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

Tuesday, 19 August 2014
Exhibit hall (Dena'ina Center)
Jacqueline Müller-Nordhorn, MD , Berlin School of Public Health, Berlin, Germany
Rebecca Muckelbauer, PhD , Berlin School of Public Health, Berlin, Germany
Heike Englert, PhD , University of Applied Sciences, Münster, Germany
Ulrike Grittner, PhD , Institute of Biometry and Clinical Epidemiology, Berlin, Germany
Hendrike Berger, PhD , Faculty of Applied Sciences, Osnabrück, Germany
Christof Prugger, MD , Paris Cardiovascular Research Centre, Paris, France
Karl Wegscheider, PhD , Department of Medical Biometry and Epidemiology, Hamburg, Germany
Stefan N Willich, MD , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
INTRODUCTION: 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.

METHODS: We included included high-risk cardiovascular primary care patients with hypercholesterolemia and an indication for statin therapy. 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.

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 (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.

CONCLUSIONS: Increases in BMI were associated with decreases in physical HRQoL, particularly in obese persons 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.