scholarly journals Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS

2016 ◽  
Vol 101 (8) ◽  
pp. 2966-2974 ◽  
Author(s):  
Anuja Dokras ◽  
David B. Sarwer ◽  
Kelly C. Allison ◽  
Lauren Milman ◽  
Penny M. Kris-Etherton ◽  
...  

Context: Polycystic ovary syndrome (PCOS) is associated with reduced health-related quality of life (HRQOL) and increased prevalence of depressive and anxiety disorders. The impact of PCOS-specific treatments on these co-morbidities is unclear. Objective: To assess the impact of weight loss and decreasing hyperandrogenism on HRQOL and mood and anxiety disorders in women with PCOS. Design/Setting/Participants: A secondary analysis of a randomized controlled trial (OWL-PCOS) of preconception treatment conducted at two academic centers in women (age, 18–40 years; body mass index, 27–42 kg/m2) with PCOS defined by Rotterdam criteria. Intervention: Continuous oral contraceptive pill (OCP) or intensive lifestyle intervention or the combination (Combined) for 16 weeks. Main Outcome Measure(s): Changes in HRQOL assessed by PCOSQ and SF-36 and prevalence of depression and anxiety disorder assessed by PRIME-MD PHQ. Results: The lowest scores were noted on the general health domain of the SF-36 and the weight and infertility domains on the PCOSQ. All three interventions resulted in significant improvement in the general health score on the SF-36. Both the OCP and Combined groups showed improvements in all domains of the PCOSQ (P < .01) compared to baseline scores. The Combined group had significant improvements in the weight, body hair, and infertility domains compared to a single treatment group (P < .05). In a linear regression model, change in weight correlated with improvements in the weight domain (P < .001) and physical well-being (P < .02), change in T correlated with improvements in the hair domain (P < .001), and change in both weight and T correlated with the infertility (P < .001) and menstrual domains (P < .05). Conclusions: Both weight loss and OCP use result in significant improvements in several physical and mental domains related to quality of life, depressive symptoms, and anxiety disorders, and combined therapies offer further benefits in overweight/obese women with PCOS.

2021 ◽  
pp. 1-24
Author(s):  
Daniela Viramontes-Hörner ◽  
Zoe Pittman ◽  
Nicholas M Selby ◽  
Maarten W Taal

Abstract Health-related quality of life (HRQoL) is severely impaired in persons receiving dialysis. Malnutrition has been associated with some measures of poor HRQoL in cross-sectional analyses in dialysis populations, but no studies have assessed the impact of malnutrition and dietary intake on change in multiple measures of HRQoL over time. We investigated the most important determinants of poor HRQoL and the predictors of change in HRQoL over time using several measures of HRQoL. We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in this prospective study. Nutritional assessments (Subjective Global Assessment [SGA], anthropometry and 24-hour dietary recalls) and HRQoL questionnaires (Short Form-36 [SF-36] mental [MCS] and physical component scores [PCS] and European QoL-5 Dimensions [EQ5D] health state [HSS] and visual analogue scores [VAS]) were performed at baseline, 6 and 12 months. Mean age was 64(14) years. Malnutrition was present in 37% of the population. At baseline, malnutrition assessed by SGA was the only factor independently (and negatively) associated with all four measures of HRQoL. No single factor was independently associated with decrease in all measures of HRQoL over 1 year. However, prevalence/development of malnutrition over one year was an independent predictor of 1-year decrease in EQ5D HSS and 1-year decrease in fat intake independently predicted the 1-year decline in SF-36 MCS and PCS, and EQ5D VAS. These findings strengthen the importance of monitoring for malnutrition and providing nutritional advice to all persons on dialysis. Future studies are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.


2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Chia-I Tsai ◽  
Yi-Chang Su ◽  
Shih-Yi Lin ◽  
I-Te Lee ◽  
Cheng-Hung Lee ◽  
...  

Aim. To evaluate how health-related quality of life (HRQOL) and traditional Chinese medicine (TCM) constitutions of Yin-Xu, Yang-Xu, and Stasis are related in type 2 diabetes patients. Method. Seven hundred and five subjects were recruited in 2010 for this study from a Diabetes Shared Care Network in Taiwan. Generic and disease-specific HRQOL were assessed by the short form 36 (SF-36) and the diabetes impact measurement scale (DIMS). Constitutions of Yin-Xu, Yang-Xu, and Stasis were then assessed by the body constitution questionnaire (BCQ), a questionnaire consisting of 44 items that evaluate the physiological state based on subjective symptoms and signs. Results. Estimated effects of the Ying-Xu and Stasis on all scales of the SF-36 were significantly negative, while estimated effects of the Yang-Xu on all scales (except for SF, RE, MH, and MCS) were significantly negative. For DIMS, the estimated effects of the Ying-Xu and Stasis on all scales were significantly negative except for Stasis on well-being, while Yang-Xu has a significantly negative effect only on symptoms. Conclusions. This study demonstrates that TCM constitutions of Yin-Xu, Yang-Xu, and Stasis are closely related to a reduction in HRQOL. These findings support the need for further research into the impact of intervention for TCM constitutions on HRQOL in patients with type 2 diabetes.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Catherine Xie ◽  
Sean Fournier ◽  
Susan Hiller ◽  
Joyce Oen Hsiao ◽  
Rachel P Dreyer

Introduction: Cardiac rehabilitation (CR) is an evidence-based program to improve secondary prevention outcomes for patients with cardiovascular disease (CVD). Lower health-related quality of life is a known risk factor for worse CVD outcomes. We examined the effects of a patient-driven appointment-based CR program on health-related quality of life. Methods: We utilized data from the Yale New-Haven Health (YNHH) CR program over a 6-year period (2012-2017). Data was collected on patient demographics, clinical characteristics and socioeconomic status. The Medical Outcome Short-Form General Health Survey (SF-36) was used to measure general health status. We evaluated SF-36 score changes pre and post CR with paired T-tests and conducted logistic regression analysis to examine predictors of improvements in health-related quality of life. Results: Over the 6-year study period, a total of 2,135 patients (27.9% women, mean age 65±12 years) were enrolled in the CR program. Patients demonstrated significant improvements in both the SF-36 physical, mental and health transition components (P<0.001) (Table) . In particular, patients had significant improvement in the social functioning domain (measures limitations patients see in their ability to participate in social activities due to physical/emotional issues), with an increase of 23.3 points out of 100. Physician-reported patient stress and/or depression on intake medical exam were significant negative predictors for improvement in the total SF-36 score (OR 0.23, 95% CI 0.08-0.80, P=0.021), with the effect driven largely by its impact on the physical component of SF-36 (OR 0.27, 95% CI 0.09-0.83, P=0.022). Conclusion: We demonstrated that a novel appointment-based CR program produced improvements in patient-reported health-related quality of life. Appointment-based CR could be a viable alternative for patients who prefer more scheduling flexibility, to optimize health status improvement and CVD outcomes.


2013 ◽  
Vol 69 (1) ◽  
Author(s):  
J. Schneiderman ◽  
H. Van Aswegen ◽  
P. Becker

To investigate the health-related quality of life (HRQOL) of survivors of major trauma at six months following discharge, using two popular HRQOL tools. A cross-sectional study was done on adult trauma survivors in Johannesburg. Subjects completed the EQ-5D and SF-36 HRQOL questionnaires. Additional demographic and clinical data were collected. The majority of subjects reported some problems in usual activities and pain/discomfort as measured with the EQ-5D at six months. The mean EQ-5D VAS was 68 (±26.1). lowest scores were reported in the role physical (44.6 ± 41.6) and role emotional (44.1 ± 45.4) domains of the SF-36. mean SF-36 physical component summary (PCS) score (62.1 ± 27.8) was higher than mental component summary score (58.7 ±20.1). EQ-5D VAS was found to be moderately correlated with age (r=-0.4; p=0.05). A negative correlation was found between SF-36 physical function score and ICU length of stay (LOS), hospital LOS and age (r=-0.4 (p=0.03), -0.4 (p=0.03) and -0.6 (p=0.00) respectively). Statistical significance was observed in the correlation between age and SF-36 general health domain (r=-0.4; p=0.02) as well as age and PCS score (r=-0.5; p=0.01). Trauma survivors in Johannesburg experience limitations in specific emotional and physical domains of HRQOL at six months after discharge. Age was associated with the level of self-rated health as well as limitations in general health and physical function. ICU and hospital LOS were associated with limitations in physical function. There is a need for physical and psychological rehabilitation after discharge from trauma intensive care.


2019 ◽  
Vol 26 (7-8) ◽  
pp. 452-461 ◽  
Author(s):  
Simon L Cichosz ◽  
Flemming W Udsen ◽  
Ole Hejlesen

Aim The aim of this study was to assess the impact on health-related quality of life (HRQoL) of a telehealth care solution compared with usual practice of patients with heart failure (HF). Methods A randomized controlled trial with a telehealth care solution (Telekit) as the intervention (with a focus on self-empowerment achieved by engaging patients in their own illness through self-monitoring) combined with usual care and usual care as the control. The primary outcome was a change in HRQoL as measured by the Short Form-36 (SF-36) questionnaire Physical Component Summary (PCS) score. Secondary outcomes were changes in HRQoL as measured by the SF-36 questionnaire Mental Component Summary (MSC) score and the HF disease-specific questionnaire Kansas City Cardiomyopathy Questionnaire 12 (KCCQ12) score, all of which were assessed from baseline to approximately 12 months’ follow-up between the two groups. Outcomes were assessed via unadjusted and adjusted analyses. Results At baseline, 299 (145 interventions, 154 controls) patients were enrolled. In the primary analysis ( n = 299), the adjusted intervention effects were PCS –0.81 (95% CI −2.7–1.1), MCS 4.66 (95% CI 1.8–7.5) and KCCQ12 3.67 (95% CI −0.7–8.1). Only the change in MCS was statistically significant. An unadjusted analysis replicated the primary analysis. Complete case analyses ( n = 193) generally resulted in a lower intervention effect on the PCS score, but the difference remained statistically insignificant. Conclusions Only the MCS score was significantly higher in the telehealth care group compared to the control group. ClinicalTrials.gov (NCT02860013), July 28, 2016


2013 ◽  
pp. 54-58
Author(s):  
Mateus Lage Martins ◽  
Rafael Corrêa Valério ◽  
Tales José Corrêa de Almeida ◽  
Vitor Rodrigues Laender ◽  
Dilermando Fazito de Resende ◽  
...  

Background: Headaches are prevalent in the pediatric population. Migraine significantly impacts the health-related quality of life (HRQoL) of sufferers. Objective: To measure the impact of migraine on the HRQoL of children, by applying the Brazilian version of the SF-36 in children with migraine and in controls. Methods: In this cross-sectional study, HRQoL was measured with the SF-36, and scores for the 8 domains of the test were contrasted comparing children (5 to 14 years) with and without migraine. Results: Sample consisted of 66 children (30 with migraine and 36 controls). Mean age was 10.9 years for migraine (Standard Deviation - SD = 3 years) and 10.4 for controls (SD = 3.1 years). Proportion of children with low HRQoL scores was significantly higher in the migraine group, relative to controls, for the 8 domains of the test: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health. Conclusion: Children with migraine are significantly impacted in their HRQoL, relative to children without migraine.


Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000880 ◽  
Author(s):  
Neil A Smart ◽  
Nicola King ◽  
Jeffrey D Lambert ◽  
Melissa J Pearson ◽  
John L Campbell ◽  
...  

ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate.ResultsThe nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p<0.001) with exercise-based CR. Improvements were also seen in AF symptom burden and markers of cardiac function.ConclusionsExercise capacity, cardiac function, symptom burden and health-related quality of life were improved with exercise-based CR in the short term (up to 6 months) targeted at patients with AF. However, high-quality multicentre randomised trials are needed to clarify the impact of exercise-based CR on key patient and health system outcomes (including health-related quality of life, mortality, hospitalisation and costs) and how these effects may vary across AF subtypes.


Lupus ◽  
2019 ◽  
Vol 28 (3) ◽  
pp. 371-382 ◽  
Author(s):  
M Gu ◽  
Q Cheng ◽  
X Wang ◽  
F Yuan ◽  
NB Sam ◽  
...  

Objective To evaluate the impact of systemic lupus erythematosus (SLE) on health-related quality of life (HRQoL) assessed with SF-36 and explore factors associated with HRQoL in SLE patients. Methods A random-effect meta-analysis was performed to calculate extracted data. Sensitivity and subgroup analyses were performed to distinguish sources of heterogeneity. Results A total of 36 articles were finally included in this meta-analysis, including 6510 patients. The pooled mean scores of SF-36 physical component summary and mental component summary were 46.10 (95% confidence interval (CI): 43.09–49.10) and 50.37 (95% CI: 47.78–52.87), respectively. Spearman's correlation analysis found that mean age, proportion of female participants, and publication decades were negatively associated with some of the SF-36 domains. Sample size and SLEDAI were positively associated with some of the SF-36 domains. Patients with SLE have lower HRQoL in comparison to the general population. Conclusions SLE has a significant impact on HRQoL, which proves that the necessity of improving HRQoL in SLE patients cannot be ignored. Measuring HRQoL should be considered as an indispensable part of the overall evaluation of health conditions of SLE patients.


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