Swedish obese subjects (SOS) -: an intervention study of obesity.: Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity
Swedish obese subjects (SOS) -: an intervention study of obesity.: Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity
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DOI：
10.1038/sj.ijo.0800553
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发表时间：
1998-02-01
影响因子：
4.9
通讯作者：
Sullivan, M
中科院分区：
文献类型：
--
作者：
Karlsson, J;Sjöström, L;Sullivan, M
目的：探讨体重减轻对重度肥胖患者健康相关生活质量（HRQL）的影响。设计：手术与传统减肥治疗的对照临床试验。受试者：在瑞典肥胖受试者（SOS）干预研究中，对前487例手术病例和他们的常规治疗进行了为期两年的随访。测量方法：使用一系列通用的和研究特定的自我评估工具或亚量表来表征重度肥胖（BMI）大于或等于34 kg/m(2)的男性和大于或等于38 kg/m(2)的女性的HRQL。一般健康感知（一般健康评级指数；当前健康状况）、心理健康（情绪形容词检查表；愉悦、激活和平静）、情绪障碍（医院焦虑和抑郁量表；焦虑和抑郁）和社会互动（疾病影响概况）的测量，由肥胖相关的社会心理问题和饮食行为的特定模块（三因素饮食问卷；克制饮食，解除抑制和感知饥饿）补充。治疗前进行评估，6个月、12个月和24个月后重复评估。结果：干预前较差的HRQL在胃限制手术后得到显著改善，而常规治疗对照组HRQL评分只有轻微波动。手术组在干预后6个月或12个月观察到峰值，在两年随访中略有至中度下降。两年后HRQL的积极变化与体重减轻的幅度有关，即体重减轻越大，HRQL改善越大，饮食行为也相应改善。结论：重度肥胖患者的生活质量因体重减轻而得到改善，大多数患者受益于减肥手术，而体重轻微减轻的手术患者的HRQL则不太积极。需要进一步的研究来确定严重肥胖手术治疗的预后预测因素，并确保HRQL的改善得以维持。
OBJECTIVE: To examine the effects of weight loss on health-related quality of life (HRQL) in subjects with severe obesity.DESIGN: Controlled clinical trial of the outcomes of surgical vs conventional weight reduction treatment.SUBJECTS: The first 487 surgical cases and their conventionally treated, matched controls were followed for two years in the Swedish Obese Subjects (SOS) intervention study.MEASUREMENTS: A battery of generic and study-specific self-assessment instruments or subscales was used to characterize HRQL in the severely obese (BMI) greater than or equal to 34 kg/m(2) for males and BMI greater than or equal to 38 kg/m(2) for females). Measures of general health perceptions (general health rating index; current health), mental well-being (mood adjective check list; pleasantness, activation and calmness), mood disorders (hospital anxiety and depression scale; anxiety and depression) and social interaction (sickness impact profile), were supplemented by obesity-specific modules on obesity-related psychosocial problems and eating behavior (three-factor eating questionnaire; restrained eating, disinhibition and perceived hunger). Assessments were conducted prior to treatment and repeated after 6, 12 and 24 months.RESULTS: Poor HRQL before intervention was dramatically improved after gastric restriction surgery, while only minor fluctuations in HRQL scores were observed in the conventionally treated controls. Peak values were observed in the surgical group at 6 or 12 months after intervention with a slight to moderate decrease at the two-year follow-up. The positive changes in HRQL after two years were related to the magnitude of weight loss, that is, the greater the weight reduction, the greater the HRQL improvements, Eating behavior improved accordingly.CONCLUSION: Quality of life in the severely obese is improved by substantial weight loss, Most patients benefit from weight reduction surgery, while HRQL in surgical patients with minor reduction in overweight is less positive. Further research is needed to determine outcome predictors of the surgical management of severe obesity and to ensure that HRQL improvements are maintained.