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Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008

BACKGROUND: Obesity is positively associated with low-level chronic inflammation, and negatively associated with several indices of health-related quality of life (HRQOL). It is however not clear if obesity-associated inflammation is partly responsible for the observed negative associations between...

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Autores principales: Wilkins, Jeffrey, Ghosh, Palash, Vivar, Juan, Chakraborty, Bibhas, Ghosh, Sujoy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091152/
https://www.ncbi.nlm.nih.gov/pubmed/30123515
http://dx.doi.org/10.1186/s40608-018-0196-2
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author Wilkins, Jeffrey
Ghosh, Palash
Vivar, Juan
Chakraborty, Bibhas
Ghosh, Sujoy
author_facet Wilkins, Jeffrey
Ghosh, Palash
Vivar, Juan
Chakraborty, Bibhas
Ghosh, Sujoy
author_sort Wilkins, Jeffrey
collection PubMed
description BACKGROUND: Obesity is positively associated with low-level chronic inflammation, and negatively associated with several indices of health-related quality of life (HRQOL). It is however not clear if obesity-associated inflammation is partly responsible for the observed negative associations between obesity and HRQOL, and also whether systemic inflammation independently affects HRQOL. We conducted an exploratory analysis to investigate the relationships between obesity, systemic inflammation and indices of HRQOL, using NHANES survey data. METHODS: Data for the variables of interest were available for 6325 adults (aged 20–75 years, BMI > 18.5 kg/m(2)). Demographic, body mass index (BMI), C-reactive protein (CRP), inflammatory disease status, medication use, smoking, and HRQOL data were obtained from NHANES (2005–2008) and analyzed using sampling-weighted generalized linear models. Data was subjected to multiple imputation in order to mitigate information loss from survey non-response. Both main effects and interaction effects were analyzed to evaluate possible mediation or moderation effects. Model robustness was ascertained via sensitivity analysis. Averaged results from the imputed datasets were reported in as odds ratios (OR) and confidence intervals (CI). RESULTS: Obesity was positively associated with poor physical healthy days (OR: 1.59, 95% CI: 1.15–2.21) in unadjusted models. ‘Elevated’ and ‘clinically raised’ levels of the inflammation marker CRP were also positively associated with poor physical healthy days (OR = 1.61, 95% CI: 1.23–2.12, and OR = 2.45, 95% CI: 1.84–3.26, respectively); additionally, ‘clinically raised’ CRP was positively associated with mental unhealthy days (OR = 1.66, 95% CI: 1.26–2.19). The association between obesity and physical HRQOL was rendered non-significant in models including CRP. Association between ‘elevated’ and ‘clinically raised’ CRP and physical unhealthy days remained significant even after adjustment for obesity or inflammation-modulating covariates (OR = 1.36, 95% CI: 1.02–1.82, and OR = 1.75, 95% CI: 1.21–2.54, respectively). CONCLUSIONS: Systemic inflammation appears to mediate the association between obesity and physical unhealthy days. Clinically raised inflammation is an independent determinant of physical and mental unhealthy days. Importantly, elevated (but sub-clinical) inflammation is also negatively associated with physical healthy days, and may warrant more attention from a population health perspective than currently appreciated. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40608-018-0196-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-60911522018-08-17 Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008 Wilkins, Jeffrey Ghosh, Palash Vivar, Juan Chakraborty, Bibhas Ghosh, Sujoy BMC Obes Research Article BACKGROUND: Obesity is positively associated with low-level chronic inflammation, and negatively associated with several indices of health-related quality of life (HRQOL). It is however not clear if obesity-associated inflammation is partly responsible for the observed negative associations between obesity and HRQOL, and also whether systemic inflammation independently affects HRQOL. We conducted an exploratory analysis to investigate the relationships between obesity, systemic inflammation and indices of HRQOL, using NHANES survey data. METHODS: Data for the variables of interest were available for 6325 adults (aged 20–75 years, BMI > 18.5 kg/m(2)). Demographic, body mass index (BMI), C-reactive protein (CRP), inflammatory disease status, medication use, smoking, and HRQOL data were obtained from NHANES (2005–2008) and analyzed using sampling-weighted generalized linear models. Data was subjected to multiple imputation in order to mitigate information loss from survey non-response. Both main effects and interaction effects were analyzed to evaluate possible mediation or moderation effects. Model robustness was ascertained via sensitivity analysis. Averaged results from the imputed datasets were reported in as odds ratios (OR) and confidence intervals (CI). RESULTS: Obesity was positively associated with poor physical healthy days (OR: 1.59, 95% CI: 1.15–2.21) in unadjusted models. ‘Elevated’ and ‘clinically raised’ levels of the inflammation marker CRP were also positively associated with poor physical healthy days (OR = 1.61, 95% CI: 1.23–2.12, and OR = 2.45, 95% CI: 1.84–3.26, respectively); additionally, ‘clinically raised’ CRP was positively associated with mental unhealthy days (OR = 1.66, 95% CI: 1.26–2.19). The association between obesity and physical HRQOL was rendered non-significant in models including CRP. Association between ‘elevated’ and ‘clinically raised’ CRP and physical unhealthy days remained significant even after adjustment for obesity or inflammation-modulating covariates (OR = 1.36, 95% CI: 1.02–1.82, and OR = 1.75, 95% CI: 1.21–2.54, respectively). CONCLUSIONS: Systemic inflammation appears to mediate the association between obesity and physical unhealthy days. Clinically raised inflammation is an independent determinant of physical and mental unhealthy days. Importantly, elevated (but sub-clinical) inflammation is also negatively associated with physical healthy days, and may warrant more attention from a population health perspective than currently appreciated. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40608-018-0196-2) contains supplementary material, which is available to authorized users. BioMed Central 2018-08-06 /pmc/articles/PMC6091152/ /pubmed/30123515 http://dx.doi.org/10.1186/s40608-018-0196-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wilkins, Jeffrey
Ghosh, Palash
Vivar, Juan
Chakraborty, Bibhas
Ghosh, Sujoy
Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008
title Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008
title_full Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008
title_fullStr Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008
title_full_unstemmed Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008
title_short Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008
title_sort exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (hrqol) analysis of nhanes 2005–2008
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091152/
https://www.ncbi.nlm.nih.gov/pubmed/30123515
http://dx.doi.org/10.1186/s40608-018-0196-2
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