Supplementary Material for: Impact of Disability, Psychological Status, and Comorbidity on Health-Related Quality of Life Perceived by Subjects with Obesity

Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide and creating substantial financial and health burdens. Obesity has a negative impact on health-related quality of life (HRQoL) with reference to physical and mental health status, social relationships, and economic factors. The aim of the present study is to investigate the association of number of comorbidities, psychological status, and disability level with HRQoL in a sample of subjects with obesity. <b><i>Methods:</i></b> A total of 273 subjects with obesity (199 women and 74 men) were recruited. Medical history and anthropometric measurements were carried out. The Italian version of the Laval questionnaire, the TSD-OC (SIO test for obesity-related disabilities), and SCL-90 (Symptom Checklist-90) tests were administered. The association between HRQoL (global and different domains scores of the Laval questionnaire – dependent variable) and age, body mass index (BMI), comorbidity, TSD-OC, and SCL-90 was analysed using a stepwise linear regression model. <b><i>Results:</i></b> BMI, disability (TSD-OC global score), and psychological symptoms (SCL-90 global severity index) were found to be the main determinants of HRQoL. Single domains of HRQoL (symptoms, activity/mobility, personal hygiene/clothing, emotions, social interaction, and sexual life) showed different patterns of associations with each domain of the Laval questionnaire. BMI, pain, and social life disruptions were found to be significantly associated with most of the HRQoL domains while age, comorbidities, psychological problems (depression, interpersonal symptoms, somatization), and disability were associated with only some domains of the Laval questionnaire. Education, psychological symptoms (obsessive-compulsive, anxiety, hostility, phobic anxiety, paranoid ideation), and disability domains (stiffness, housework, outdoor activities, occupational activities) were not associated with any of the dimensions of the Laval questionnaire. <b><i>Discussion/Conclusion:</i></b> The present study identified key determinants of QoL in subjects with obesity, which could help in refining the multidimensional diagnostic assessment of obesity as well as designing more effective interventions to improve HRQoL in these patients.

肥胖已成为全球范围内快速蔓延的公共卫生问题，受累国家数量持续攀升，并带来了沉重的经济与健康负担。肥胖会对与健康相关的生活质量（Health-Related Quality of Life, HRQoL）产生负面影响，涉及躯体与精神健康状况、社会关系及经济因素等多个维度。本研究旨在探讨肥胖受试者队列中，共病数量、心理状态与残疾程度与HRQoL之间的关联。<b><i>方法：</i></b> 本研究共招募273名肥胖受试者（其中女性199名，男性74名）。采集受试者病史并开展人体测量学检测。采用意大利语版Laval量表、TSD-OC（肥胖相关残疾SIO测试）以及SCL-90（症状自评量表90，Symptom Checklist-90）进行测评。以HRQoL（Laval量表的总体及各维度得分作为因变量）与年龄、体质量指数（Body Mass Index, BMI）、共病情况、TSD-OC评分及SCL-90评分之间的关联为研究对象，采用逐步线性回归模型进行分析。<b><i>结果：</i></b> 研究发现，BMI、残疾程度（TSD-OC总体得分）与精神症状（SCL-90总体严重程度指数）是影响HRQoL的主要决定因素。HRQoL的各维度（躯体症状、活动/移动能力、个人卫生/着装、情绪状态、社会交往与性生活）与Laval量表的各维度呈现出各异的关联模式。BMI、疼痛与社交生活障碍与多数HRQoL维度存在显著关联；而年龄、共病情况、精神问题（抑郁、人际症状、躯体化）及残疾程度仅与Laval量表的部分维度相关。受教育程度、精神症状（强迫症状、焦虑、敌对、恐怖焦虑、偏执观念）以及残疾相关维度（僵硬感、家务劳动、户外活动、职业活动）则与Laval量表的所有维度均无显著关联。<b><i>讨论与结论：</i></b> 本研究明确了肥胖受试者生活质量的关键影响因素，这有助于优化肥胖的多维度诊断评估，并为制定更有效的干预方案以改善此类患者的HRQoL提供科学依据。