Health-Related Quality of Life in Tehran Lipid and Glucose Study

The role of changes in metabolic syndrome status on health-related quality of life in Bogor City, West Java, Indonesia: A cross-sectional study

Background

Metabolic syndrome (MetS) is a cluster of chronic conditions, including central obesity, hypertension, impaired glucose metabolism, and dyslipidemia (low HDL, high LDL, and triglycerides). A diagnosis of MetS is made when three or more of these symptoms are present. If left unmanaged, MetS can lead to serious health complications such as cardiovascular disease and type 2 diabetes. Over time, individuals with MetS may experience a decline in their health-related quality of life (HRQoL), especially due to its chronic nature.

Objective

This study aimed to evaluate the effects of changes in MetS status on HRQoL.

Methods

This study employed a cross-sectional design. Secondary data from the cohort study of Non-Communicable Disease (NCD) risk factors, conducted by the Health Research and Development Agency of the Ministry of Health of the Republic of Indonesia in Bogor City, was used. Data from four follow-up periods (2011/2012 to 2017/2018) were analyzed. A total of 874 respondents were selected via total sampling based on inclusion and exclusion criteria. Data were collected in 2021, which included measures of knowledge, health check-ups, and HRQoL using the SF-36 questionnaire. Statistical analyses, including chi-square tests, t-tests, and multiple regression analyses, were conducted to examine the associations between MetS status and HRQoL.

Results

Descriptive analysis revealed that 19% (171 participants) had worsened MetS status, while 80.4% (703 participants) showed improvement. Chi-Square analysis found that respondents with worsening MetS status were 1.6 times more likely to experience poor HRQoL in the physical dimension (95% CI = 1.1-2.3), but no significant effect was found for the mental dimension (PR = 1.1, 95% CI = 0.8-1.6). Multiple logistic regression analysis revealed that comorbidities interacted with worsening MetS status to significantly affect HRQoL in the physical dimension. The adjusted prevalence ratios (PR) were 27.5 (95% CI = 10.3-73.2) for those with comorbidities and 9.2 (95% CI = 5.7-15.0) for those without comorbidities, after controlling for age, mental health, BMI changes, routine health checks, and knowledge.

Conclusion

Changes in MetS status towards worsening have a significant negative effect on HRQoL, particularly in the physical dimension. The presence of comorbidities in individuals with worsening MetS status greatly increases the risk of poor HRQoL. Healthcare professionals and nurses should consider the interaction between MetS and comorbidities in patient management. Nurses are encouraged to monitor HRQoL in patients with MetS, promote education on managing comorbidities, and collaborate across disciplines to enhance patient care and intervention programs aimed at improving HRQoL.

Abdominal obesity and hypertension are correlated with health-related quality of life in Taiwanese adults with metabolic syndrome

OBJECTIVE

Metabolic syndrome (MetS) gains more attention due to high prevalence of obesity, diabetes and hypertension among adults. Although obesity, diabetes and hypertension can certainly compromise health-related quality of life (HRQoL), the correlations of sociodemographic factors, quality of life and MetS remains unclear. This study aims to investigate the association between HRQoL and MetS in an Asian community of the sociodemographic characteristics.

RESEARCH DESIGN AND METHODS

We performed a cross-sectional study by recruiting 2588 Taiwanese patients aged ≥30 years between August 2015 and August 2017. Sociodemographic data and anthropometric variables were obtained from medical records and physical examination. Meanwhile, HRQoL was assessed by 36-Item Short-Form Health Survey questionnaires.

RESULTS

The overall prevalence of MetS was 32.8%. Multivariate analysis revealed that age ≥65 years (OR=1.987, p<0.001), body mass index (BMI) ≥24 kg/m² (OR=7.958, p<0.001), low educational level (OR=1.429, p=0.014), bad self-perceived health status (OR=1.315, p=0.01), and betel nut usage (OR=1.457, p=0.048) were associated with the development of MetS. For patients with MetS, the physical and mental health domains of HRQoL are negatively correlated with abdominal obesity and hypertension, respectively.

CONCLUSIONS

Adult MetS in Taiwan was associated with certain sociodemographic factors including older age, high BMI, low educational level, bad self-perceived health status, and betel nut use. Abdominal obesity and hypertension was correlated with HRQoL in patients with MetS.

Contributions and Implications of the Tehran Lipid and Glucose Study

Tehran Lipid and Glucose Study (TLGS), an epidemiological study of non-communicable disease with 20 years follow up in a developing country in nutrition transition is a unique study in 15000 family based individuals, 3 - 75 years of age in a part of large city of Tehran. The success rate of recruitment for 20 years, intervention for lifestyle change, and thyroid, reproduction and cardiometabolic genetic studies derived from TLGS have paved suitable path towards precision medicine. In this review, baseline findings and changes of risk factors for the development of NCD including body weight, nutrition, physical activity, blood pressure, tobacco smoking, serum glucose and serum lipids as well as metabolic syndrome, chronic kidney disease, quality of life and biochemical findings in TLGS cohort have been summarized. The results of community based intervention for lifestyle change caused decreases in the prevalence of metabolic syndrome and the incidence of diabetes. It is concluded that TLGS has served as a model for other cohort studies in Iran and the region; it has helped to mobilize scientists in developing countries; it has established locally needed definitions of NCD variables; has served as a model for cohort studies in developing countries in nutrition transition with all socioeconomic constraints and has helped manpower education and development of local CVD risk scores for implementation of NCD management.