Relationship between weight status and health-related quality of life in Chinese primary school children in Guangzhou: a cross-sectional study

Abstract

BackgroundTo investigate the association between weight status and health-related quality of life (HRQOL) among pupils in Guangzhou, China.MethodsThe study comprised 5781 children aged 8–12 years from 29 schools. Height and weight were objectively measured using standardized methods, and BMI z-score derived using the age and sex specific WHO reference 2007 for 5–19 years. Weight status was classified as underweight (<−2SD), healthy weight (between -2SD and 1SD), overweight/obesity (>1SD). HRQOL was measured by the self-report version of the Pediatric Quality of Life Inventory 4.0.ResultsAfter controlling for gender, age, school type, parental education, and family income, HRQOL scores were significantly lower in overweight/obese compared with healthy weight children only in the social functioning domain (β = −1.93, p = 0.001). Compared with healthy weight children, underweight children had significantly lower total (β = −1.47, p = 0.05) and physical summary scores (β = −2.18, p = 0.02). Subgroup analysis for gender indicated that compared to healthy weight, total (β = −1.96, p = 0.02), psychosocial (β = −2.40, p = 0.01), social functioning (β = −3.36, p = 0.001), and school functioning (β = −2.19, p = 0.03) scores were lower in overweight/obese girls, but not boys. On the other hand, being underweight was associated with lower physical functioning (β = −2.27, p = 0.047) in girls, and lower social functioning (β = −3.63, p = 0.01) in boys. The associations were mainly observed in children aged 10 and over, but were not significant in younger children. Children from private schools had generally lower HRQOL compared to those in public schools, but the associations with weight status were similar in both groups.ConclusionsThe relationship between overweight/obesity and HRQOL in children in China is not as prominent as that seen in children in western or high-income countries. However, there appears to be gender and age differences, with more of an impact of overweight on HRQOL in girls and older children compared with boys and younger children. Underweight is also associated with lower HRQOL. Future intervention to prevent both obesity and undernutrition may have a positive impact on the HRQOL in children in China.

Measuring health-related quality of life in elementary and secondary school students using the Chinese version of the EQ-5D-Y in rural China

“…Although the symptoms incurred from myopia or abnormal weight might be minor compared to those from severe conditions such as acute lymphoblastic leukemia, this yet implies the EQ-5D-Y may not be sensitive to them, which is similar to the findings reported in previous studies [8,16]. Indeed, studies using the PedsQL 4.0 in China found that the two conditions did have significant lower HRQOL scores than healthy children and adolescents in one or several aspects [24,30]. Hence, it has to be used with caution in children and adolescents with minor or no health conditions.…”

“…We also examined the difference in frequency between groups known to be different in health status. The groups included: 1) those with and without myopia; 2) those who were underweight, normal weight, and overweight according to BMI level [30]. The EQ-5D-Y may not differentiate the differences between the groups given the nature of the two conditions and study samples [8,16].Chi-square or Fisher's exact test were performed whenever appropriate to test whether there were statistically significant difference between the groups in the percentage; and the categories 'some' and ' a lot of' were collapsed to a single category ('any problem').…”

Prevalence of body dissatisfaction and its effects on health-related quality of life among primary school students in Guangzhou, China

“…However, the evidence supporting an association in population-based samples has remained inconclusive. A large number of relevant population-based studies have shown a significant inverse association between obesity and HRQoL, particularly in the physical, social and school domains [7–9]. However, other studies have found no associations between weight status and HRQoL [10–12].…”

Obesity and health-related quality of life in adolescents from ethnic groups of rural areas of Buryatia, Russia

“…Другое исследование, проведенное в Кувейте и спланированное, подобно представленному на парных выборках, показало, что ожирение затрагивает СÇКЖ детей только в области физического функционирования [27]. Еще два исследования, проведенные в Китае (Гуанчжоу), показали, что за исключением в одном из них школьного [28], а в другом социального [29] функционирования, ожирение не имело значимого влияния на СÇКЖ. Можно заметить, что все упомянутые исследования не включали детей европеоидных ýтносов, поýтому логичным объяснением наших находок может быть влияние на восприятие избыточного веса культурных традиций того или иного ýтноса.…”