Do Metabolically Healthy People with Obesity Have a Lower Health-Related Quality of Life? A Prospective Cohort Study in Taiwan

The association between metabolically healthy obesity (MHO) and health-related quality of life (HRQOL) has not been thoroughly evaluated. This study enrolled 906 adult participants aged 35–55 years between 2009 and 2010 in Northern Taiwan; 427 participants were followed up after eight years. Normal weight, overweight, and obesity were evaluated via body mass index. Metabolic health was defined as the absence of cardiometabolic diseases and having ≤1 metabolic risk factor. HRQOL was evaluated using the 36-Item Short Form Health Survey (SF-36), Taiwan version. Generalized linear mixed-effects models were used to analyze the repeated, measured data with adjustment for important covariates. Compared with metabolically healthy normal weight individuals, participants with metabolically unhealthy normal weight and obesity had a significantly poorer physical component summary score (β (95% CI) = −2.17 (−3.38–−0.97) and −2.29 (−3.70–−0.87), respectively). There were no significant differences in physical and mental component summary scores among participants with metabolically healthy normal weight, overweight, and obesity. This study showed that metabolically healthy individuals with obesity and normal weight had similar HRQOL in physical and mental component summary scores. Maintaining metabolic health is an ongoing goal for people with obesity.

Clinical Manifestations, Histopathological Changes And Quality Of Life In Patients With Advanced Knee Osteoarthritis Caused By Age, Trauma, Obesity And Their Combination

Objective — to reveal and analyze clinical characteristics, knee joint histopathology, and quality of life in patients at late stages of knee osteoarthritis (OA) triggered by age, trauma, metabolic syndrome, or their combination. Material and methods — We studied 120 subjects with knee OA (sensu Altman R.D., 1991) of Kellgren-Lawrence Grades 3-4. They were distributed among 4 groups (30 participants in each) based on the presence of age-related, post-traumatic, metabolic, or combined phenotypes. Clinical examination of patients with pain and their functional status evaluation (via Visual Analogue Scale, WOMAC, Lequesne index), quality of life assessment (MOS SF-36 questionnaire), along with histopathological study of medial tibial plateau cartilage and synovial membrane, were caried out, followed by statistical data processing. Results — Age-related OA phenotype was characterized by the latest clinical onset [59.5 (54-68) years of age] with the largest average patient age [72.5 (63-77) years], moderate to severe pain and knee dysfunction [total WOMAC score of 160 (127-190) points and Lequesne index of 20 (8-21) points], severe degenerative cartilage lesions [8.5 (6-10) points sensu Mankin] with high-grade synovitis [5 (3-8) points sensu Krenn]. Post-traumatic OA phenotype was distinguished by the lowest pain, stiffness and knee functional limitations [total WOMAC score of 129 (100-166), Lequesne index of 15 (14-19)], the highest quality of life in patients [physical component summary of 34.1 (30.5-36.1) points, mental component summary of 40.4 (32.9-43.8) points] against the background of local severe cartilage lesions [8 (6-8) sensu Mankin] with reparative pattern and synovial fibrosis. For metabolic OA phenotype, the typical traits included female-biased sex ratio (87%), high prevalence of clinical synovitis (77%), severe pain and functional knee disorders [total WOMAC score of 188 (162-207) points, Lequesne index of 20 (19-23) points], the worst quality of life [physical component summary of 28.0 (24.3-31.9) points, mental component summary of 30.9 (26.9-35.9) points], vascular invasion of cartilage, and high-grade synovitis [4 (3-5) points sensu Krenn]. Combined OA phenotype was characterized by variable clinical and histopathological features. Conclusion — Comprehensive comparative clinical and morphological analysis of late-stage knee OA of various origin was completed, and age-related, post-traumatic, metabolic and combined OA phenotypes were studied. The methodological basis for differential approach to treating different categories of OA patients was developed.

Teacher Teleworking during the COVID-19 Pandemic: Association between Work Hours, Work–Family Balance and Quality of Life

Background: Teachers worldwide had to reinvent their work routine according to teleworking during the COVID-19 pandemic, a work format that negatively impacts individuals’ physical and mental health. This study evaluates the association between work hours, work–family balance and quality of life (QoL) among teachers during the Chilean health emergency of the COVID-19 pandemic. Teachers from across Chile were contacted via email and social media to answer an online survey. QoL was evaluated via the SF-36 questionnaire, work hours and work–family balance in the pandemic. A total of 336 teachers from across Chile participated in this study. Teachers had a low QoL score, associated with age (p < 0.05). Teachers who were ≤44 showed lower deterioration risks in the Physical Component Summary (OR: 0.54) than the ≥45-year-old age group; simultaneously, the younger group (≤44 years) had a greater risk (OR: 2.46) of deterioration in the Mental Component Summary than teachers over 45 years. A total of 78.7% of teachers reported having increased their work hours during the COVID-19 pandemic due to teleworking and 86% indicated negative effects on their work–family balance. Pandemic work hours and negative work–family balance increase the risk of reducing the Mental Component Summary (OR: 1.902; OR: 3.996, respectively). Teachers presented low median QoL scores, especially in the Mental Component Summary, suggesting that it would be beneficial to promote a better workload distribution for teachers in emergency contexts, considering the adverse effects of teleworking.

Health-Related Quality of Life in Ankle Osteoarthritis: A Case-Control Study

Objective Ankle osteoarthritis (OA) has a prevalence of 3.4% in the general population of which 70% to 78% is posttraumatic, affecting younger patients with a longer projected life span compared with hip and knee OA. The current literature reports the physical and mental quality of life (QoL) of patients with ankle OA, to be similar to end-stage hip OA, end-stage kidney disease and digestive heart failure. However, the QoL of ankle OA patients has not yet been determined compared with a matched control group representing the general population. Our aim is to determine the physical and mental QoL compared with a matched control group. Design The Physical and Mental Component Summaries of the Short Form–36 of 100 patients with ankle OA were compared with 91 age- and gender-matched controls. This case-control study is a substudy of the PRIMA trial, in which the efficacy of platelet-rich plasma injections for ankle OA is determined. Results A clinically relevant difference was found for both the Physical ( P=0.003; 95% CI −6.7 to −1.3) and Mental Component Summary scores ( P < 0.001; 95% CI −10 to −6). Patients with ankle OA had a median of 45 points (matched controls 52 points) and 43 points (matched controls 53 points) for the Physical and Mental Component summary scores, respectively. Conclusions Patients with ankle OA had a clinically relevant poorer mental and physical QoL compared with matched controls from the general population. Furthermore, the physical QoL of patients with ankle OA from younger age categories was affected more than those in older age categories.

Physical function and health-related quality of life after surgery for nontuberculous mycobacterium pulmonary disease: a prospective cohort study

Background: Nontuberculous mycobacterium pulmonary disease (NTM-PD) is a progressive condition characterized by exercise intolerance and impaired health-related quality of life (HRQOL). NTM-PD is sometimes treated with surgery in combination with medication, but little is known about the postoperative physical function and HRQOL. This study aimed to investigate the exercise capacity and HRQOL of patients with NTM-PD preoperatively and 6 months postoperatively.Methods: This prospective observational study included patients with NTM-PD and was conducted at Fukujuji Hospital. The intervention was surgical resection plus perioperative and post-discharge physical therapy. The physical function was assessed preoperatively and 6 months postoperatively using the 6-minute walk test (6MWT). HRQOL was assessed preoperatively and 6 months postoperatively using the Short-Form 36 Health Survey (SF-36) and St. George’s Respiratory Questionnaire. The postoperative HRQOL was compared between patients with and without preoperative clinical symptoms.Results: In total, 35 patients were analyzed. Preoperative clinical symptoms were present in 20 of 35 patients (57%), and the preoperatively symptomatic group had significantly lower preoperative HRQOL than the preoperatively asymptomatic group (p < 0.05). Thirty-two patients completed the 6-month follow-up. Compared with preoperatively, there were significant improvements at 6 months postoperatively in the 6MWT (p < 0.01) and HRQOL, mainly in the SF-36 mental component summary (p < 0.01). The SF-36 mental component summary in the preoperatively symptomatic group was very significantly improved from preoperatively to 6 months postoperatively (p < 0.05).Conclusions: The combination of surgical treatment and physical therapy for NTM-PD contributes to improvements in physical function and HRQOL.

The validation of the measurement of the mental and physical components of SF-12 in Iranian elderly

This study aimed to assess the validity and reliability of the mental component summary (MCS) and physical component summary (PCS) of SF-12. 140 Iranian elderly aged 60 years and older from the general population (100 male vs 40 female) of the Shiraz city were recruited by convenient sampling. The questionnaire on quality of life (SF-12, two dimensions: the physical component α = 0.68; and the mental component α = 0.71) was used to collect the data analyzed with the AMOS software. According to the structural equation model (SEM), four subscales of SF-12 (emotional role, social function, vitality and mental health) can predict mental component summary (respectively: coefficient = 0.65, 0.57, 0.78 and 0.90) and four subscales of SF-12 (general health, physical function, bodily pain and physical role) can predict physical component summary (respectively: coefficient = 0.58, 0.70, 0.74 and 0.88). The goodness-of-fit indices showed that the model for predicting mental and physical components in the elderly was excellent (X2 / df = 1.61, RMSEA= 0.07, CFI = 0.96 and NFI=0.92).

The Associations Between Blood Pressure and Quality of Life in Elderly Patients with Hypertension in China

Objective: To investigate the status of quality of life (QOL) and examine the changes in quality of life with increasing age in elderly patients with hypertension; to determine the associations between blood pressure and quality of life in hypertensive elderly at different age groups; to determine the relationships between ranges of blood pressure and quality of life. Method: This was a cross-sectional study design. The study recruited 752 elderly patients with hypertension from one general hospital, thirty urban community clinics and rural clinics in Suzhou from October 2016 to October 2017.The quality of life was assessed by The Short Form Health Survey (SF-36), which is categorized into two aggregate summaries, including physical component summary (PCS) and mental component summary (MCS). Furthermore, PCS included four dimensions, namely; physical functioning (PF), role limitation because of physical health (RP), bodily pain (BP) and general health perceptions (GH); MCS included another four dimensions, namely; vitality (VT), social functioning (SF), role limitation because of emotional health problems (RE) and mental health (MH). Result: The result showed that scores of physical component summary (PCS) gradually decreased and scores of mental component summary (MCS) was stable with increasing age. In PCS, the scores of the bodily pain and physical functioning dimensions and in MCS the social functioning dimension score dropped in participants with age ≥ 85 years. Following analysis, the results showed that diastolic blood pressure (DBP) was positively associated with PCS (r=0.112, P =0.003). We further analyzed the relationship between DBP and PCS (including 4 dimensions) of quality of life at different age groups. We found that DBP had a positive relationship with PSC (r=0.114, P =0.003) and the bodily pain dimension (r=0.205, P < 0.001) in the elderly with an age < 85 years, while there was no relationship between DBP and PCS in the elderly with an age ≥ 85 years. After adjusting for the effects of socio-demographic and clinical factors, there was no association between DBP and PCS (B=0.026, P= 0.633), while DBP still had a positive effect on the bodily pain dimension (B=0.234, P= 0.026). Conclusions: We found that DBP had a positive relationship with physical quality of life in the elderly with age < 85 years.Therefore, medical personnel should maintain the DBP within normal range but may allow higher level, when managing hypertensive elderly patients aged < 85 years, so as to relieve their pain, which can help improve their quality of life.

A Longitudinal Analysis of SF-36 scores Within the Candrive Cohort: An Example of Survivor Bias

A bias inherent to prospective studies is focusing only on individuals who remain in the study; these individuals may differ from those who leave early. To examine this issue, we analyzed SF-36 scores by completion status for individuals enrolled in the seven-year Candrive cohort. The SF-36 provides a self-reported evaluation of health and well-being along two subscales, the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Of 928 participants in the cohort, 887 had at least two consecutive years of data starting at baseline (age=76.17, SD=4.81; 61.9% male). A total of 142 participants had 7 years of data. Study discontinuation (due to withdrawal, driving cessation, or death) happened least in early years, and peaked after 6 years (n=235). When analyzed according to completion status, patterns of change in SF-36 scores varied. For example, participants with 7 years of data had mean PCS scores ranging from 51.41 (SD=7.92) at baseline to 46.93 (SD=9.46) at year 7, a change of 0.75 points per year. For those with only two years of data, scores were lower and dropped from 45.82 (SD=9.98) to 43.59 (SD=10.90), a change of 2.23 points over a single year (p&lt;.001). Differences are also evident for other groups. While the results indicate relative stability of SF-36 scores among participants who remained in the study, participants who dropped out reported greater deterioration in scores. These results highlight important differences between participants based on completion status.

Family Function and Health-Related Quality of Life Among Low-Income Residents with Hypertension: A Cross-Sectional Study in Central China

Backgroud Family is the most important social support available to hypertensive patients, which may affect their health-related quality of life (HRQOL) and health outcomes. However, data on the relationship between family function and HRQOL among hypertensive residents are sparse, particularly for those low-income residents with hypertension. In this study, we aimed to examine the effects of family function on physical and mental health among low-income residents with hypertension in Central China, and to explore the independent contributions of socio-demographic variables, health-related factors and family function to each domain of HRQOL. Methods This cross-sectional, community-based survey, studied 295 low-income residents with hypertension. Family function was measured using the Family APGAR Index (Adaptation, Partnership, Growth, Affection, and Resolve). HRQOL was assessed using the SF-12 Questionnaire. Clustered multiple linear regressions were used to analyze the independent contributions of family function to each domain of HRQOL.Results 35.90% of low-income hypertensive residents had highly functional family. Multiple regression analyses showed that those with higher Family APGAR scores obtained higher general health (β=0.168, P=0.008), bodily pain(β=0.167, P=0.008), mental component summary (β=0.330, P<0.001), role limitations due to emotional problems (β=0.138, P=0.022), mental health (β=0.302, P<0.001), vitality (β=0.264, P<0.001), and social function (β=0.312, P<0.001) scores, whereas no independent contribution of family function to physical component summary was observed. On these subscales, the independent contributions of family function accounted for 15.75%, 14.29%, 39.63%, 5.47%, 94.67%, 51.92% and 57.58%, respectively (more than all socio-demographic and health-related variables in the MH, VT and SF domains). Conclusion Family function was significantly associated with HRQOL among low-income hypertensive residents. This relation holds for both mental component summary and each of its individual domains, as well as partial physical domains.

Health-Related Quality of Life of Military Policemen in Salvador, Brazil: Cross-Sectional Study.

Background: Brazil is a violent society and police officers play a fundamental role in this scenario. Police work is a stressful occupation. Dealing with routine violence, police officers must have high standards of physical and mental health. Patrolling the streets involves several risks and stressful situations that may hamper military policemen's quality of life. This study aimed to identify factors associated with health-related quality of life in military policemen. Methods: A cross-sectional design study investigated a random sample of 329 male military police officers, engaged in patrolling the streets of Salvador, Bahia, Brazil. A structured questionnaire was applied to the policemen during their working hours. Information was collected about age, education, marital status, housing, car ownership, police rank, working day, alcohol consumption, smoking, frequency of vigorous physical activity and weight and height, in order to calculate body mass index. Health-related quality of life was evaluated through the 36-Item Short Form Survey Questionnaire (SF-36). Work ability was assessed through the Work Ability Index questionnaire. Poor work ability was defined by a Work Ability Index 7-27 points. Multivariable linear regression models were used to measure the impact of police officer characteristics on variation in the Physical Component and Mental Component Summary scores.Results: Normalised scores were below 50.0 for seven out of the eight SF-36 domains and for the two component summaries. The SF-36 Physical Component Summary was associated with poor work ability, while the Mental Component Summary was associated with poor work ability, excessive alcohol consumption, and younger age. Poor work ability affected 10.3% of the workforce. Decreases of 7.363 units (%) in the Physical Component Summary mean and of 12.862 units (%) in the Mental Component Summary mean were estimated for policemen with poor work ability.Conclusions: The military police officers investigated presented poor health-related quality of life, associated with younger age, excessive alcohol consumption, and poor work ability, which may hamper the performance of their professional activities.