Objective To study the association between body mass index (BMI) and the health-related quality of life (HRQOL) in the middle-aged and older Chinese people. Methods Data of 9539 middle-aged and older adults was collected from a cross-sectional survey performed in 9 provinces of China (Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and Henan province). MO SSF-36 was used to measure HRQOL. BMI classification was in accordance with the criteria recommended by the Ministry of Health of China. Rank sum test was used to compare HRQOL between subjects with normal weight and those with different BMI classification. Multiple logistic regression analysis was used to assess the association of HRQOL with BMI after adjusted for sex, age, marital, education, physical activity status and chronic diseases. Results When compared with middle-aged and older adults at normal weight range (18.5≤BMI<24) , data on physical domain (P<0.001) , mental domain (P< 0.01) and 8 dimensions of HRQOL (physical functioning, mental health, P<0.05; role-physical, bodily pain, general health, vitality, social functioning, role-emotional, P<0.01)among subjects with underweight (BMI<18.5) were significantly lower while mental component summary (P<0.05) of overweight subjects (24≤BMI<28) was significantly higher. Obese subjects (BMI≥28) had worse physical function (physical functioning, P<0.01) but better mental health (mental health, P<0.01; mental component summary, P<0.05). After adjusting for other factors, and compared to middle aged and older adults with normal weight, data on odds ratios (ORs) of impaired HRQOL in physical domain (OR=1.67, 95% CI: 1.35-2.06), mental domain (OR=1.39, 95%CI: 1.13-1.70) and 8 dimensions increased among underweight subjects while ORs of impaired HRQOL in mental domain (0R=0.86,95% CI: 0.78-0.95) and role-physical, vitality, social functioning, role-emotional and mental health dimensions decreased among overweight subjects. ORs increased (OR=1.51,95% CI: 1.27-1.80) in impaired HRQOL in physical functioning dimension but decreased in mental domain (OR=0.71,95%CI: 0.60-0.85) as well as vitality, role-emotional and mental health dimensions among obese subjects. Conclusion HRQOL of each domain were different among middle aged and older adults with different BM1 classification. Underweight people had poor HRQOL in both physical domain and psychological domain, and obese people had poor physical function but good mental health condition.%目的 研究中国中老年人BMI与健康相关生命质量(HRQOL)的关系.方法 汇集9省市(汀苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)横断面健康状况调查中老年人群数据共9539例.采用秩和检验比较BMI分类不同的中老年人生命质量的差异;用多元logistic回归模型检验排除性别、年龄、婚姻状况、学历、运动水平和慢性病史等混杂因素后,中老年人BMI分类与生命质最的相关性.结果 与体重正常的中老年人相比,体重过轻组SF-36的生理领域(P<0.001)、心理领域(P<0.01)及其8个维度(生理机能、精神健康,P<0.05;生理职能、躯体疼痛、健康状况、精力、社会功能、情感职能,P<0.01)生命质量均显著较差;超重组心理领域生命质量显著较好(P<0.05);肥胖组生理机能维度显著较差(P<0.01),心理领域(P<0.05)、精神健康维度(P<0.01)显著较好.排除已知的混杂因素后,体重过轻组在生理领域(OR=1.67,95%CI:1.35～2.06)、心理领域(OR=1.39,95%CI:1.13～1.70)以及所有8个维度生命质量减损的危险度显著增高;超重组心理领域(OR=0.86,95%CI:0.78～0.95)及其生理职能、精力、社会功能、情感职能、精神健康维度生命质最受损的危险度显著降低;肥胖组生理机能维度(OR=1.51,95%CI:1.27～1.80)受损的危险度显著增高,心理领域(OR=0.71,95%CI:0.60～0.85)及其精力、情感职能、精神健康维度生命质量受损的危险度显著降低.结论 BMI分类不同的中老年人其SF-36各领域生命质量不同,体重过轻组生理领域和心理领域生命质量均较差,超重和肥胖组心理领域生命质最较好,肥胖组生理领域生命质量较差.超重和肥胖的中老年人生命质量的减损与慢性疾病有关.
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