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

Abstract

Context: Beyond the objective outcomes of metabolic syndrome (MetS), the association between this syndrome and its patient-centered outcomes need to be investigated in Middle-Eastern countries. This report aims to summarize the Tehran lipid and glucose study (TLGS) findings regarding the association between MetS and health-related quality of life (HRQoL) and its influential factors through the past decade.

Evidence acquisition: The current review has been conducted on the TLGS published data regarding different aspects of the association between MetS and HRQoL in adult participants through the last decade. To assess HRQoL, the Iranian version of short form health survey (SF-36) was used. To define MetS the most commonly used insulin resistance (IR)-and waist circumference (WC) - based MetS definitions have been applied in the publications reviewed.

Results: As a whole, MetS was a determinant of poor physical HRQoL only in women (OR: 1.78; 95% CI: 1.21 - 2.61), particularly in those with more component of MetS (P < 0.001). Results further showed that only reproductive aged women with MetS were more likely to report poor PCS compared to those without MetS even after adjusting for age (OR: 1.7, 95% CI: 1.0 - 3.0; P < 0.05). Different structures of MetS and physical HRQoL constructs in men and women as well as age and smoking with significant gender-specific effects on mental HRQoL were factors responsible for the gender specific pattern observed. Considering the duration of MetS, only women with intermittent MetS indicated higher risk for reporting poor PCS (OR: 2.75, 95% CI: 1.19 - 6.37; P < 0.001) compared to those without MetS. The observed sex-specific pattern used to detect poor HRQoL in those with MetS was confirmed by all WC-based definitions except for the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) definition. However, none of IR-based definitions could detect poor physical and mental HRQoL in either gender.

Conclusions: In summary, in the TLGS population, the association between MetS and HRQoL followed a sex specific pattern, mainly significant only in women and in the physical aspect.

Keywords: Health-Related Quality of Life; Metabolic Syndrome; TLGS.

Figure 1.. The sampling frame of study. Abbreviation: HRQoL, health-related quality of life.

Figure 2.. HRQoL physical and mental scores in men and women. Data are represented as mean ± SE. * P < 0.05. Abbreviations: MCS, mental component summary; MetS, metabolic syndrome; PCS, physical component summary.

Figure 3.. HRQoL scores according to different waist circumference-based definitions of metabolic syndrome in men and women. Data are represented as mean ± SE. AHA/NHLBI, American Heart Association/National Heart, Lung, and Blood Institute; IDF, the International Diabetes Federation; JIS, the Joint Interim Statement; MCS, mental component summary; NCEP-ATP III, the National Cholesterol Education Program Adult Treatment Panel III; PCS, physical component summary.

Figure 4.. HRQoL scores according to different Insulin-based definitions of metabolic syndrome in men and women. Data represented as mean ± SE. Abbreviations: AACE, the American Association of Clinical Endocrinology; EGIR, the European Group for the Study of Insulin Resistance; MCS, mental component summary; PCS, physical component summary; WHO, the World Health Organization.