The impact of obesity on diabetes, hyperlipidemia and hypertension in the United States
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The prevalence of obesity and associated cardiometabolic risk factors such as diabetes, hyperlipidemia and hypertension is increasing significantly for all demographic groups.
Research design and methods
The 2000 and 2002 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the U.S. population, was used to estimate the marginal impact of obesity on health function, perception, and preferences for individuals with diabetes, hyperlipidemia, and hypertension using multivariate regression methods controlling for age, sex, race, ethnicity, education, income, insurance, smoking status, comorbidity, and proxy response. Three different instruments were used: SF-12 physical component scale (PCS-12) and mental component scale (MCS-12); EQ-5D index and visual analogue scale (VAS). Censored least absolute deviation was used for the EQ-5D and VAS (due to censoring) and ordinary least squares (OLS) was used for the PCS-12 and MCS-12.
After controlling for sociodemographic characteristics, diabetes, hyperlipidemia, and hypertension were associated with significantly lower scores compared to normal weight individuals without the condition for all four instruments. Obesity significantly exacerbated this association. Controlling for comorbidity attenuated the negative association of obesity and cardiometabolic risk factors on instrument scores. In addition, scores decreased for increasing weight and number of risk factors.
Obesity significantly exacerbates the deleterious association between diabetes, hyperlipidemia, and hypertension, and health function, health perception, and preference-based scores in the United States.
KeywordsDiabetes Health-related quality of life Hyperlipidemia Hypertension Obesity
This research was supported by a research grant from Sanofi-Aventis.
- 5.American Heart Association. 2005. Heart Disease and Stroke Statistics—2005 Update. Dallas, TX: American Heart Association.Google Scholar
- 6.Kahn, R., Buse, J., Ferrannini, E., & Stern, M. (2005). The metabolic syndrome: Time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 28, 2289–2304. doi: 10.2337/diacare.28.9.2289.PubMedCrossRefGoogle Scholar
- 12.Sach, T. H., Barton, G. R., Doherty M., Muir K. R., Jenkinson C., & Avery A. J. (2006). The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D. International Journal of Obesity, 31, 189-196. doi: 10.1038/sj.ijo.0803365 CrossRefGoogle Scholar
- 16.Lalonde, L., Clarke, A. E., Joseph, L., Mackenzie, T., & Grover, S. A. (1999). Comparing the psychometric properties of preference-based and nonpreference-based health-related quality of life in coronary heart disease Canadian Collaborative Cardiac Assessment Group. Quality of Life Research, 8, 399–409. doi: 10.1023/A:1008991816278.PubMedCrossRefGoogle Scholar
- 17.Sullivan, P. W., Ghushchyan, V., Wyatt, H. R., Wu, E. Q., & Hill, J. O. (2007). Impact of cardiometabolic risk factor clusters on health-related quality of life in the US. Obesity (Silver Spring, Md.), 15, 511–521.Google Scholar
- 19.Chambers, B. A., Guo, S. S., Siervogel, R., Hall, G., & Chumlea, W. C. (2002). Cumulative effects of cardiovascular disease risk factors on quality of life. The Journal of Nutrition Health & Aging, 6, 179–184.Google Scholar
- 20.Documentation Files, P.U.F. Agency for Healthcare Research and Quality (AHRQ). (2005). Accessed April 28, 2006, at http://www.meps.ahrq.gov/PUFFiles/H60/H60doc.htm.
- 21.Panel 7 Longitudinal Weight Files. Agency for Healthcare Research and Quality (AHRQ), (2005). Accessed November 10, 2003, at http://www.meps.ahrq.gov/PUFFiles/H80/H80doc.htm.
- 30.Wee, H. L., Cheung, Y. B., Li, S. C., Fong, K. Y., & Thumboo, J. (2005). The impact of diabetes mellitus and other chronic medical conditions on health-related Quality of Life: Is the whole greater than the sum of its parts? Health and Quality of Life Outcomes, 3, 2. doi: 10.1186/1477-7525-3-2.PubMedCrossRefGoogle Scholar
- 31.Edwards, D. S., Winn, D. M., & Kuriantzik, V. (1994). Evaluation of the National Health Interview Survey diagnostic reporting. Hyattsville: National Center for Health Statistics; Report No. 2:1.Google Scholar
- 34.Centers for Disease Control and Prevention. (2002). National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the U.S., 2000. Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention.Google Scholar