Gender differences in the association between body mass index and health-related quality of life among adults:a cross-sectional study in Shandong, China

Abstract

Background This study aims to assess the association between body mass index (BMI) and health-related quality of life (HRQOL), and to further explore gender differences in BMI-HRQOL association among adults. Methods We used data from the fifth Health Service Survey of Shandong Province, which was part of China’s National Health Service Survey (NHSS), a total of 27,257 adults aged 18 and over were interviewed. The HRQOL was measured using the EuroQOL-5 Dimensions (EQ-5D) instrument. One-way ANOVA and Post hoc tests were used to compare EQ-5D utility values and visual analogue scale (VAS) scores between BMI categories. Tobit regression models were used to identify the association between BMI and HRQOL for male and female separately after controlling for influential confounders, and to assess gender differences on the relationship between BMI and HRQOL. Results The prevalence of underweight in men and women were 3.2 and 5.3%, respectively, while the prevalence of overweight/obesity in men and women were 35.7 and 34.6%, respectively. Men had higher EQ-5D utility values and VAS scores than women. The mean EQ-5D utility value and VAS score was highest in obese men and normal-weight women, respectively. After controlling potential confounders, being underweight was significantly and negatively associated with lower HRQOL among adults. The relationship between obesity and gender was that in women obesity was negatively and significantly associated with HRQOL, whereas in men this association was positive but not statistically significant. Results of gender by BMI interaction in regression model showed that this difference between men and women in this respect was significant. Conclusions The association between BMI and HRQOL differed by gender and the so-called “obesity-HRQOL paradox” phenomenon was verified in male adults . Gender difference should be considered when implementing targeted weight control programs and appropriate interventions to improve HRQOL.

Associations between perceived environmental pollution and health-related quality of life in a Chinese adult population

“…Regarding the association between BMI and HRQoL, the findings in this study were in line with an England study that there was a significant association between BMI and HRQoL in the general population [103]. The findings in this study were not in agreement with inverse association between BMI and self-reported physical HRQoL [104], inverse association between BMI and physical HRQoL and positive association between BMI and mental HRQoL [105], inverse U-shaped association scores [106], and complex association [107]. Regarding the association between smoking and HRQoL, the findings in this study were not in agreement with inverse association [108][109][110][111][112].…”

Mass Spectrometry-Based Metabolomics Analysis of Obese Patients’ Blood Plasma

“…Meanwhile, another study has reported that the association between obesity and a lower HRQOL was significant for women, but not for men [21]. Furthermore, it has been demonstrated that obesity in women was negatively and significantly associated with HRQOL, whereas in men this association was positive but not statistically significant [29]. The overall view on the metabolic pathways provided by our approach may give a possible explanation for these findings.…”

“…The association between BMI and HRQOL differs by gender. Therefore, there was evidence of the so-called "obesity-HRQOL paradox" [29], with more pronounced alterations in metabolic pathways in women, whereas men at the same BMI values have alterations in the same pathways and in the same direction (downregulated), but they are sufficiently less pronounced. Our results suggest that from the viewpoint of biochemical insights, the BMI borders should be corrected to make them more consistent with the HRQOL, which will make the BMI more valid for implementing targeted weight control programs and appropriate interventions to improve the HRQOL.…”

Associations between perceived environmental pollution and health-related quality of life in a Chinese adult population

“…Regarding the association between BMI and HRQoL, the findings in this study were not in agreement with inverse association between BMI and physical HRQoL and positive association between BMI and mental HRQoL [67], inverse U-shaped association scores [68], and complex association [69]. Regarding the association between smoking and HRQoL, the findings in this study were not in agreement with inverse association [70][71][72].…”