Dataset Information

Which obesity phenotypes predict poor health-related quality of life in adult men and women? Tehran Lipid and Glucose Study.

ABSTRACT:

Purpose

This study aimed to explore the association between different obesity phenotypes and health-related quality of life (HRQoL) among Tehranian men and women.

Methods

The participants of this study were 2880 healthy adults (aged>19 years) who participated in Tehran Lipid and Glucose Study (TLGS). To obtain socio-demographic and HRQoL information, participants were interviewed by trained interviewers and were stratified by body mass index categories and metabolic status. Dysmetabolic status was defined as having either metabolic syndrome or diabetes according to the Joint Interim Statement definition and American Diabetes Association. Poor HRQoL was defined as the first quartile of HRQoL scores and logistic regression analysis was used to compare sex-specific odds ratios.

Results

Mean age of participants was 47.7±15.6 and 47.8±14.2 years in men and women respectively. The most and the least common obesity phenotypes were overweight-normal metabolic status and normal weight-dysmetabolic status, respectively. Only mean scores for physical HRQoL were significantly different among obesity phenotypes in both men and women (p<0.05). In addition, after adjusting for age, marital status, level of education, job status and physical activity, the odds of reporting poor physical HRQoL was significantly higher in men (OR: 1.960, 95% CI: 1.037-3.704; p<0.05) and women (OR: 2.887, 95% CI: 1.674-4.977; p<0.001) with obese-dysmetabolic status, compared to their counterparts with normal weight-normal metabolic status. However, except for overweight-normal metabolic women, who were less likely to report poor mental HRQoL (OR: 0.638, 95% CI: 0.415-0.981; p<0.05), none of the phenotypes were associated with poor mental HRQoL in either gender.

Conclusions

Compared to those with normal weight normal metabolic status, only obese dysmetabolic individuals were more likely to report poor physical HRQoL in both genders.

SUBMITTER: Amiri P

PROVIDER: S-EPMC6135393 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Which obesity phenotypes predict poor health-related quality of life in adult men and women? Tehran Lipid and Glucose Study.

Amiri Parisa P Jalali-Farahani Sara S Rezaei Marjan M Cheraghi Leila L Hosseinpanah Farhad F Azizi Fereidoun F

PloS one 20180912 9

<h4>Purpose</h4>This study aimed to explore the association between different obesity phenotypes and health-related quality of life (HRQoL) among Tehranian men and women.<h4>Methods</h4>The participants of this study were 2880 healthy adults (aged>19 years) who participated in Tehran Lipid and Glucose Study (TLGS). To obtain socio-demographic and HRQoL information, participants were interviewed by trained interviewers and were stratified by body mass index categories and metabolic status. Dysmet ...[more]

PMID: 30208087

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Project description:BackgroundTo investigate the association between different obesity phenotypes and the risk of incident hypertension among both genders.MethodsThe study population included 3659 Iranians (men?=?1540), aged ?20?years free of hypertension at baseline. Participants were classified into six categories of body mass index (BMI)-metabolic health status, in which unhealthy metabolic status was defined based on the presence of >?1 component of metabolic syndrome (MetS) using the joint interim statement (JIS) criteria or the presence of insulin resistance (IR). The association between different obesity phenotypes and incident hypertension was assessed using multivariate Cox's proportional hazard models adjusted for age, current smoking, low physical activity, diabetes mellitus, family history of premature cardiovascular disease, estimated glomerular filtration rate, phase of recruitment, BMI and systolic blood pressure, considering metabolically healthy normal weight group as the reference.ResultsAfter a median follow-up of 11.6?years 1122 participants (men?=?493) experienced hypertension. Using JIS criteria, a significant higher risk of hypertension was observed among metabolically healthy obese and well as metabolically unhealthy groups among men in the age adjusted model; however, a significant higher risk in the fully adjusted model was seen among women in the metabolically healthy obese [hazard ratio (HR) 95% confidence interval (CI) 1.96(1.16-3.32)] as well as metabolically unhealthy normal weight [1.98(1.37-2.86)], overweight [2.08(1.49-2.90)] and obese [2.06(1.27-3.30)] groups. Using insulin sensitive normal weight group as the reference, among men, being overweight or obese with and without IR was significant predictors of incident hypertension in the age adjusted model; however, among women, insulin resistant overweight [1.46(1.06-2.02)] and obese groups, [1.63(1.01-2.62)] showed significant risk in the fully adjusted model.ConclusionWe concluded that first, there was significant difference between genders in the associations between obesity phenotypes and incident hypertension. Second, in general, metabolic status defined by MetS components as compared to IR could do better in identifying high risk women for hypertension. Third, women populations who are metabolically healthy obese using MetS definition or those with either >?1 component of metabolic syndrome or overweight/obese ones with IR should be prioritized for implementing urgent preventive strategies against hypertension focusing on lifestyle changes.

Project description:Health-related quality of life (HRQOL) is a multi-dimensional concept that is affected by different variables. A large body of evidence shows that socio-demographic factors have a significant influence on HRQOL. When considering differences in cultural contexts and social values of various countries and the lack of evidence regarding socio-demographic determinants of HRQOL among the Iranian general population, it is important to verify the main socio-demographic determinants of HRQOL in an urban Iranian population.This study aimed to explore socio-demographic factors associated with HRQOL and to ascertain the determinants of poor HRQOL in participants of the Tehran lipid and glucose study (TLGS).The participants included 3491 adults, aged ≥ 20 years, who had participated in the TLGS. To obtain socio-demographic and HRQOL information, participants were interviewed by trained interviewers. Mean HRQOL scores were compared using the student's t test and analysis of variance (ANOVA). To determine significant determinants of poor HRQOL, multivariate logistic regression analysis was performed.Mean ages of males and females were 47.7 ± 15.6 and 47.8 ± 14.2 years, respectively and 58.6% of participants were male. Males had significantly higher scores compared to females in both the physical and mental domains of HRQOL (P < 0.001). In males, significant determinants of poor physical HRQOL were older age, being married, being unemployed yet having other sources of income, having literacy levels below high school diploma, and having chronic diseases (P < 0.05). In females, however older age and being housewives were significant determinants of poor physical HRQOL (P < 0.05). In addition, significant determinants of poor mental HRQOL were younger age and being single or divorced/widowed in males and younger age and being illiterate as well as having literacy levels below high school diploma in females (P < 0.05).Current findings highlight the importance of socio-demographic determinants of HRQOL in both genders, specifically in the physical domain, and demonstrate their roles to be more prominent in males. These findings highlight gender-specific associations between socio-demographic factors and various aspects of HRQOL among the TLGS population, which could be applied in future research focusing on non-communicable diseases and planning health promotion programs.

Project description:BackgroundTo assess the impact of changes in different glucose tolerance states on risk of incident cardiovascular disease (CVD)/coronary heart disease (CHD).MethodsA total of 4094 Iranians (43.9% men) aged???30 years, without diabetes and CVD at enrolment were included. The following categories were defined both at baseline visit and 3 years later (second visit): normal fasting glucose (NFG), normal glucose tolerance (NGT), NFG and NGT (NFG/NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and IFG and/or IGT (IFG/IGT). Changes in the categories, i.e. regression to normoglycemia, remaining in previous status and progression to diabetes were assessed. We used Cox's proportional hazard models adjusted for traditional risk factors and their changes, to estimate the hazard ratio (HR) with 95% confidence interval (CI) of different changing categories for incident CVD/CHD.ResultsDuring a median follow-up of 12.42 years, 428 subjects (men?=?265) experienced CVD. Considering persistent NFG/NGT as reference, participants who shifted from NFG/NGT to IFG/IGT showed a lower hazard of CVD in the fully adjusted model, HR 0.72 [95% CI 0.52-0.996, P?=?0.048]. Moreover, subjects who shifted from IFG, IGT and IFG/IGT to diabetes had an increased risk of CVD/CHD. The risk however, was only statistically significant for those with IFG/IGT, 1.61 [(1.03-2.51), P?=?0.04] for CVD and 1.75 [(1.10-2.78), P?=?0.02] for CHD; considering IFG/IGT at both visits as reference. Furthermore, those who regressed from IFG/IGT to normoglycemia were at the same risk as those remained in IFG/IGT state, 1.12 [(0.79-1.60), P?=?0.52] for CVD and 1.04 [(0.70-1.53), P?=?0.85] for CHD. Among a subgroup of population with insulin data (n?=?803) those with insulin resistance (IR) that converted to diabetes showed a higher risk for CVD, 3.68 [(1.49-9.06), P?=?0.01] and CHD, 2.76 [(1.00-7.60), P?=?0.05] events in the fully adjusted model.ConclusionsAmong participants with IFG, IGT or IFG/IGT at baseline, only those who developed diabetes had a higher risk of developing CVD/CHD. Persistent IFG/IGT was not associated with higher risk, compared with those reverted to normoglycemia. Moreover, subjects who converted from NFG/NGT to incident IFG/IGT showed a signal for lower risk of CVD/CHD.

Project description:Background Coronary heart disease (CHD) is one of the leading causes of death. Alarmingly Iranian populations had a high rank of CHD worldwide. The current study aimed to assess the prevalence of CHD across different glycemic categories. Methods This study was conducted on 7718 Tehranian participants (Men?=?3427) aged ?30?years from 2008 to 2011. They were categorized based on glycemic status. The prevalence of CHD was calculated in each group separately. CHD was defined as hospital records adjudicated by an outcome committee. The association of different glycemic categories with CHD was calculated using multivariate logistic regression, compared with normal fasting glucose /normal glucose tolerance (NFG/NGT) group as reference. Results The age-standardized prevalence of isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT), both impaired fasting glucose and impaired glucose tolerance (IFG/IGT), newly diagnosed diabetes mellitus (NDM), and known diabetes mellitus (KDM) were 14.30% [95% confidence interval (CI): 13.50–15.09], 4.81% [4.32–5.29], 5.19% [4.71–5.67], 5.79% [5.29–6.28] and 7.72% [7.17–8.27], respectively. Among a total of 750 individuals diagnosed as cases of CHD (398 in men), 117 (15.6%), 453 (60.4%), and 317 (42.3%) individuals had a history of myocardial infarction (MI), cardiac procedure, and unstable angina, respectively. The age-standardized prevalence of CHD for the Tehranian population was 7.71% [7.18–8.24] in the total population, 8.62 [7.81–9.44] in men and 7.19 [6.46–7.93] in women. Moreover, among diabetic participants, the age-standardized prevalence of CHD was 13.10 [9.83–16.38] in men and 10.67 [8.90–12.44] in women, significantly higher than corresponding values for NFG/NGT and prediabetic groups. Across six levels of glycemic status, CHD was associated with IFG/IGT [odds ratio (OR) and 95% CI: 1.38 (1.01–1.89)], NDM [1.83 (1.40–2.41)], and KDM [2.83 (2.26–3.55)] groups, in the age- and sex-adjusted model. Furthermore, in the full-adjusted model, only NDM and KDM status remained to be associated with the presence of CHD by ORs of 1.40 (1.06–1.86) for NDM and 1.91 (1.51–2.43) for KDM. Conclusion The high prevalence of CHD, especially among diabetic populations, necessitates the urgent implementation of behavioral interventions in the Tehranian population, according to evidence-based guidelines for the clinical management of diabetic patients.

Project description:BackgroundNon-participation in cohort studies, if associated with both the exposure and occurrence of the event, can introduce bias in the estimates of interest. This study aims to identify factors associated with follow-up participation in Tehran Lipid and Glucose Study, a large-scale community-based prospective study in West Asia.MethodsA sample of 10,368 adults from TLGS was included in the analysis. All analyses were split according to sex and age groups (20-39, 40-59, and 60 years). The associations between socio-demographic, health, and lifestyle factors with response rate were identified using the Generalized Estimating Equations model.ResultsOver the median of 15.7 years of follow up the response rate was 64.5%. The highest response rate was observed in those aged 40-59 years for both sexes. Current smokers had lower odds of response in both sexes for all age groups, ranging from 0.51 to 0.74, p < 0.01. In young adults, being single (OR = 0.79, OR = 0.57, p ≤ 0.01, respectively for men and women) and unemployed (OR = 0.73, OR = 0.76, p ≤ 0.01, respectively for men and women) in both sexes, high physical activity in men (OR = 0.77, p < 0.01), high education (OR = 0.75, p = 0.02) and obesity (OR = 0.85, p = 0.05) in women were associated with lower response rate. For the middle-aged group, diabetes in men (OR = 0.77, p = 0.05) and hypertension (OR = 0.84, p = 0.05), and having a history of cancer (OR = 0.43, p = 0.03) in women were factors associated with lower response rates. Finally, interventions for both sexes (OR = 0.75, OR = 0.77, p ≤ 0.05, respectively for men and women) and being divorced/widow in women (OR = 0.77, p = 0.05) were the factors associated with the lower response rate in the elderly.ConclusionsLong-term participation was influenced by socio-demographic, health, and lifestyle factors in different sex- and age-specific patterns in TLGS. Recruitment strategies targeting these factors may improve participant follow-up in longitudinal studies.

Dataset Information

Which obesity phenotypes predict poor health-related quality of life in adult men and women? Tehran Lipid and Glucose Study.

Purpose

Methods

Results

Conclusions

Publications

Which obesity phenotypes predict poor health-related quality of life in adult men and women? Tehran Lipid and Glucose Study.

Similar Datasets

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