Elsevier

Annals of Epidemiology

Volume 18, Issue 3, March 2008, Pages 165-171
Annals of Epidemiology

Metabolic Syndrome and Health-Related Quality of Life among U.S. Adults

https://doi.org/10.1016/j.annepidem.2007.10.009Get rights and content

Purpose

Little is known about the association between health-related quality of life and the metabolic syndrome. The objective of this study was to compare health-related quality of life in adults with and without the metabolic syndrome.

Methods

We performed a cross-sectional analysis of 1859 men and women aged ≥20 years from the National Health and Nutrition Examination Survey 2001–2002. Health-related quality of life was assessed with the Centers for Disease Control and Prevention HRQOL-4 tool.

Results

A larger percentage of participants with the metabolic syndrome had fair or poor health (difference = 11.3%, p = 0.002), ≥14 physically unhealthy days (difference = 5.0%) (p = 0.129), ≥14 mentally unhealthy days (difference = 7.4%) (p = 0.010), and ≥14 activity-limitation days (difference = 5.8%) (p = 0.024) during the past 30 days than participants without the metabolic syndrome. After adjusting for age, sex, ethnicity, educational status, and smoking status, participants with the metabolic syndrome were more likely to have fair or poor health (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.21–3.13), ≥14 mentally unhealthy days (OR, 1.97; 95% CI, 1.28–3.02), and ≥14 activity limitation days (OR, 3.20; 95% CI, 1.46–7.02) than those without the metabolic syndrome.

Conclusions

U.S. adults with the metabolic syndrome experience worse health-related quality of life than adults without this syndrome.

Introduction

The metabolic syndrome is a constellation of abnormalities such as abdominal obesity, dyslipidemia, high blood pressure, dysglycemia, inflammation, and prothrombotic factors. Much remains to be learned about the dimensions and magnitude of the public health burden of the metabolic syndrome. A comprehensive understanding of these issues is of some importance given the high and increasing prevalence of this syndrome in the United States 1, 2, 3. It is clear that people with the metabolic syndrome have an increased risk of developing diabetes or cardiovascular disease (4). In addition, the metabolic syndrome has been linked to a growing list of other adverse events 5, 6, 7, 8. The economic toll of this syndrome is still not understood. Health-related quality of life provides another metric to assess the public health burden of a condition.

Several of the components of the metabolic syndrome such as obesity, hypertension, and diabetes have been associated with decreased health-related quality of life 9, 10, 11, 12, 13. Therefore, it is reasonable to assume that people with the metabolic syndrome might well have decreased health-related quality of life. However, little is known about how people with the metabolic syndrome perceive their quality of life. Therefore, our objective was to estimate health-related quality of life among adults with the metabolic syndrome in the United States. In addition, because many studies have found gender differences in quality of life 14, 15, 16, 17, we also examined possible gender differences in the association between the metabolic syndrome and health-related quality of life.

Section snippets

Methods

We examined data from the National Health and Nutrition Examination Survey (NHANES) 2001–2002 for participants aged ≥20 years. Detailed information about the methods and procedures of this survey is available elsewhere (18). In brief, a representative sample of the noninstitutionalized civilian U.S. population was selected through a stratified multistage design. Trained interviewers, using a computer-assisted personal interview system, interviewed participants at home. Participants were asked

Results

Of the 5411 participants aged ≥20 years, 2205 were included in a nationally representative subsample that had measurements of concentrations of glucose and triglycerides using reference methods. After elimination of pregnant females and participants with missing data, 1859 participants had complete information for the variables used to establish status of the metabolic syndrome, health-related quality of life questions, and covariates. In this analytic sample, mean age was 45.5 years, 49.5%

Discussion

Our results indicate that people with the metabolic syndrome have reduced health-related quality of life compared with those who do not have this syndrome. This difference was not fueled by the presence of diabetes or cardiovascular disease. Our results are consistent with one other study conducted in Brazil (36) and help to fill in another aspect of the public health burden associated with the metabolic syndrome.

Of the five components that define the metabolic syndrome, abdominal obesity and

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    Disclaimer: The findings and conclusions in this article are those of the authors and do not represent the views of the Centers for Disease Control and Prevention.

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