Health-related quality of life in individuals with metabolic syndromeA cross-sectional study

  1. A. Marcos-Delgado 1
  2. E. López-García 2
  3. M.A. Martínez-González 3
  4. J. Salas-Salvadó 4
  5. D. Corella 5
  6. M. Fitó 6
  7. D. Romaguera 7
  8. J. Vioque 8
  9. A.M. Alonso-Gómez 9
  10. J. Wärnberg 10
  11. J.A. Martínez 11
  12. L. Serra-Majem 12
  13. R. Estruch 13
  14. J.C. Fernández-García 14
  15. J. Lapetra 15
  16. X. Pintó 16
  17. J.A. Tur 17
  18. J. López-Miranda 18
  19. N. Cano-Ibañez 19
  20. M. Delgado-Rodríguez 20
  21. P. Matía-Martín 21
  22. L. Daimiel 22
  23. E. Carriedo 23
  24. J. Vidal 24
  25. Vázquez, C. 25
  26. E. Ros 26
  27. E. Lozano-Oloriz 3
  28. M. Bulló 4
  29. J.V. Sorlí 5
  30. M.D. Zomeño 27
  31. M. Fiol 7
  32. S. González-Palacios 8
  33. C. Sorto-Sánchez 28
  34. N. Pérez-Farinós 29
  35. N. Goñi-Ruiz 3
  36. A. Sanchez-Villegas 12
  37. A. Muñoz-Garach 14
  38. J.M. Santos-Lozano 30
  39. A. Galera 16
  40. C. Bouzas 17
  41. E. Toledo 3
  42. N. Babio 4
  43. J.I. González 5
  44. J.L. del Val-García 31
  45. M. Moñino 7
  46. M.C. Martínez-Vergaran 8
  47. L. Goicolea-Güemez 9
  48. I. Galilea-Zabalza 32
  49. J. Basora 4
  50. M.A. Muñoz 33
  51. P. Builf 3
  52. T. Fernández-Villa 34
  53. Show all authors +
  1. 1 University of León, León, Spain
  2. 2 Universidad Autónoma de Madrid/ IdiPaz, Madrid, Spain
  3. 3 University of Navarra, Department of Preventive Medicine and Public Health, IdiSNA, Pamplona, Spain
  4. 4 Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain
  5. 5 Department of Preventive Medicine, University of Valencia, Valencia, Spain
  6. 6 Hospital del Mar de Investigaciones Médicas Municipal d‘Investigació Médica (IMIM), Barcelona, Spain
  7. 7 Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
  8. 8 Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
  9. 9 Araba University Hospital; University of the Basque Country UPV/EHU; Vitoria-Gasteiz, Spain
  10. 10 University of Málaga-Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
  11. 11 University of Navarra, Pamplona, Spain
  12. 12 University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
  13. 13 Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
  14. 14 Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
  15. 15 Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
  16. 16 Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
  17. 17 University of Balearic Islands, Palma de Mallorca, Spain
  18. 18 Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
  19. 19 Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
  20. 20 Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
  21. 21 Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
  22. 22 Nutritional Genomics and Epigenomics Group, IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
  23. 23 Centro de Salud de José Aguado. Gerencia de Atención Primaria de León
  24. 24 Department of Endocrinology, Institut d‘Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
  25. 25 Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
  26. 26 Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
  27. 27 Blanquerna, School of Health Sciences, Universitat Ramon Llull, Barcelona
  28. 28 Bioaraba Health Research Institute; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU; Vitoria-Gasteiz, Spain
  29. 29 Departament of Public Health, University of Málaga-Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain
  30. 30 Departament of Medicine, University of Sevilla, Sevilla, Spain
  31. 31 Institut Català de la Salut and IDIAP Jordi Gol, Barcelona, Spain
  32. 32 (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
  33. 33 Unitat de Suport a la Recerca de Barcelona. IDIAPJGol. Gerencia de Atención Primaria de Barcelona. Institut Català de la Salut, Barcelona
  34. 34 Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, University of León, León, Spain
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Year of publication: 2020

Issue: 8

Pages: 524-537

Type: Article


More publications in: Semergen: revista española de medicina de familia

Sustainable development goals


Introduction and objectives Metabolic syndrome (MetS) is a combination of various cardiovascular risk factors with a major impact on morbidity and premature mortality. However, the impact of MetS on self-reported health-related quality of life (HRQoL) is unknown. This study evaluated the HRQoL in a Spanish adult population aged 55 years and older with MetS. Method A cross-sectional analysis was performed with baseline data from the PREDIMED-Plus multicentre randomized trial. The participants were 6430 men and women aged 55–75 years with overweight/obesity (body mass index ≥27 and ≤40 kg/m2) and MetS. The SF-36 questionnaire was used as a tool to measure HRQoL. Scores were calculated on each scale of the SF-36 by gender and age. Results Participants showed higher scores in the social function (mean 85.9, 95% CI; 85.4–86.4) and emotional role scales (mean 86.8, 95% CI; 86.0–87.5). By contrast, the worst scores were obtained in the aggregated physical dimensions. In addition, men obtained higher scores than women on all scales. Among men, the worst score was obtained in general health (mean 65.6, 95% CI; 65.0–66.2), and among women, in body pain (mean 54.3, 95%CI; 53.4–55.2). A significant decrease was found in the aggregated physical dimensions score among participants 70–75 years old, but an increased one in the aggregated mental dimensions, compared to younger participants. Conclusions Our results reflect that the MetS may negatively affect HRQoL in the aggregated physical dimensions, body pain in women, and general health in men. However, this adverse association was absent for the psychological dimensions of HRQoL, which were less affected.

Funding information


Bibliographic References

  • S. O’Neill, L. O’Driscoll Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies Obes Rev, 16 (2015), pp. 1-12, 10.1111/obr.12229 CrossRefView Record in ScopusGoogle Scholar
  • S. Sookoian, C.J. Pirola, Metabolic Syndrome: From the genetics to the pathophysiology Curr Hypertens Rep, 13 (2011), pp. 149-157, 10.1007/s11906-010-0164-9 CrossRefView Record in ScopusGoogle Scholar
  • P. Guallar-Castillón, R.F. Pérez, E. López García, L.M. León-Muñoz, M.T. Aguilera, A. Graciani, et al. Magnitude and management of metabolic syndrome in Spain in 2008–2010: the ENRICA Study Rev Española Cardiol, 67 (2014), pp. 367-373, 10.1016/J.RECESP.2013.08.014 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • M.L. Vetter, T.A. Wadden, J. Lavenberg, R.H. Moore, S. Volger, J.L. Perez, et al. Relation of health-related quality of life to metabolic syndrome, obesity, depression and comorbid illnesses Int J Obes, 35 (2011), pp. 1087-1094, 10.1038/ijo.2010.230 CrossRefView Record in ScopusGoogle Scholar
  • P. Serrano-Aguilar, S.R. Muñoz-Navarro, Y. Ramallo-Fariña, M.M. Trujillo-Martín Obesity and health related quality of life in the general adult population of the Canary Islands Qual Life Res, 18 (2009), pp. 171-177, 10.1007/s11136-008-9427-1 CrossRefView Record in ScopusGoogle Scholar
  • A. Cardaso Suárez, X. Dopico Calvo, E. Iglesias-Soler, C.M. Cardaso Suárez, F. Gude Sampedro Health related to quality of life and their relationship with adherence to the mediterranean diet and physical activity at the university in Galicia Nutr Clín Diet Hosp, 37 (2017), pp. 42-49, 10.12873/372cadarso Google Scholar
  • G. Wannamethee, A.G. Shaper Self-assessment of health status and mortality in middle-aged British men Int J Epidemiol, 20 (1991), pp. 239-245 [accessed 15.12.18] CrossRefView Record in ScopusGoogle Scholar
  • S. Heistaro, P. Jousilahti, E. Lahelma, E. Vartiainen, P. Puska Self rated health and mortality: a long term prospective study in eastern Finland J Epidemiol Community Health, 55 (2001), pp. 227-232 [accessed 15.12.18] View Record in ScopusGoogle Scholar
  • PubMed – NCBI. Published 2018 [accessed 15.12.18]. Google Scholar
  • J.E. Ware SF-36 health survey update Spine (Phila Pa 1976), 25 (2000), pp. 3130-3139 [accessed 15.12.18] ossRefView Record in ScopusGoogle Scholar
  • G. Vilagut, M. Ferrer, L. Rajmil, P. Rebollo, G. Permanyer-Miralda, J.M. Quintana, et al. The Spanish version of the Short Form 36 Health Survey: a decade of experience and new developments Gac Sanit, 19 (2005), pp. 135-150 [accessed 15.12.18] ArticleDownload PDFCrossRefView Record in ScopusGoogle Scholar
  • M.A. Martínez-González, P. Buil-Cosiales, D. Corella, M. Bulló, M. Fitó, J. Vioque Cohort Profile: design and methods of the PREDIMED-Plus randomized trial Int J Epidemiol (2018), 10.1093/ije/dyy225 Google Scholar
  • J. Salas-Salvadó, A. Díaz-López, M. Ruiz-Canela, J. Basora, M. Fitó, D. Corella Effect of a lifestyle intervention program with energy-restricted Mediterranean diet and exercise on weight loss and cardiovascular risk factors: one-year results of the PREDIMED-Plus trial Diabetes Care (2018), 10.2337/dc18-0836 dc180836 Google Scholar
  • Estudio Predimed-Plus. [accessed 24.05.19]. Google Scholar
  • K.G.M.M. Alberti, R.H. Eckel, S.M. Grundy, P.Z. Zimmet, J.I. Cleeman, K.A. Donato, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; National heart, lung, and blood institute; American heart association; World heart federation; International atherosclerosis society; And international association for the study of obesity Circulation, 120 (2009), pp. 1640-1645 CrossRefView Record in ScopusGoogle Scholar
  • M.M. García, I. Rohlfs, J.M.F. Vila, J. Sala, A. Peña, R. Masiá Comparison between telephone and self-administration of Short Form Health Survey Questionnaire (SF-36). Undefined (2005)ía-Rohlfs/3bf34b63fccba8658f8cbd1ae879e70e2e028f15 [accessed 23.12.18] Google Scholar
  • E. López-García, J.R. Banegas, A. Graciani Pérez-Regadera, J.L. Gutiérrez-Fisac, J. Alonso, F. Rodríguez-Artalejo Population-based reference values for the Spanish version of the SF-36 Health Survey in the elderly Med Clin (Barc), 120 (2003), pp. 568-573 [accessed 15.12.18] ArticleDownload PDFView Record in ScopusGoogle Scholar
  • E. López-García, J.R. Banegas Banegas, J.L. Gutiérrez-Fisac, A. Gzaciani Pérez-Regadera, L. Díez- Gañán, F. Rodríguez-Artalejo Relation between body weight and health-related quality of life among the elderly in Spain Int J Obes, 27 (2003), pp. 701-709, 10.1038/sjijo0802275 CrossRefView Record in ScopusGoogle Scholar
  • R. Busutil, O. Espallardo, A. Torres, L. Martínez-Galdeano, N. Zozaya, Á. Hidalgo-Vega The impact of obesity on health-related quality of life in Spain Health Qual Life Outcomes, 15 (2017), p. 197, 10.1186/s12955-017-0773-y Google Scholar
  • W.W.M. Lee, K.C. Choi, R.W.Y. Yum, D.S.F. Yu, S.Y. Chair Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: a systematic review Int J Nurs Stud, 53 (2016), pp. 331-341, 10.1016/j.ijnurstu.2015.09.010 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • M.F. Barcones-Molero, A. Sánchez-Villegas, M.A. Martínez-González, M. Bes-Rastrollo, M. Martínez-Urbistondo, J. Santabárbara, et al. The influence of obesity and weight gain on quality of life according to the SF-36 for individuals of the dynamic follow-up cohort of the University of Navarra Rev Clínica Española, 218 (2018), pp. 408-416, 10.1016/J.RCE.2018.05.005 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • Ministerio de Sanidad SS. e I. Encuesta Europea de Salud En España 2014; 2014. [accessed 10.12.18]. Google Scholar
  • Ministerio de Sanidad SS e I. Informe Anual Del Sistema Nacional de Salud 2016. Madrid; 2016. [accessed 15.12.18]. Google Scholar
  • J. Carretero Gómez, J.C. Arévalo Lorido, R. Gómez Huelgas, M.T. Sánchez Vidal, M. Suárez Tembra, J.M. Varela Aguilar, et al. Prevalence of obesity according to Edmonton staging in the Internal Medicine consultations. Results of the OBEMI study Rev Clínica Española, 217 (2017), pp. 71-78, 10.1016/j.rce.2016.11.003 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • Instituto Nacional de Estadística de España. Encuesta sobre discapacidades, autonomía personal y situaciones de dependencia. Published 2008 [accessed 15.12.18]. Google Scholar
  • A.J. Cameron, D.J. Magliano, D.W. Dunstan, P.Z. Zimmet, K. Hesketh, A. Peeters, et al. A bi-directional relationship between obesity and health-related quality of life: evidence from the longitudinal AusDiab study Int J Obes, 36 (2012), pp. 295-303, 10.1038/ijo.2011.103 CrossRefView Record in ScopusGoogle Scholar
  • P.E. Korhonen, T. Seppälä, S. Järvenpää, H. Kautiainen Body mass index and health-related quality of life in apparently healthy individuals Qual Life Res, 23 (2014), pp. 67-74, 10.1007/s11136-013-0433-6 CrossRefView Record in ScopusGoogle Scholar
  • S.N. Slagter, J.V. van Vliet-Ostaptchouk, A.P. van Beek, J.C. Keers, H.L. Lutgers, M.M. van der Klauw, et al. Health-related quality of life in relation to obesity grade, type 2 diabetes metabolic syndrome and inflammation PLOS ONE, 10 (2015), p. e0140599, 10.1371/journal.pone.0140599 CrossRefGoogle Scholar
  • R.M. Díaz Maceira, F.J. Rodríguez Ferrer, R.M. Quincoces Prol, E. Hormigó Polo, A. Gaínza Laffita, L. Cedeño Bueno, et al. Obesity versus healthy life style: its appearence on the elder age and ways to abolish it. Lect Educ física y Deport ISSN-e 1514-3465 No 206, 2015 (2015), p. 10 [accessed 15.12.18] View Record in ScopusGoogle Scholar
  • M.C. Minayo, S. de, Z.M. Hartz, A. de, P.M. Buss Qualidade de vida e saúde: um debate necessário Cien Saude Colet, 5 (2000), pp. 7-18, 10.1590/S1413-81232000000100002 View Record in ScopusGoogle Scholar
  • J.L. Gutiérrez-Fisac, P. Guallar-Castillón, L.M. León-Muñoz, A. Graciani, J.R. Banegas, F. Rodríguez-Artalejo Prevalence of general and abdominal obesity in the adult population of Spain, 2008–2010: the ENRICA study Obes Rev, 13 (2012), pp. 388-392, 10.1111/j.1467-789X.2011.00964.x CrossRefView Record in ScopusGoogle Scholar
  • J. Karlsson, C. Taft, A. Rydén, L. Sjöström, M. Sullivan Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study Int J Obes, 31 (2007), pp. 1248-1261, 10.1038/sj.ijo.0803573 CrossRefView Record in ScopusGoogle Scholar
  • J. Alonso, E. Regidor, G. Barrio, L. Prieto, C. Rodríguez, L. de la Fuente Population reference values of the Spanish version of the Health Questionnaire SF-36 Med Clin (Barc), 111 (1998), pp. 410-416 [accessed 15.12.18] View Record in ScopusGoogle Scholar