title: Longitudinal association between body mass index and health-related quality of life.
abstract: OBJECTIVE
  Health-related quality of life (HRQoL) is an important outcome in individuals with a high risk for cardiovascular diseases. We investigated the association of HRQoL and body mass index (BMI) as an indicator for obesity.
  
  
  METHODS
  Secondary longitudinal analysis of the ORBITAL study, an intervention study which included high-risk cardiovascular primary care patients with hypercholesterolemia and an indication for statin therapy.
  
  
  METHODS
  HRQoL was determined with the generic Short Form (SF)-12 health status instrument. Body weight and height were assessed at baseline and at months 6, 12, 18, 24, 30, and 36. We used a linear and a linear mixed-effects regression model to investigate the association between BMI and SF-12 summary scores at baseline as well as between change in BMI and SF-12 summary scores over 3 years. We adjusted for age, sex, smoking status, and in the longitudinal analysis also for the study arm and its interaction term with time.
  
  
  RESULTS
  Of the 7640 participants who completed the baseline questionnaire, 6726 participants (mean age: 61 years) were analyzed. The baseline BMI was inversely associated with physical and mental SF-12 summary scores (β [95% CI] per 1 kg/m2: -0.36 [-0.41; -0.30] and -0.05 [-0.11; -0.00], respectively). A significant association between the change in BMI and physical SF-12 summary scores over time was only present in women (-0.18 [-0.27; -0.09]) and only in obese participants (-0.19 [-0.29; -0.10]). A change in BMI was directly associated with mental SF-12 summary scores (0.12 [0.06; 0.19]) in the total population.
  
  
  CONCLUSIONS
  Increases in BMI were associated with decreases in physical HRQoL, particularly in obese individuals and in women. In contrast, the mental HRQoL seemed to increase with increasing BMI over time. Thus, body weight management with respect to the HRQoL should be evaluated differentially by sex and body weight status.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00379249.
authors.affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Müller-Nordhorn
authors.affiliation: Berlin School of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Muckelbauer
authors.affiliation: University of Applied Sciences, Münster, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Englert
authors.affiliation: Department of Biostatistics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Grittner
authors.affiliation: University of Applied Sciences, Osnabrück, Germany.
authors.forename: Hendrike
authors.initials: H
authors.lastname: Berger
authors.affiliation: Cardiology Practice, Henstedt-Ulzburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Sonntag
authors.affiliation: Centre of Rehabilitation Research, University of Potsdam, Potsdam, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Völler
authors.affiliation: Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France.
authors.forename: Christof
authors.initials: C
authors.lastname: Prugger
authors.affiliation: Department of Medical Biometry and Epidemiology, University of Hamburg, Hamburg, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000473:pathology; D011743:Pyrimidines / Q000627:therapeutic use; D011788:Quality of Life; D012307:Risk Factors; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium