian Xu
Zhongliang Zhou
Yanli Li
Jinjuan Yang
Xiaoyuan Guo
Jianmin Gao
Ju’e Yan
Gang Chen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0347-9

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