Severe Obesity and Comorbid Condition Impact on the Weight-Related Quality of Life of the Adolescent Patient

被引:61
作者
Zeller, Meg H. [1 ]
Inge, Thomas H. [1 ]
Modi, Avani C. [1 ]
Jenkins, Todd M. [1 ]
Michalsky, Marc P. [2 ]
Helmrath, Michael [1 ]
Courcoulas, Anita [3 ]
Harmon, Carroll M. [4 ,5 ]
Rofey, Dana [3 ]
Baughcum, Amy [2 ]
Austin, Heather [4 ]
Price, Karin [6 ]
Xanthakos, Stavra A. [1 ]
Brandt, Mary L. [6 ]
Horlick, Mary [7 ]
Buncher, Ralph [8 ]
机构
[1] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA
[2] Nationwide Childrens Hosp, Columbus, OH USA
[3] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA
[4] Univ Alabama Birmingham, Birmingham, AL USA
[5] SUNY Buffalo, Buffalo, NY 14260 USA
[6] Texas Childrens Hosp, Houston, TX 77030 USA
[7] NIDDK, NIH, Bethesda, MD 20892 USA
[8] Univ Cincinnati, Cincinnati, OH USA
基金
美国国家卫生研究院;
关键词
LONGITUDINAL ASSESSMENT; BARIATRIC SURGERY; HEALTH; CHILDREN; OVERWEIGHT; PEDSQL(TM)-4.0; ASSOCIATIONS; PREDICTORS; 10-YEAR; TRENDS;
D O I
10.1016/j.jpeds.2014.11.022
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives To assess links between comorbid health status, severe excess weight, and weight-related quality of life (WRQOL) in adolescents with severe obesity and undergoing weight-loss surgery (WLS) to inform clinical care. Study design Baseline (preoperative) data from Teen Longitudinal Assessment of Bariatric Surgery, a prospective multicenter observational study of 242 adolescents with severe obesity (Median(BMI) = 50.5 kg/m(2); Mean(age) = 17.1; 75.6% female; 71.9% white) undergoing WLS, were used to examine the impact of demographics, body mass index (BMI), presence/absence of 16 comorbid conditions, and a cumulative comorbidity load (CLoad) index on WRQOL scores (Impact of Weight on Quality of Life-Kids). Results WRQOL was significantly lower than reference samples of healthy weight, overweight, and obese samples. Of 16 comorbid conditions, the most prevalent were dyslipidemia (74.4%), chronic pain (58.3%), and obstructive sleep apnea (56.6%). Male subjects had a greater CLoad (P = .01) and BMI (P = .01), yet less impairment in total WRQOL (P < .01) than females. CLoad was a significant predictor of male WRQOL. For females, psychosocial (vs physical) comorbidities, BMI, and white race were significant predictors of WRQOL impairment. Less prevalent conditions (eg, stress urinary incontinence) also emerged as contributors to lower WRQOL. Conclusions WRQOL impairment is substantial for adolescents with severe obesity undergoing WLS, with predictors varying by sex. These patient-data highlight targets for education, support, and adjunctive care referrals before WLS. Furthermore, they provide a comprehensive empirical base for understanding heterogeneity in adolescent WRQOL outcomes after WLS, as weight and comorbidity profiles change over time.
引用
收藏
页码:651 / U962
页数:13
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