Efecto de la actividad física, la obesidad y el sueño en la calidad de vida relacionada con la salud en Individuos con Síndrome Metabólico

Abstract

Introduction Health-related quality of life (HRQoL) has become an essential parameter for public health, given its ability to estimate the global burden of disease in populations makes it a good predictor of mortality. Due to the increased prevalence of metabolic syndrome (MetS) in the population, it is vital to discern the relationship between MetS and HRQoL. As such, the main objective of this doctoral thesis is to estimate HRQoL in adults with MetS and the related factors that influence it. Methods Available information was used from the PREDIMED-Plus study, a multicenter randomized clinical trial that collects data on HRQoL using the SF-36 questionnaire, anthropometric measurements, level of physical activity and sleep duration using accelerometry. A cross-sectional descriptive analysis of HRQoL was performed. Through linear regression models adjusted for potential confounding factors, the association between HRQoL, level of physical activity, degree of obesity, and sleep duration was evaluated at the start of the study and at a one-year follow-up. Additionally, logistic regression models were fit to discern whether physical activity, body mass index (BMI), and sleep duration predict clinically significant changes in HRQoL. Results Our results reflect that increased physical activity leads to an increase in the mean HRQoL scores. In women, up to a 10-point difference was found between light and moderate-to-vigorous physical activity in physical function, physical role, vitality, social function, and emotional role. Furthermore, subjects who improved their physical activity levels throughout the follow-up year had a 91% chance of clinically significant improvement in their physical aggregate component (PCS), compared to those who remained inactive during that year (OR = 1.91; 95% CI: 1.23-2.96). In terms of obesity, the higher the BMI, the lower the average scores in physical areas. However, a BMI >30kg/m2 predicts an improvement in these areas at one year and subjects who lose weight throughout the year are more likely to improve their HRQoL, compared to those whose BMI was unchanged (PCS OR = 1.85, 95% CI = 1.43-2.40). We observed that extreme values in nightly sleep duration (<6h/>9h) negatively affect the PCS. A correlation was also found between napping and improving the physical aggregate component (MCS) in individuals with a short night's sleep (<7h) (Coefficient β = 6.3 (1.3-11.3) p= 0.01). Conclusions Our results show that MetS negatively affects the physical domains of HRQoL and physical activity level, BMI and sleep duration are related factors that influence it. Results suggest that improving these factors leads to an improved HRQoL in individuals with MetS. However, more clinical trials are needed to evaluate these associations.